C4 culturally and linguistically tailored health promotion

Role of culture and language in successful health promotion models

PRESENTED BY

CATIE’s Ontario Hepatitis C Immigrant and Newcomer Program

Community Health Programming

Fozia Tanveer, Manager, Immigrant and Newcomer Hepatitis C

June 13, 2018

Presentation overview

• • • • • • •

Presenter disclosure The program Context Program areas Role of newcomers Impact and reach Partners

Faculty/Presenter Disclosure

Fozia Tanveer Relationships with financial sponsors: • • • • •

Grants/Research Support: None Speakers Bureau/Honoraria: None Consulting Fees: None Patents: None Other: None

Disclosure of Financial Support

This program has received financial support from the Ontario Ministry of Health and long-term Care.

This program has received in-kind support from [organization name] in the form of [describe support here – e.g. logistical support].

Potential for conflict(s) of interest: No conflict of interest to declare

The program

CATIE’s Ontario Hepatitis C Immigrant and Newcomer Program is the only provincial program working to raise the awareness of largest immigrant communities in their own languages through culturally adapted resources.

The program is funded by the Ontario Ministry of Health and Long-term Care and is part of the province’s strategy to address hepatitis C in Ontario

Why is hepatitis C important for immigrants?

Context • 35% of all hepatitis C infections in Canada are estimated to be among foreign-born population (1) • Canadian immigrants have a prevalence of ~2% which is higher than overall Canadian prevalence of about 1.0 %(2) • Immigrants have 2-4 fold higher mortality from liver cancer and viral hepatitis vs. Canadian born (3) • On average it takes ten years after arriving in Canada before immigrants were diagnosed with hepatitis C (4) • No mandatory screening for viral hepatitis as part of the immigration process.

(1, 2) Trubnikov M, Yan P, Archibald C. Estimated Prevalence of Hepatitis C Virus infection in Canada, 2011. Canada Communicable Disease Report: Volume 40-19, December 18, 2014.

(3) DesMeules M, Gold J, McDermott S, Cao Z, Payne J, Lafrance B, et al. Disparities in Mortality Patterns Among Canadian Immigrants and Refugees, 1980-1998: Results of a National Cohort Study. J Immigr Health. 2005;7(4):221-32.

(4) Greenaway, Christina et al. “A Population-Based Study of Chronic Hepatitis C in Immigrants and Non-Immigrants in Quebec, Canada.” BMC Infectious Diseases 17 (2017): 140. PMC. Web. 29 Jan. 2018.

Immigration to Canada About 22% of people in Canada are born outside the country

(5)

Immigration to Ontario • About 30% of people in Ontario are born outside the country (6)

Communities we work with And their immigration rate in 2016 • • • •

Philippines: 41,785 India: 39, 790 China: 26,850 Pakistan: 11,340

(7) http://canadaimmigrants.com/canada-immigrants-by-source-country-2016/

Program areas 1. Community focussed 1.1 Linguistically and culturally adapted resources 1.2 Community education and outreach

1.3 Ethnic media engagement 2. Service provider focussed 2.1 Education and awareness on hep C basics

2.2 Blended Learning

Newcomers and in-language health promotion Newcomers with right credentials are offered Hep C Basics training

Facilitate community workshops and outreach tables

Engaged in paid work while gaining Canadian experience

Translate and review Hep C information for CATIE

Contribute to community wellbeing through their skills and work

Program areas 1.1 Linguistically and culturally adapted hepatitis C resources • Multilingual website • Print brochures

Program areas (Cont’d) 1.1.a Adaptation of resources • Community Advisory Councils

• Translation by trained community facilitators • Translation review (community & medical)

Program areas (Cont’d) 1.2 Community education and outreach • Community outreach and engagement

• Hep C basics workshop • CATIE’s team of community facilitators

Community workshops and outreach tables

Community facilitator’s training

Program areas (Cont’d)

1.3 Ethnic media engagement • Editorials, advertising and media campaigns • Radio and television talkshows • Meetings and dialogues with ethnic media

Ethnic media dialogues

Some newspaper clippings

Program areas (Cont’d) 2. Service provider focussed work 2.1 Education and awareness of settlement workers Education and awareness sessions for frontline workers in settlement, community development and newcomer health sectors on hepatitis C in immigrants and newcomers 2.2 Blended Learning for frontline workers Six-week training course on foundational knowledge of Hep C and specialized knowledge on Hep C in immigrants

Successful Ontario program model profiled nationally • At 7th CanHepC Symposium 2018 • In an article entitled ‘Addressing Hepatitis C in the Foreign-Born Population: A key to HCV Elimination in Canada’ in a Special Issue of the Canadian Liver Journal as a successful model to increase the uptake of hepatitis C screening and treatment in Canadian immigrants and newcomers.

Impact of in-language health promotion in program success Multilingual website (yourlanguage.hepcinfo.ca) •

CATIE has reached 148,684 people through its multilingual website

•

CATIE’s Hep C awareness messages have reached a much wider audience

•

CATIE’s Hep C awareness messages have reached over 200000 people across Ontario.

Workshops and outreach tables  CATIE has directly reached 10,000 immigrant and newcomers through its workshops and literature tables  89% of participants reported an increase in knowledge

 the average knowledge score of participants increased from 3.5 to 7  More than 99% of the participants said they will use this knowledge in their daily life  CATIE has trained and employed 50 newcomers as community facilitators in this program

Impact and reach (Cont’d) CATIE’s has distributed 61,165 multilingual print brochures Arabic

3,031

Hindi

3,143

Spanish

14,869

Tagalog

9,670

Punjabi

9,150

Urdu

9,405

Chinese

11,897

Total

61,165

Partners 1.Toronto Public Health’s AIDS and Sexual Health InfoLine 2. Punjabi Community Health Services (Peel Region and Ottawa) 3. Chinese Canadian National Council Toronto Chapter 4. Committee of Progressive Pakistani Canadians 5. Kababayan Multicultural Centre 6. St. Stephen’s Community House 7. Human Endeavour 8. Toronto South Local Immigration Partnership 9. Jewish Family Services, Ottawa 10.Toronto Chinese Health Education Committee

CATIE Team • Yukun Zhao, Coordinator, Immigrant and Newcomer Hepatitis C Community Health Programming • Fozia Tanveer, Manager, Immigrant and Newcomer Hepatitis C Community Health Programming • Melisa Dickie, Associate Director, Hepatitis C Knowledge Exchange • Tim Rogers, Director, Knowledge Exchange