Improving health literacy about dementia among older Chinese and Vietnamese AustraliansBetty Haralambous A C , Paulene Mackell A , Xiaoping Lin A , Marcia Fearn A and Briony Dow A B
B School of Global and Population Health, University of Melbourne, Grattan Street, Parkville, Vic. 3010, Australia.
C Corresponding author. Email: firstname.lastname@example.org
Australian Health Review - https://doi.org/10.1071/AH17056
Submitted: 27 February 2017 Accepted: 22 July 2017 Published online: 7 September 2017
The number of older people in the population is increasing faster than for any other age group. This population growth, while positive, is associated with increasing incidence of chronic and progressive diseases such as dementia. This requires older people to navigate services that may not be designed to meet their needs. This issue can be further amplified in culturally and linguistically diverse populations who often have limited English language proficiency and limited knowledge of diseases such as dementia. Health literacy, a person’s ability to access, understand, appraise and apply information about their health and health care, including navigating health services, is low among older people and even lower among older people born overseas. This paper describes findings from a recent research study which developed and used the Cultural Exchange Model. The model is based on a process of collaboration, whereby researchers, service providers and community members work together to build evidence about a particular topic, in this case dementia. The study demonstrated that the Cultural Exchange Model facilitates opportunities for researchers, health professionals, community workers and carers to improve their knowledge of conditions such as dementia and rapidly translate evidence into practice. It also showed that it is possible to recruit, engage and generate new knowledge within populations that are traditionally excluded from research but have high prevalence of dementia. This study shows health literacy is an evolving process. Access to ongoing education for professionals, not only of the clinical condition and the service system, but also the cultural elements of the communities they are working with, requires consideration.
What is known about the topic? We know there is limited health literacy among older people and among older people from culturally and linguistically diverse (CALD) backgrounds. We also know that the older CALD population is increasing rapidly and with that comes increased chronic illness and chronic diseases, including mental health issues and dementia.
What does this paper add? This case study has added to the knowledge base in relation to health literacy and older people from CALD backgrounds. The use of the Cultural Exchange Model is documented in terms of how it enhances our improved understanding of both the barriers and enablers older Chinese and Vietnamese people with dementia face when seeking help. This paper highlights key findings from a study, which could be used by researchers and practitioners when working with older people from CALD backgrounds more broadly.
What are the implications for practitioners? This paper highlights findings from research that has reinforced that health literacy is an evolving process. It requires professionals to recognise the gaps in their own understanding of conditions such as dementia and understand how these gaps might influence help-seeking behaviours of older people and their carers. Access to ongoing education of clinical conditions and the service system is required, but also the cultural elements of the communities they are working with should be considered.
Additional keywords: ageing, education and training, equity, health services, models of care.
References World Health Organization. World report on ageing and health. Geneva: WHO, 2015.
 Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O’Donnell M, Sullivan R, Yusuf S. The burden of disease in older people and implications for health policy and practice. Lancet 2015; 385 549–62.
| The burden of disease in older people and implications for health policy and practice.CrossRef |
 Haralambous B, Dow B, Tinney J, Lin X, Blackberry I, Rayner V, Lee S-M, Vrantsidis F, Lautenschlager N, LoGiudice D. Help seeking in older Asian people with dementia in Melbourne: using the Cultural Exchange Model to explore barriers and enablers. J Cross Cult Gerontol 2014; 29 69–86.
| Help seeking in older Asian people with dementia in Melbourne: using the Cultural Exchange Model to explore barriers and enablers.CrossRef |
 Alzheimer’s Australia. What is dementia? 2017; Available from: https://www.fightdementia.org.au/about-dementia/what-is-dementia [verified 15 August 2017].
 Prince M, Bryce R, Ferri C. World Alzheimer Report 2011: the benefits of early diagnosis and intervention. London: Alzheimer’s Disease International; 2011. Available from: https://www.alz.co.uk/research/WorldAlzheimerReport2011.pdf [verified 15 August 2017].
 Australian Bureau of Statistics. Health literacy Australia. Canberra: Australian Bureau of Statistics; 2008.
 Australian Bureau of Statistics. 2071.0 Reflecting a nation: stories from the 2011 Census, 2012–2013. Canberra: Australian Bureau of Statistics; 2012.
 Federation of Ethnic Communities’ Councils of Australia (FECCA). Review of Australian research on older people from culturally and linguistically diverse backgrounds. Canberra: FECCA; 2015.
 Department of Immigration and Border Protection. The people of Victoria: statistics from the 2011 Census. Canberra: 2014.
 Haralambous B, Dow B, Goh A, Pachana NA, Bryant C, LoGiudice D, Lin X. Depression is not an illness. It’s up to you to make yourself happy’: perceptions of Chinese health professionals and community workers about older Chinese immigrants’ experiences of depression and anxiety. Australas J Ageing 2016; 35 249–54.
| Depression is not an illness. It’s up to you to make yourself happy’: perceptions of Chinese health professionals and community workers about older Chinese immigrants’ experiences of depression and anxiety.CrossRef |