With diverse languages, nationalities, low literacy and health literacy, and socio-economic disadvantage adding to the complexity, Zachariah said community co-design was used from the outset.
The webinar heard of the importance of acknowledging and working with the existing resilience and knowledge of CALD communities, including new arrivals.
One example was to listen to those from countries which had dealt with serious infectious diseases such as Ebola, dengue and malaria, saying their lived experiences could help inform best practice going forward.
Use plain English
The need to use plain, simple English and concepts came through repeatedly during the Think Tank, with a Communication and Co-ordination breakout session hearing that public health and government material is still too complex, there’s a need for bite-size, easy-to-understand ‘chunks’, and that some terms don’t translate into another language.
It heard that demands on translation services are enormous and unrealistic, such as a request to translate thousands of words into 40 languages overnight, and that there is a lack of qualified translators.
There was also a need to get simple, plain English information out to community groups as quickly as possible, with the Queensland evaluation study finding community leaders very effective in picking up, simplifying and translating material for wider use.
Don’t rely on websites alone
Among the multiple channels used by communities to disseminate and receive COVID-19 information were official government websites, social media, audio/visual (YouTube and Facebook), WhatsApp, Zoom, email and the phone calls.
The Bendigo Community Health Service (BCHS), which delivers refugee services to Karen, Afghan and South Sudanese refugees, worked with Karen, Dinka and Dari speakers to co-design fact sheets, crafting simple English scripts.
Each was checked by two other language speakers for accuracy, then translated into fact sheets and audio-visual segments, before being disseminated using platforms including YouTube and Viber. Between July 2020 and July 2021, the BCHS online resource hub had 20,000 hits.
Local community champions and bilingual staff
Trusted local messengers were at the heart of effective engagement with diverse communities.
SWDA founder Sainab Sheikh used her own experience of twice having COVID-19, once last year and again in 2021, to spread the word to her community of the seriousness of the illness and press the need for testing and vaccination.
In western Sydney, the WSLHD created COVID safety champions and used bilingual members of its own team – some speaking 20-plus languages – to engage with communities.
With the message having to be tweaked repeatedly and the translation service under the pump, the WSLHD worked with community members to provide information that was clear, made sense and was accessible.
WSLHD also worked with trustworthy messengers – ordinary people, doctors, religious leaders and pharmacists – to drive calls to action and empower the message.
Reinforcing the importance of local champions, the Queensland engagement study found that each community leader reached an average of 200 people while for some it was thousands: evidence of how one trusted community leader can supercharge messaging.
Break down silos between service providers
Dr Nadia Chaves, an infectious diseases specialist at a Victorian community health service provider, cohealth, chaired a session on ways to break down silos between service providers working with culturally diverse communities on COVID-19.
It heard of frustration over the duplication of work across states, and of community members having to repeat themselves in meetings because of a failure to share information across government agencies.
There were also concerns raised about confusing messages and an overload of information, with community groups left wondering what to read and what to leave.
Kaye Graves, of Bendigo Community Health Services, spoke of the time spent building up service providers’ knowledge of the pre-settlement experiences of migrant communities.
BCHS began the work in 2012, working with the local hospital and other main services, building their understanding of the refugee journey, culture and faith of the Karen, Afghan and South Sudanese migrant communities.
Graves said understanding the risk and protective factors, such as poor health literacy, are central to creating an optimal settlement environment, and the region now has a refugee settlement network of major providers. This enables increased service coordination, understanding of unmet needs and gaps and identification of professional development needs in working with these communities.
Promote digital inclusion
Difficulties in navigating health department websites, especially for vaccination bookings, were common across diverse communities, according to service providers engaged in the Think Tank.
Community groups such as the Somali Women’s Development Association and the Bendigo Community Health Services underlined concerns with stories of community members being unable to access bookings due to confusing websites.
There were also issues with finding relevant information on local outbreaks, with local postcode searches being difficult, and particularly challenging for those with low digital literacy and little English.
Access to technology such as smart phones and the internet was also highlighted as a barrier for CALD communities, with one social media provider pointing out that digital transformation had not yet taken place in his small, typically face-to-face community, leading to challenges in disseminating information.
One suggestion was the engage tech-savvy international students and young tertiary students to help community members. The idea was to train these students to explain information or processes to community members, with the session told the students could be a great asset for government agencies.
Associate Professor Ben Harris-Roxas, a lecturer at the School of Population Health at the University of NSW, who chaired a session on enhancing communication, said governments are expecting people to navigate increasingly complex systems, such as MyAgedCare, the Carer Gateway and the NDIS which have a large digital component.
Harris-Roxas called for simple innovations such as the appointment reminder translation tool developed by the NSW Multicultural Health Communication Service and private initiatives such as the covid19nearme.com.au website set up by Ken Tsang to track exposure sites that now also maps vaccination clinics.
Harris-Roxas wants critical discussion on low health and digital literacy, saying it shouldn’t be implied as a deficit on the part of people and communities, when it’s a deficiency in the way health professionals and services respond to varying needs.
Evaluations of engagement with CALD communities in Greater Brisbane
For more information, see here.
- Surveyed 51 CALD community members, 31 community leaders
- Community members received information from multiple sources, but mostly from own communities and via social media
- Leaders and Queensland Government seen as trustworthy/credible sources
- Having access to audio/visual and information in their own language important
- Barriers for community members: lack of information in their own language, information overload, dealing with fake news
- Key supports for community members: simple, translated audiovisual material, community leaders/groups, regular information from authorities and access to information via social media
- Most had good knowledge of COVID-19
- Suggested improvements: access to translations in a range of formats, personalised information sharing, support of more CALD leaders and bicultural workers
- Community leaders reported broad adoption of information sharing
- On average, each leader passed on information to 200 community members
- Most translated and adapted information for community members
- Similar barriers to community members. Supports included technology/smart phones, existing relationships and networks, regular information sharing and simple visual messaging for sharing
- Remunerating, training and supporting leaders, as well as early and continued outreach and engagement
- Translated material created and shared early in as many formats as possible
- Engagement of more community leaders and bicultural workers
- Authentic engagement with CALD community and leaders to be built on over time, using an embedded community