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

In This Article

Key Findings

Of the 800 people randomly selected for the telephone interview, 590 agreed to participate (response rate, 74%). The majority of these respondents was women, between the ages of 35 and 64; who had at least an undergraduate or college education; and were in good or better health.

Overall, 36% of the respondents had previously seen either the BCHG short video clips or the documentary at home. However, only 67% of the total sample of respondents actually watched any Farsi language television programming, meaning that just over half (54%) of those who watched Farsi TV had seen the Farsi language BCHG videos.

Initial findings from this telephone survey highlighted poor awareness levels and low utilization rates of the BCHG program among participants prior to viewing the videos. Although the BC Handbook was mailed to all households in BC prior to the videos (in April 2001), for many participants (67%) watching the Farsi videos was the first time that they had received any information about the BCHG program, and almost all participants reported that watching the videos had encouraged them to use the program (98%) and that they intended to promote the services to others (87%). In addition, the majority of participants who had accessed at least one of the BCHG program components reported being satisfied with the services that they had received (88%). Furthermore, the majority of participants in the follow-up focus groups, held 1 year after the airing of the promotional videos, self-reported continued utilization of, and overall satisfaction with, the BCHG resources (59%). According to statistics provided by the BC Ministry of Health,[12] the number of callers to the BC NurseLine who request Farsi translation increased significantly around the time of the airing of the videos (between October and December 2004) as well as a moderate increase in September 2004, just after the videos had been produced.

Participants almost universally indicated that they perceive healthcare professionals, particularly medical doctors, to be the most credible messengers of health information. This credibility was enhanced further if the doctors were well known in the community. In fact, title and prestige were the most important factors identified by participants in determining the credibility of a health messenger. It was suggested that the appearance and context of the health messenger were important to their credibility as well. Comments were made by participants that the doctor in the documentary should be wearing a white coat and be situated in a clinic or hospital. The language used by the doctor in the documentary should be more straightforward and without technical terms or medical jargon to be more accepted by a wider audience.

The overall opinion of participants was that self-care resources in general might be unsuited to Iranian culture, and that this divergence had thus far prevented many Iranians from using the BCHG program adequately. For example, Iranian culture does not traditionally place a strong emphasis on preventive healthcare, and many Iranians (particularly older generations) tend to seek out health advice only when they perceive that they have a serious condition, or that it is an emergency.[24] A common perception held by participants was that health advice received from nurses or translators, over the telephone or from the Internet, is not as trustworthy as that received face to face from a doctor. In addition, the focus group discussions highlighted a number of initial misconceptions held by participants about the BCHG program, including confusion over how the program is intended to coordinate with other health services, such as doctors' visits and emergency services, as well as concerns about the quality of care offered.

The majority of participants indicated that they believed that the wider GVA Iranian community could be encouraged to embrace preventive healthcare services in general, and specifically the BCHG program, provided that promotion of the program was targeted directly to their community, was culturally appropriate, and sustained. The overall response of participants to the videos aired in this study was positive, and most participants believed that the videos had the potential to be effective in their community. During the focus group discussions, however, a number of recommendations were made for improvement of the videos and promotion of the BCHG program in general.

Although most participants believed that young people would be the easiest age group to educate (being more adaptable and less likely to be settled into habits), it was also pointed out that educating only young people, without including their parents and grandparents, would have the potential to create conflict within households. Thus, it was believed that promotional messages and media channels should target all age groups, varying according to the interests and needs of each group. For example, participants recommended the Internet, English-language television channels, school and university settings, and youth volunteers as channels for promoting the program among young people. For older age groups, Farsi language newspapers and magazines, local Farsi TV channels, community gatherings, and well-known, respected volunteers from the community were seen as being more appropriate promotional channels.

Participant reactions to the 2 different communication models (direct/ documentary and indirect/drama) appeared to be affected greatly by personal preferences, with relatively equal numbers preferring each of the 2 types. In general, it seemed that the direct model (documentary) was considered to be both more informative and more professional, and thus improved the credibility of the BCHG program in many participants' views. The indirect (drama/role-play) model, on the other hand, was generally thought to be very well suited to Iranian cultural practices and norms, and thus made the services more appealing and approachable to many participants. Therefore, it seems that using a combination of the 2 communication models would be most effective in promoting the BCHG program.

The focus group sessions were very popular among participants, and the general opinion was that facilitated group sessions were more effective environments for learning about the BCHG program. Viewers in the group sessions reported enjoying fewer distractions while watching the videos than they would have had at home, and appreciated the opportunity for discussion of the topics and issues raised. At the same time, the convenience of watching videos at home, and being able to discuss the issues raised with their families, appealed to a number of participants. Thus, it would seem prudent to use a combination of facilitated group sessions and mass media[22] in promoting the BCHG program in order to ensure wide dissemination of the messages, as well as to provide concerned and motivated citizens with an opportunity to raise questions and discuss relevant issues.


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