The development of an English as a second language cancer prevention curriculum for new immigrants to Australia: A translational research approach

Background: Australian immigration patterns are changing, and the country is becoming increasingly multicultural. This pattern brings health implications. Disparities are noted in cancer incidence and mortality, as well as in uptake of cancer prevention activities such as screening. While many immigrants arrive to Australia with knowledge and skills to manage their health,typically little is known about Australia’s cancer risks, optimal cancer prevention strategies or available cancer screening resources. Others may have less proficient English language skills to be able to obtain, understand and use available resources. Approaches that blend health literacy into existing migrant adult English as a second language (ESL) education show promise as a way to improve health literacy in new immigrants while improving language proficiency. Adopting a translational research approach may help in the development and evaluation of a curriculum that could reach across multiple cultures and geographic locations within Australia. Method: A cancer prevention awareness curriculum was developed in two stages: (1) using a participatory actionresearch approach, focus groups and interviews were held with key stakeholders: ESL teachers and students. The RE-AIM translation evaluation framework (evaluating barriers and facilitators to intervention reach, efficacy, adoption, implementationand maintenance) underpinned interview questions and analysis of transcripts. (2) Based on the results of this study, a draft curriculum was produced and returned to the stakeholders for feedback via a quantitative survey to establish the potential reach of the curriculum’s components to different genders, ages and cultures. Results:Data collection for stage 2 feedback is underway in Adelaide, South Australia (N=25 to date). Conclusions: Results from stage 2 will help to shape the final form of the curriculum to be trialled in 2019 for efficacy to improve students’ health literacy and knowledge regarding cancer risks and prevention strategies, primary prevention intentions, behaviours and English language skills. The trial will also examine the degree of the curriculum’s adoption by teaching staff, implementation into existing programming and maintenance of primary outcomes over time. Clinical implications:If found to be efficacious, this approach could be a feasible alternative to traditional health messaging for migrants to Australia.