A project involving the University of Huddersfield is helping to overcome language barriers for asthma patients in the South Asian community.
Straight Talking – Helping make health literature equitable has devised a series of innovative multilingual, multimedia, culturally-targeted resources for patients who have poor health literacy to help them understand how they can self-manage their asthma.
Drs Mike Snowden and Michelle Bartholomew, Course Leader for the Master of Public Health, collaborated with the Mid Yorkshire NHS Trust and Yorkshire and Humber Partners Academic Health Science Network to produce materials including YouTube videos and leaflets that addressed a gap in explaining asthma self-care to people for whom English is not their first language.
The materials have been distributed both nationally and internationally after being evaluated amongst clinicians, health care professionals and community members from West Yorkshire.
Straight Talking was recently a finalist in the Most Impactful Project Addressing Health Inequalities category at the Health Service Journal Partnership awards, 20032023.
"We were shocked that there were so many people from the South Asian community who were struggling to manage their asthma. There were limited resources and what was available was predominantly written in English. When we first looked at the resources available for asthma self-management, we found there was just one video online and that was only in English, and with the printed material there was absolutely nothing written in for example, Urdu or Punjabi," says Dr Bartholomew, whose innovative earlier work has included assessing the impact of COVID-19 on older women in the African-Caribbean community.
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"We had seen research that suggested that language barriers and medical terminology were leading to misunderstandings, and additionally there were additionally cultural differences and myths around asthma.
"The video and literature were shown to people from South Asian communities in West Yorkshire, and their reaction was that the video was not clear, and the leaflets were difficult to understand and they didn't show feature individuals like them. It featured predominantly white individuals, and whilst it mentioned the benefits of exercise, it solely featured a man playing football. It did not 'speak' to them at all. It wasn't fit for purpose.
"For the evaluation, we consulted with GP's, pharmacists, asthma nurses and respiratory consultants to get their understanding of why they felt South Asian people were not managing their asthma correctly. Working with Dr Llinos Jones from Mid Yorkshire Trust, we devised a video that features a conversation with a GP and an Imam. It was important to tackle a few myths around asthma, so as an example the video explains how it is fine to use an inhaler even during Ramadan.
"We have to consider that not everyone in the community has access to a mobile phone, so there are informative leaflets and posters at surgeries, community centres and the mosques. It's not just for the patients with asthma, it is beneficial for the families as well. The evaluation also helped us plan a purse-size document that can be quickly available.
"It has been a bottom-up approach, listening to the community members and putting it all into practice. A need was identified, we addressed it and people are feeling the benefits in the community," says Dr Snowden.
A range of literature in different languages has been produced, along with further videos featuring an avatar that gives information on asthma care and management in 10 languages, including Urdu, Arabic, Bengali, Hindi, Punjabi and Gujarati and more.
But rather than just relying on instructions given remotely, the project has also helped and trained community members to become 'asthma champions' who can explain to family and friends in their community.
Vanessa Barrett, Asthma Project Researcher, Michelle Bartholomew, Harriet Smith, Workstream Lead-Accelerated Access Collaborative (Yorkshire and Humber Partners Academic Health Science Network) and Llinos Jones, Consultant Physician Respiratory Medicine Mid Yorks Trust (Principal Investigator) "They are not medically trained, but trained in a supportive role to help people manage their asthma," adds Dr Bartholomew.
"Getting a doctor's appointment had been an issue for some individuals and we have heard stories of asthma champions going to GP appointments with them and ensuring that they are fully aware and understand the advice given by their GP, thus reducing any language barriers. For example, ensuring awareness and understanding of when there are two inhalers and which one to use at the right time.
"They are doing a phenomenal job and for people from the South Asian community it is a huge benefit to have someone from your own community that can help you manage your asthma. It was also about breaking down negative assumptions about asthma and that it is possible to live a relatively normal life."
The HSJ nomination is also set to help spread the outcomes of the project further afield.
"We have had phenomenal support from GPs, wanting the materials and the HSJ nomination has helped to spread the knowledge of it," adds Dr Snowden. "I have been in touch with people from different health sectors. It could be spread to different communities where similar issues over language exist for other conditions."
