School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia.
Centre for Culture, Ethnicity and Health, Melbourne, Victoria, Australia.
Vaccine. 2020 Sep 22;38(41):6410-6417. doi: 10.1016/j.vaccine.2020.07.071. Epub 2020 Aug 14.
The internet is a source of health information for many consumers. However, little is known about the availability of online resources about immunisation (for children and adults) directed at refugee and migrant populations. The aim of this study was to evaluate the health literacy demand (understandability, actionability & readability) and cultural appropriateness of immunisation resources in Australia for these communities.
Our study involved two search approaches. Firstly, Google trends was used to identify the most common search terms used in Australia. Search terms used included 'immunisation', 'vaccine' and 'refugee immunisation' amongst others. These search terms were entered into: Google, Bing, Duck Duck Go and Yahoo and the first 5 pages of results for each search were examined. Searches were conducted from November 2018 to June 2019. Secondly, requests were sent out directly to key stakeholders in local health districts and state/territory health departments. Understandability and actionability were assessed using the Patient Education Materials Assessment Tool (PEMAT). The Simple Measure of Gobbledygook (SMOG) and the Flesch readability ease tools were used to assess readability. Cultural appropriateness was assessed using additional criteria developed by the Centre for Culture, Ethnicity and Health (CEH), Victoria, Australia.
27/33 resources were included in the analysis. The overall mean understandability score was 70% (range: 50-100%). The overall mean actionability score of the resources was 47% (range: 0-83%). In terms of readability, the mean score was a 10.5, which was indicative of an eleventh grade reading level. The average Flesch-Kincaid readability score was 47.7. The average score for cultural appropriateness was 79% (range: 29-100%).
Our findings suggest that there are currently not many refugee-specific resources on immunisation. Future work needs to better improve the health literacy demand of online immunisation information. Engaging with members from migrant communities is also recommended so that appropriately tailored resources are co-developed.
互联网是许多消费者获取健康信息的来源。然而，对于针对难民和移民群体的免疫接种（儿童和成人）在线资源的可获得性，知之甚少。本研究旨在评估澳大利亚针对这些社区的免疫资源的健康素养需求（可理解性、可操作性和可读性）和文化适宜性。
我们的研究涉及两种搜索方法。首先，使用 Google 趋势来确定澳大利亚最常用的搜索词。使用的搜索词包括“免疫接种”、“疫苗”和“难民免疫接种”等。将这些搜索词输入到：Google、Bing、Duck Duck Go 和 Yahoo 中，并检查每个搜索的前 5 页结果。搜索于 2018 年 11 月至 2019 年 6 月进行。其次，直接向当地卫生区和州/地区卫生部门的主要利益相关者发送请求。使用患者教育材料评估工具（PEMAT）评估可理解性和可操作性。使用简单的文字难度工具（SMOG）和弗莱什阅读舒适度工具评估可读性。使用澳大利亚维多利亚州文化、种族和健康中心（CEH）制定的其他标准评估文化适宜性。
27/33 项资源被纳入分析。总体可理解性评分的平均值为 70%（范围：50-100%）。资源的总体可操作性评分平均值为 47%（范围：0-83%）。在可读性方面，平均得分为 10.5，表明阅读水平为 11 年级。平均弗莱什-金凯德阅读难度得分为 47.7。文化适宜性的平均得分为 79%（范围：29-100%）。
我们的研究结果表明，目前针对免疫接种的难民特定资源并不多。未来的工作需要更好地提高在线免疫信息的健康素养需求。还建议与移民社区成员合作，共同开发量身定制的资源。
