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Enhancing COVID-19 public health communication for culturally and linguistically diverse communities: An Australian interview study with community representatives
Abstract
Background: Public health crises present challenges for providing accessible, timely, and accurate health information to culturally and linguistically diverse (CALD) communities. Aim: The aim of this qualitative project was to explore strategies used by CALD community organizations to improve communication about COVID-19 for their communities; we also aimed to identify gaps and challenges. Methods: We interviewed 16 representatives from Greek, Italian, and Chinese CALD organizations in Melbourne, Australia. The interviews were analyzed thematically. Results: Community leaders played a significant role in engaging their community members with accurate key health information. There were differences between language communities about preferred channels for receiving information. As the pandemic intensified, there was a shift from written communication to more interactive exchanges between authorities and community leaders. Discussion: The findings suggest effective public health communication is enhanced by the mediation and outreach strategies adopted by CALD community organizations; further, stakeholders need to be cognizant of heterogeneity of needs and preferences. This may optimize information dissemination to meet specific needs. Conclusions:The CALD organizations have developed communication strategies involving different kinds of mediation to reach specific sub-groups, especially the most vulnerable. These strategies can inform future public health engagement.
... Information intermediaries could include staff from community organisations, community or religious leaders, bilingual case or youth workers or 'natural' leaders (for example, a person who has completed medical training but does not practice in Australia) across the age spectrum. Through influencing the flow of communication, information intermediaries shape and inform their community's reality and knowledge in a culturally appropriate and salient manner [18]. ...
... Recent literature has reported the communication gap between CaLD members and the public health dissemination system, caused mainly by a lack of access to COVID-19 specific information and ineffective communication channels for CaLD groups and communities to receive necessary information [3,12,18,19,[28][29][30][31]. This was particularly problematic for those with low digital or English literacy levels, and older ethic minority adults [18,32]. ...
... Recent literature has reported the communication gap between CaLD members and the public health dissemination system, caused mainly by a lack of access to COVID-19 specific information and ineffective communication channels for CaLD groups and communities to receive necessary information [3,12,18,19,[28][29][30][31]. This was particularly problematic for those with low digital or English literacy levels, and older ethic minority adults [18,32]. A similar tension emerged from our discussion with community leaders, suggesting governments placed significant responsibility on community leaders and organisations to deliver public health messaging to communities. ...
Background
The Australian Government implemented a range of public health response strategies and communication approaches to reduce the spread of COVID-19; however, concerns have been raised around a failure to sufficiently consider culturally and linguistically diverse (CaLD) communities in these processes. This research aimed to understand the factors that have impacted COVID-19 communication and engagement efforts during the pandemic from the perspective of key CaLD community and faith-based leaders. A further aim was to understand the processes that could be adopted to support future communication strategies, including promoting pandemic-related vaccines.
Approach
This study included 29 key informant interviews with community and faith-based leaders in New South Wales, Australia.
Results
The overwhelming message from community leaders was a sense of shared responsibility between their organisations and governments in communicating pertinent and accurate COVID-19 related information to CaLD communities. They expressed a sense of duty to keep their community members safe. However, community leaders and others shouldered significant costs related to resources and time that need to be acknowledged by governments in preparing for future disease outbreaks. They felt that governments should consider: 1) improving communication between governments and CaLD organisations; 2) responding to the specific CaLD needs with greater agility; 3) foregrounding social media in their communication strategy; 4) reinvesting in local public health units to know their population; 5) developing a health ambassadors model program; 6) preparing a hybrid model of translators/interpreters to fill the gap; and, 7) reimagining vaccine information campaigns to target CaLD communities better.
Conclusion
Given the technical details about the COVID-19 virus conveyed in government information campaigns and the media, ensuring the most vulnerable populations, including people from CaLD backgrounds, access clear, concise and timely public health messaging from governments and community organisations requires further attention.
... The reasons why OTS are less trusted than NOTS are analyzed. For one thing, "thin" trust appears when the bonds between governments and foreign nationals are weak because of their official status and reputation (Khodyakov 2007;Cadwell 2020;Karidakis et al. 2022). For another, the quality of public services is critical for people to determine whether governments can be trusted (Van de Walle and Bouckaert 2003, 891; Ye and Lyu 2020, 8). ...
... Studies show that higher levels of trust have been linked with increasingly intimate relations (Arlikatti, Lindell, and Prater 2007). Friends/colleagues as information mediators maintain intimate and strong bonds with foreign nationals and in this case, "thick" trust can be engendered (Khodyakov 2007;Cadwell 2020;Karidakis et al. 2022). ...
Trust is important in public health communication to culturally and linguistically diverse (CALD) communities during pandemics. This empirical research, using quantitative data from 107 foreign nationals at a university in Shanghai, probes into how trust varied in official translation services (OTS) and non-official translation services (NOTS) during COVID-19. Statistical analysis was carried out by IBM SPSS Statistics 26 and it was found that (1) NOTS which are more frequently used are more trusted compared with OTS; (2) NOTS are uncorrelated with demographics while OTS are correlated with demographics, among which education and trust in OTS suggest a linear positive relationship (Sig. = 0.003, β = 0.467), whereas age and trust in OTS suggest a linear negative relationship (Sig. = 0.027, β = −0.348); (3) there is a positive relationship between the frequency of using services and trust, i.e., higher frequency implies higher trust. The findings of this case study can have implications for policy makers and the representatives of CALD communities.
... In particular, ICT-enabled healthcare systems lower the cost of healthcare providers like physicians or analysts traveling to a location to collect data for analysis. E-Health systems aid healthcare providers and policymakers in making informed decisions and responding to public health emergencies, promoting environmentally conscious cultures during epidemics like COVID-19 [134]. • Mental health treatment: The WHO's 2020-2025 global plan on digital health is one of many national and international attempts to promote digital technologies in mental healthcare. ...
Ensuring good health and well-being is one of the crucial Sustainable Development Goals (SDGs) that aims to promote healthy lives and well-being for people of all ages. This involves providing affordable and environmentally friendly medical services to the public fairly and equitably. Good health and well-being goals include achieving fair health outcomes and strong healthcare systems. It also highlights the importance of integrating sustainable health considerations into the policy frameworks of developing countries, which are established to address the social factors that influence health. Regarding healthcare reform, Information and Communication Technologies (ICTs) play a pivotal role as key enablers to improve patient access, treatment quality, and system efficiency. This shift in focus also highlights the significance of fostering digital accessibility, sustainability, inventiveness, cybersecurity, and digital leadership. Nevertheless, incorporating progressively advancing ICT technology into healthcare systems, sometimes called digital transformation, is not simple. However, some challenges arise in integration, application design, and security measures. While numerous studies have been suggested to tackle incorporating ICT technologies into healthcare systems, these studies have had limited scope and have not considered several factors. Therefore, there is a pressing need for an extensive research study focusing on integration technologies, design challenges, security and privacy challenges, application areas, and the potential positive and negative effects. Therefore, this paper contributes as the research literature study covering an important SDG, “Good health and well-being,” and its digital transformation, along with summarising our research findings in a detailed and taxonomical way. First, we analyze an all-encompassing taxonomy of prior research on healthcare and well-being, emphasizing incorporating ICT in healthcare, specifically with sustainability, security and privacy challenges, design and integration challenges, applications associated with Electronic Health (E-Health), and potential future avenues for exploration. Then, we explore the need for digital transformation in healthcare and its significant components, highlight E-Health’s importance and benefits, explore its integration and design challenges, and categorize the security and privacy challenges. Next, we determine the role of Blockchain Technology as today’s leading technology in E-Health. We discuss Blockchain Technology and its characteristics, highlight its benefits, and describe the possible types of Blockchain-based E-Health use cases. Furthermore, we compare the positive and negative impacts of ICT integration and identify open issues and challenges of integrating ICT technologies into the healthcare systems. We also discuss future research directions, strengthening researchers to address the issues in future solutions.
We have investigated the use of machine translation in urgent ‘behavior-change communication’ to improve emergency messaging to multicultural communities. This innovative study is the first to evaluate raw machine translations, as well as two editing processes—machine translation results that have been corrected by a human (post-edited), and machine translation of source texts that have been corrected by a human (pre-edited). In doing so, we provide data on problems that may arise when using machine translation in emergency communications and insights into what may be required to address them. As a result, we provide practical suggestions for how to reduce or avoid machine translation problems and risks, to create more efficient and effective, as well as culturally appropriate emergency communication strategies.
The COVID-19 pandemic provided lessons for health policies across the globe. We assessed the knowledge, attitudes and practices of vulnerable populations in an informal settlement in Mumbai, India, during the pandemic. We discuss the viability and effectiveness of communication strategies using the results and provide suggestions for policy modifications regarding awareness generation and behavioral change during health emergencies. The study was conducted through a telephone survey among 460 respondents (233 men and 226 women) from April to May 2021.
Television (94%) and family (70%) were the most common sources of information, but they were not the most trusted. Most respondents knew the causes and preventive measures of COVID-19, including vaccination. However, awareness did not always result in changes in attitudes and behavior- 66% perceived low or no risk to COVID-19, while 93% did not consider it essential to wear masks in workspaces and 78% did not sanitize hands before entering workspaces. More respondents had fears related to loss of employment (53%) than their physical (10%) or mental (4%) health.
The study highlights the need for context-specific communication strategies among vulnerable populations. This includes reliable and accessible sources of information, an emphasis on information accuracy and detail, and a holistic and multidimensional approach to awareness and information sharing.
Australia is a world leader in providing valuable resources that support multilingual access to healthcare services. However, the COVID‐19 pandemic revealed that these resources are not always effective in ensuring that linguistically diverse citizens have access to information in a crisis. In this paper, we consider whether authorities around the world have implemented effective approaches that might be adapted to enhance multilingual communications in public health crises in the Australian context. Using a systematic literature review, we identify strategies implemented by governments and public health authorities to effectively support communication in a range of languages during public health emergencies. Four databases were searched and resulting studies analysed. We found that substantial bodies of the literature document the communication needs of culturally and linguistically diverse communities and the role of community and religious organisations in providing that support. However, there is almost no attention to the role that governments or public health authorities might play in implementing strategies to address those needs. Analysis of the studies suggests that public health authorities could benefit from working more collaboratively with community organisations to establish communication strategies that are timely, trustworthy, efficient and capable of cultural and linguistic nuance in public health emergencies.
Health communication is a critical component of public health, which includes health education resources. Resource effectiveness is improved where health literacy demands, including the cultural appropriateness of resources, match the intended audience. International guidelines support the tailoring of resources for migrants from culturally and linguistically diverse backgrounds (CaLD). Five focus groups (n = 18) and interviews (n = 9) with people from CaLD migrant backgrounds explored community perspectives on sexual health resources developed by a state department of health, specifically clarity, comprehensiveness, cultural appropriateness and strategies for dissemination. We identified three major thematic areas relating to simplicity, cultural norms and beliefs and dissemination. Participants recommended resource delivery in different formats as part of a broader intervention. Generally, sexual health information was deemed appropriate and easily understood. However, the resources used simplified language that participants reported was vague and inaccurate at times, potentially contributing to misinformation and reinforcing stigma relating both to the status of being a migrant and sexual health. Findings suggest the need for more nuanced health resource development beyond translation and language simplification. Resources developed in different formats, including different health literacy demands, using approaches that engage the target group in design and dissemination and contextualized within a comprehensive health promotion project, are likely to be more effective.
Risk communication during a public health crisis necessitates the provision of accessible, timely and accurate health information to the public. The aim of this research project was to explore the availability and characteristics of COVID-19 and vaccine health promotional materials published in Aboriginal and Torres Strait Islander languages. We aimed to identify the strategies used by Aboriginal-led organizations and Departments of Health to improve communication about COVID-19 and vaccination. Health promotion resources published online between January 2020 and December 2021 were identified by means of a desktop scan and a content analysis was subsequently conducted. We also interviewed five Aboriginal-led organizations and interview data were analyzed thematically. Findings illustrate the vital role of Aboriginal and Torres Strait Islander languages in high stakes information transfer and, in particular, the push by Departments of Health and language groups to create and disseminate important messaging in Aboriginal and Torres Strait Islander languages. This is best achieved by utilizing local knowledge, existing relationships and local connections. Finally, a multimodal approach to the production and dissemination of pandemic health information better caters for the diverse specific needs of these communities. ARTICLE HISTORY
The objectives of the study were to (i) document refugee, immigrant and migrant (RIM) communities’ knowledge, attitudes and beliefs (KABs) related to the Coronavirus disease (COVID-19) vaccine and (ii) identify best practices for developing and disseminating culturally and linguistically responsive health messaging addressing those KABs. Thirteen online focus groups (OFGs) in 10 languages were conducted. Each OFG was conducted in the participants’ native language. OFGs were recorded, transcribed, translated and uploaded to qualitative software for coding. A thematic analysis was conducted. Results suggest that while there was some variation between different language groups (e.g. whether religious leaders were seen as trusted sources of information about COVID), there were also important commonalities. Most language groups (i) alluded to hearing about or having gaps in knowledge about COVID-19/the COVID-19 vaccine, (ii) reported hearing negative or conflicting stories about the vaccine and (iii) shared concerns about the negative side effects of the vaccine. There continues to be a need for health messaging in RIM communities that is culturally and linguistically concordant and follows health literacy guidelines. Message content about the COVID-19 vaccine should focus on vaccine importance, effectiveness and safety, should be multimodal and should be primarily delivered by healthcare professionals and community members who have already been vaccinated.
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