title: Evaluation of a hepatitis B educational ESL curriculum for Chinese immigrants.
abstract: OBJECTIVE
  According to recent census data, 1,216,600 Canadians are of Chinese descent, and over 80% of Chinese Canadians are foreign born. Approximately 10% of Chinese immigrants are chronic carriers of hepatitis B, compared with less than 0.5% of the general population. English as a second language (ESL) classes provide ready access for individuals with limited English proficiency who are not reached by English language health education materials and media campaigns. We conducted a group-randomized trial to evaluate the effectiveness of a hepatitis B ESL educational curriculum for Chinese immigrants.
  
  
  METHODS
  Five community-based organizations that provide ESL education in the greater Vancouver area participated in the study. Forty-one ESL classes (which included 325 Chinese students) were randomly assigned to experimental or control status. A follow-up survey, conducted six months after randomization, assessed knowledge about hepatitis B. Generalized estimating equations were used to analyze the data.
  
  
  RESULTS
  Follow-up surveys were completed by 298 (92%) of the students. At follow-up, experimental group students were significantly (p < 0.05) more likely than control group students to know that immigrants have higher hepatitis B infection rates than people who were born in Canada; hepatitis B can be spread during childbirth, during sexual intercourse and by sharing razors; hepatitis B is not spread by sharing eating utensils; and hepatitis B infection can cause cirrhosis and liver cancer.
  
  
  CONCLUSIONS
  Our findings indicate that ESL curricula can have a positive impact on health knowledge among Chinese immigrants with limited English. Future research should evaluate the effectiveness of ESL curricula for other immigrant groups, as well as other health topics.
authors.affiliation: Cancer Prevention Program, Fred Hutchinson Cancer Research Center, (M3 - B232), 1100 Fairview Avenue North, Seattle, WA 98109, USA. vtaylor@fhcrc.org
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Taylor
authors.forename: Chong
authors.initials: C
authors.lastname: Teh
authors.forename: Wendy
authors.initials: W
authors.lastname: Lam
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Acorda
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: Gloria
authors.initials: G
authors.lastname: Coronado
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Christopher
authors.initials: C
authors.lastname: Bajdik
authors.forename: Gregory
authors.initials: G
authors.lastname: Hislop
mesh_terms: D000328:Adult; D002681:China / Q000208:ethnology; D003479:Curriculum; D054242:Emigrants and Immigrants / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B; D006801:Humans; D007802:Language; D008297:Male; D015397:Program Evaluation; D014481:United States