Evaluation of a hepatitis b educational ESL curriculum for Chinese immigrants

Background: Chinese are the largest Asian sub-group in North America, and the majority of Chinese Americans/Canadians are foreign born. Approximately 10% of Chinese immigrants to North America are chronic carriers of hepatitis B, compared to less than 1% of the general population. ESL classes provide ready access to limited English speaking individuals who are not reached by English language health education materials and media campaigns. Objective: We conducted a group-randomized trial to evaluate the effectiveness of a hepatitis B ESL educational curriculum for Chinese immigrants to Canada. Methods: Five community-based organizations that provide ESL education in the greater Vancouver area participated in the study. Forty-one ESL classes (that included 325 Chinese students) were randomized to experimental or control status. Outcome ascertainment was based on a follow-up survey, conducted six months after randomization. General estimating equations were used to analyze the data. Results: Follow-up surveys were completed by 298 (92%) of the randomized students. At follow-up, experimental group students were significantly (p<0.05) more likely than control group students to know that immigrants have higher HBV infection rates than people who were born in Canada; HBV can be spread during childbirth, during sexual intercourse, and by sharing razors; HBV is not spread by sharing eating utensils; and HBV infection can cause cirrhosis and liver cancer. Discussion: Our findings indicate that ESL curricula can positively impact health knowledge among limited English speaking Chinese immigrants. Future research should evaluate the effectiveness of ESL curricula for other immigrant groups, as well as other health topics.