Healthy Montgomery :: Promising Practices :: Hepatitis B ESL Education Curriculum for Chinese Immigrants

The Community Health Improvement Process for Montgomery County, Maryland

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An Evidence-Based Practice meets the following HCI criteria:

1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.

2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.

3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.

Hepatitis B ESL Education Curriculum for Chinese Immigrants

Ranking	Evidence-Based Practice
Description	The goal of this promising practice is to provide Hepatitis B awareness curriculum to the immigrant Chinese population. The Chinese immigrant population in North America has a rate of Hepatitis B infection that is 10 times higher than the general population's rate of approximately 0.5 percent. The curriculum presents information about the disease and raises awareness of preventative measures. The health education curriculum is designed for low to intermediate English level english as a second language (ESL) students that would increase knowledge about Hepatitis B and encourage them to get Hepatitis B testing. Certified ESL teachers are trained in the Hepatitis B curriculum. The Hepatitis B curriculum provides information on the high rate of Hepatitis B viral infection in Chinese communities, how the virus is transmitted from person to person, and the symptoms of infection. The curriculum uses standard ESL teaching strategies, such as filling in the blanks and working in pairs. For example, a pair of students takes turns reading, speaking, listening, and writing their respective worksheets that were missing certain vocabulary words. Once the blanks are filled in, the students answer reading comprehension questions. The curriculum endea with a pamphlet in both Chinese and English about the key points from the lesson.
Goal / Mission	To educate the Chinese Canadian immigrant community on Hepatitis B knowledge and to promote Hepatitis B testing through ESL curriculum
Results / Accomplishments	The Hepatitis B Educational ESL Curriculum has been shown to significantly increase knowledge about Hepatitis B infection and transmission in Chinese immigrants. To evaluate the effectiveness of the program, a group-randomized trial study was conducted. 41 ESL classes from five community-based organizations that provided the ESL classes in the greater Vancouver area participated in the study. ESL students who participated in the study were randomly assigned to receive either the experimental Hepatitis B curriculum or a control curriculum on physical activity. After six months, the students were asked to complete a follow-up survey that tested their knowledge of particular Hepatitis B infection and transmission facts that were discussed in the experimental curriculum. This data was then analyzed through generalized estimating equations to assess the effectiveness of the curriculum in teaching the Chinese immigrants about Hepatitis B. In total, 325 students were initially enrolled in the study, and 298 (92%) of the students were able to complete the follow-up survey. The follow-up survey demonstrated that experimental group students were statistically significantly (p<0.05) more likely than control group students to know that Chinese immigrants have higher rates of Hepatitis B infection than Chinese people born in Canada [OR=2.0, CI: (1.2-3.5)]; Hepatitis B can be transmitted through childbirth [OR=1.8, CI: (0.9-3.4)], sexual intercourse [OR=2.1, CI: (1.2-3.6)], and sharing of razors [OR=9.4, CI: (3.1-28.6)]; Hepatitis B cannot be spread through sharing of utensils [OR=4.4, CI: 2.4-8.2)]; and Hepatitis B can cause cirrhosis [OR=2.9, CI: 1.2-7.0)] and liver cancer [OR=3.1, CI: (1.3-7.1)]. Overall, these results show that the Hepatitis B ESL curriculum is an evidence-based practice that is effective in increasing knowledge about Hepatitis B among Chinese immigrants in Canada.
Categories	Health / Immunizations & Infectious Diseases
Organization(s)	Immigrant Services Society, Richmond Continuing Education, and S.U.C.C.E.S.S.
Source	US National Cancer Institute
Date of Publication	2009
Date of Implementation	2006
Location	Country: Canada
Primary Contact	Vicky Taylor Fred Hutchinson Cancer Research Center (M3-B232), 1100 Fairview Avenue North, Seattle, WA 98109 (206) 667-5114 vtaylor@fhcrc.org http://www.fhcrc.org/
For more details	http://www.ncbi.nlm.nih.gov/pmc/articles/PMC283...
Target Audience	Adults, Racial / Ethnic Minorities
Submitted By	Ellen Chiu, Stephanie Ng, Jennifer Zhao - UC Berkeley School of Public Health
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