title: Assessing the effect of culturally specific audiovisual educational interventions on attaining self-management skills for chronic obstructive pulmonary disease in Mandarin- and Cantonese-speaking patients: a randomized controlled trial.
abstract: BACKGROUND
  Patient education is a key component in the management of chronic obstructive pulmonary disease (COPD). Delivering effective education to ethnic groups with COPD is a challenge. The objective of this study was to develop and assess the effectiveness of culturally and linguistically specific audiovisual educational materials in supporting self-management practices in Mandarin- and Cantonese-speaking patients.
  
  
  METHODS
  Educational materials were developed using participatory approach (patients involved in the development and pilot test of educational materials), followed by a randomized controlled trial that assigned 91 patients to three intervention groups with audiovisual educational interventions and one control group (pamphlet). The patients were recruited from outpatient clinics. The primary outcomes were improved inhaler technique and perceived self-efficacy to manage COPD. The secondary outcome was improved patient understanding of pulmonary rehabilitation procedures.
  
  
  RESULTS
  Subjects in all three intervention groups, compared with control subjects, demonstrated postintervention improvements in inhaler technique (P<0.001), preparedness to manage a COPD exacerbation (P<0.01), ability to achieve goals in managing COPD (P<0.01), and understanding pulmonary rehabilitation procedures (P<0.05).
  
  
  CONCLUSIONS
  Culturally appropriate educational interventions designed specifically to meet the needs of Mandarin and Cantonese COPD patients are associated with significantly better understanding of self-management practices. Self-management education led to improved proper use of medications, ability to manage COPD exacerbations, and ability to achieve goals in managing COPD.
  
  
  CONCLUSIONS
  A relatively simple culturally appropriate disease management education intervention improved inhaler techniques and self-management practices. Further research is needed to assess the effectiveness of self-management education on behavioral change and patient empowerment strategies.
authors.affiliation: Respiratory Division, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Department of Graduate Studies, Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, Canada.
authors.forename: Iraj
authors.initials: I
authors.lastname: Poureslami
authors.affiliation: Respiratory Department, Burnaby Hospital, University of British Columbia, Burnaby, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Kwan
authors.affiliation: Respiratory Division, University of British Columbia, Vancouver, Canada; Department of Integrative Oncology, BC Cancer Research Centre, Vancouver, Canada.
authors.forename: Stephen
authors.initials: S
authors.lastname: Lam
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada; Department of Internal Medicine, Providence Health Care Authority, Vancouver, Canada.
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Khan
authors.affiliation: VGH Divisions of Respiratory Medicine, University of British Columbia, Vancouver, Canada; Respiratory Medicine, Vancouver Coastal Health Authority, Vancouver Coastal Health Research Institute, Institute for Heart and Lung Health, The Lung Centre, Gordon and Leslie Diamond Health Care Centre, Vancouver, Canada.
authors.forename: John Mark
authors.initials: JM
authors.lastname: FitzGerald
mesh_terms: D000223:Adaptation, Psychological; D000280:Administration, Inhalation; D000368:Aged; D044466:Asian People / Q000523:psychology*; D001296:Audiovisual Aids; D001955:British Columbia / Q000453:epidemiology; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002681:China / Q000208:ethnology; D032882:Comprehension; D065246:Culturally Competent Care / Q000208:ethnology*; D018450:Disease Progression; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D057220:Health Literacy; D006801:Humans; D007802:Language; D008297:Male; D055118:Medication Adherence / Q000208:ethnology; D009330:Nebulizers and Vaporizers; D010174:Pamphlets; D010353:Patient Education as Topic / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology / Q000523:psychology; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D013997:Time Factors; D016896:Treatment Outcome; D014741:Video Recording
chemical_list: D001993:Bronchodilator Agents
keywords: COPD; Chinese community; cultural background; educational material; self-efficacy; self-management