Co-Designing Strategies to Improve Asthma Health Literacy With Culturally and Linguistically Diverse Communities

Background

Evidence indicates that an early intervention nurse-led model of care transitioning consumers with asthma from hospital to home improves asthma health literacy and asthma control compared with usual care. This intervention, however, is not reaching individuals from Culturally and Linguistically Diverse (CALD) communities who require added support to navigate our health care system.

Aims

To (1) investigate the barriers and enablers to improving asthma care in consumers from three CALD communities and (2) improve the nurse-led programme to suit the needs of CALD consumers with asthma.

Methods

Participants with asthma from Vietnamese, Indian and Sri Lankan communities and clinicians providing asthma care completed separate and combined focus group workshops. Qualitative data were collected on the barriers and enablers for asthma health literacy, attendance at clinics and Emergency Department presentations. Input was sought on to how to adapt the nurse-led programme to support CALD consumers. Data was thematically analysed and discussed in the combined clinician and consumer session with a view to integrating the key findings into the current care model.

Results

Nine consumers with asthma and nine clinicians were recruited. Key findings included language and communication barriers (despite interpreters), poor understanding of asthma, poor cultural support (other than interpreters), poor trust in the hospital system, lack of access to and affordability of general practice, specialist clinics and hospitals.

Conclusion

The findings informed the modification of our model of care to include bicultural health educators, who support consumers' transition from hospital to home. This model of care is currently under evaluation.

So What?

Nurse-led models of asthma care improve asthma control and health literacy but are not reaching individuals from CALD communities. We asked participants with asthma from three CALD communities, and clinicians looking after those with asthma to provide insights on the barriers (challenges) and enablers (solutions) to improving asthma outcomes and the health care journey for CALD consumers.