Development of an ESL curriculum to educate Chinese immigrants about hepatitis B

Chinese immigrants to North America have substantially higher rates of chronic hepatitis B infection than the general population. One promising approach to health communication for immigrants is the design and evaluation of English-as-a-second-language (ESL) curricula. The Health Behavior Framework, results from a community-based survey of Chinese Canadian immigrants with limited English proficiency, and findings from focus groups of ESL instructors as well as Chinese ESL students were used to develop a hepatitis B ESL educational module. This research was conducted in Vancouver, British Columbia (over one-quarter of Vancouver residents are of Chinese descent). Survey data showed that less than three-fifths (57%) of the respondents had been tested for hepatitis B, and also documented some important hepatitis B knowledge deficits. For example, only 41% knew that Chinese Canadians are more likely to be infected with hepatitis B than white Canadians. Further, only about one-quarter (24%) had ever received a physician recommendation for hepatitis B serologic testing. The ESL lesson aims to both promote hepatitis B testing and improve knowledge about hepatitis B. It includes seven different ESL exercises (warm-up, vocabulary cards, information-gap, video, jigsaw, guided discussion, and problem/advice cards); and specifically addresses five Health Behavior Framework constructs (knowledge, health beliefs, cultural beliefs, social norms/support, and communication with provider). Our curriculum development methods could be replicated for other health education topics and in other limited English-speaking immigrant populations (e.g., Spanish-speaking).