Health promotion curriculum development for Vietnamese refugees: Pretest and posttest health confidence.

摘要

Long-term effects of war in Vietnam have affected the health status of Vietnamese refugees in the United States (U.S.). Upon their arrival in developed, Western countries, Vietnamese refugees have struggled with access to adequate health care because of their socioeconomic status, language problems, cultural misunderstandings, and poor communications with service providers. Consequently, they have low confidence in managing health issues and are at risk for physical and psychological illness.; The Harvard Program in Refugee Trauma (HPRT) developed a free, community health education program culturally tailored for Vietnamese and Cambodian refugees, called Health Promotion Curriculum (HPC), which was designed to help Southeast Asian refugees feel increased empowerment about health concerns. HPRT consulted with the Vietnamese American Civic Association (VACA) and Cambodian Mutual Alliance Association (CMAA) to develop and implement the program. The author co-developed the HPC and examined the initial archived data.; The study examined the effectiveness of HPC on the health confidence of Vietnamese and Cambodian refugees. Vietnamese (n = 15) and Cambodian (n = 10) refugees from the greater Boston area attended HPC pilot classes. Among the participants, 48% met the criteria for PTSD, 12% met the criteria for major depression, and 40% met the criteria for both diagnoses. Despite the small sample size, there were significant changes in confidence in health promotion for the full sample and for each ethnic group (i.e., Vietnamese and Cambodian) in pretest and posttest repeated measures analysis of variance (ANOVAS), as measured by a 4-point, 12-item Likert-type questionnaire with strong internal consistency reliability. There were no pre-post changes with regard to gender, age, major depression and PTSD diagnostic groups, and a comparison between the two ethnic groups.; The implications of the study have been examined in the light of the small sample size, limitations of a pretest-posttest study, use of a naturally occurring community sample, and the absence of a control group. A program evaluation model is proposed and examined in order to enhance the success of HPRT's health education curriculum in its future implementation as part of its efforts to address the pervasive health disparities of Southeast Asian refugees, as well as, of other refugee groups.