Getting the right message: a content analysis and application of the health literacy INDEX tool to online HIV resources in Australia

'You are making it sound like you are talking to a child': exploring community sentiment on developing and disseminating tailored sexual health education resources for migrants

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.

Development and evaluation of health education resources for culturally and linguistically diverse populations: a systematic review

People from culturally and linguistically diverse (CaLD) backgrounds in Australia generally experience poorer health outcomes, explained in part by low levels of health literacy. We conducted a systematic review to examine the development and evaluation of health education resources designed for CaLD populations. Five electronic databases were searched for English language, peer-reviewed studies published between 1980 and 2020. Thirty-four studies met the inclusion criteria. Twenty-four different health education resources were described and broadly categorized into four types: media campaigns (n = 10), text-based materials (n = 5), films (n = 8) and radio (n = 1). Studies were assessed against domains adapted from a health literacy guideline incorporating: need, collaboration, audience, health literacy, theory, test and process and impact evaluation. All but one study met the majority of the domains. All studies reported positive evaluation outcomes; this may be due to studies involving community early in resource design and including health literacy considerations in their design. Reporting resource design and evaluation against standard practice controls is recommended to build a more robust evidence base for developing effective health education resources for use by audiences from CaLD backgrounds.

"Maybe it's an Indo thing": Transnational health experiences of Indonesian women living in Australia

Migrant health-seeking behaviour is understood to be influenced by transnationalism. This paper explores how transnationalism influences health seeking behaviour among Indonesian women living in Perth, Western Australia. Using a participatory action research approach, we conducted five focus groups with 21 women from Indonesia living in Perth. Transnational practices were common amongst Indonesian women. Transnational health-seeking (seeking Indonesian resources in Australia); transnational social support (between countries); and transnational healthcare (return to Indonesia) were common practices amongst Indonesian women. Transnational social networks were a critical source of health information and support. Findings suggest public health interventions may be improved through utilization of transnational social networks.

Exploring the Intersections of Migration, Gender, and Sexual Health with Indonesian Women in Perth, Western Australia

This paper explores the intersections of migration, gender, and sexual health with Indonesian women living in Perth, Western Australia. The study was part of a larger participatory action research project to co-design an intervention to increase HIV testing in migrant Indonesian women. Unstructured interviews were conducted with adult Indonesian women (n = 10) on their experiences of migration and sexual health. Zimmerman's migration phases (pre-departure and travel, destination, and return) provided a framework to conceptualize women's migration journeys. We found that women's migration journeys were shaped by gender, with male-led migration often reinforcing gender norms. Structural and sociocultural factors (including visa status) influenced women's sense of belonging while living in Australia, such as help-seeking behaviour and engagement in sexual relationships. Intersecting factors of gender, culture, and the migration process should be considered when designing public health interventions to improve women's sexual health, in particular migration policies and procedures.