Assessing the Effectiveness of Informational Video Clips on Iranian Immigrants' Attitudes Toward and Intention to Use the BC HealthGuide Program in the Greater Vancouver Area

Iraj Poureslami, PhD; David Murphy, MS; Anne-Marie Nicol, PhD; Ellen Balka, PhD; Irving Rootman, PhD

Disclosures
In This Article

Background

In recent years, significant emphasis has been placed on the availability of consumer health information and self-care resources.[1,2,3,4] Increasingly, health departments in Canada and other developed countries are implementing government-sponsored health and self-care information programs delivered directly to the public via telephone, the Internet, and other innovative approaches.[5,6,7] One assumption is that these approaches can improve self-awareness of the diseases and healthy behaviors, help the public to prevent injuries and infections, and monitor and/or manage symptoms from home,[2,5,8] thereby reducing unnecessary use of facility-based medical care.[9,10] However, in order for these resources to be effective, individual consumers require a minimum level of health literacy and knowledge of the healthcare system's language,[5,11] that is, being able to access, understand, evaluate, and communicate the available information.[3,12] Internet health resources, in particular, require a specific skill set, such as basic reading and writing skills in the language in which the information is available, a working knowledge of computers, a basic understanding of science, and an appreciation of the social context that mediates how online health information is produced, transmitted, and received[4,7,12] -- the skills now widely referred to as "eHealth literacy."[3,12] Therefore, although consumer-directed health information resources hold great potential for improving public health and easing demand on health systems,[8,12] their value depends largely on the ability of their intended users to access and use them effectively.[3,6]

The British Columbia (BC) Ministry of Health provides a comprehensive health information program, the BC HealthGuide (BCHG) Program, which was introduced in the province in April 2001.[12,13] The program consists of 4 components[12]: A handbook (BC HealthGuide handbook), a toll-free telephone service (BC NurseLine), a health information Web site (BC HealthGuide OnLine), and fact sheets (BC HealthFiles). The BCHG handbook, a self-care reference guide, provides basic, medically reviewed guidelines on how to recognize and cope with over 190 common health concerns.[14] The BC NurseLine is a toll-free, 24-hour, 7 days a week service, staffed by specially trained registered nurses who provide confidential health information and advice.[13] Between 5:00 pm and 9:00 am, a BC NurseLine pharmacist is also available. BCHG OnLine is a comprehensive Internet Web site with widespread, medically reviewed health information, and BC HealthFiles are a series of 1-page, easy-to-understand fact sheets covering a wide range of public and environmental health and safety issues.[12] BCHG Program health information is updated routinely.

This comprehensive health information program is designed to benefit the health of BC's population as a whole by improving consumer access to timely and accurate health information and advice,[13,14] expanding consumer knowledge on managing personal health risks and conditions,[12] alleviating pressure on emergency and physician services due to improper use, and reducing costs due to inappropriate use of the healthcare system.[12,13,14] However, little is known about whether BC's ethnocultural communities are using the services provided, when and for what purposes they are being used, and levels of satisfaction with and users' perceptions of the services. Having learned that utilization of the BCHG program was lower than desired among certain populations, we undertook a collaborative research and intervention process aimed at increasing awareness and utilization of the services. The goal of this study was to determine whether culturally sensitive videos could be used effectively to increase utilization of the BCHG program among the Iranian population of the Greater Vancouver Area (GVA, including Burnaby, Coquitlam, North Vancouver, Surrey, Richmond, Vancouver, and West Vancouver). This community is the province's largest Middle Eastern immigrant group, a fast-growing, new immigrant community, which has doubled in size since the late 1980s.[15] This study also sought to develop a model for video production that combines participatory design and social marketing with production practices that can be used for communicating health information.[16,17] Furthermore, we wanted to develop a method of evaluation for this type of intervention. In this article, we provide an overview of the project and suggest that the model outlined here may be effectively transferred to other ethnocultural populations with success.

The intention of this project was to increase the use of a health service (BCHG program) within a specific population (GVA's Iranian community) through the creation and airing of culturally sensitive videos. The study also aimed to compare and contrast different communication models (direct vs indirect messages) and modes of delivery (facilitated group sessions vs at-home viewing) that could serve as a model for introducing BCHG program resources to other ethnic communities in the GVA and BC. We hoped to develop more general and transferable design guidelines for producing media that promotes health services among culturally specific groups. The design guidelines developed are part of an iterative process intended to inform future health service promotions targeted to cultural minority groups beyond the one specified in this project.

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