While many public health lessons were learned from the coronavirus pandemic, perhaps some of the most important were about how to best communicate with Australia’s Aboriginal and Torres Strait Islander communities and Culturally and Linguistically Diverse (CALD) communities.
The needs of these communities are significantly different to the mainstream within a public health context and what was learned throughout the pandemic has many applications as we grapple with communicating about Antimicrobial Resistance (AMR).
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“Initially communication was not culturally or linguistically tailored, and migrant and refugee communities faced substantial barriers accessing public health information.
Dr Regina Torres-Quiazon
For Dr Regina Torres-Quiazon, Director of Programs at the Multicultural Centre for Women’s Health (MCWH), the delays in getting targeted information to CALD communities during the pandemic was a real concern.
“Initially communication was not culturally or linguistically tailored, and migrant and refugee communities faced substantial barriers accessing public health information. Government messaging was slow to tailor information for CALD communities and arrived too late, amplifying inequities,” Dr Torres-Quiazon said.
“The lack of early multilingual communication deepened fear, confusion and trauma, especially during public housing tower lockdowns in Melbourne.
“However, MCWH and similar organisations stepped in to fill gaps, providing in-language, culturally meaningful health information through multilingual health educators and outreach.”
Some of MCWH’s key successes included:
- Rapid adaptation of MCWH’s model of health education: Delivering more than 27 online multilingual education sessions in languages including Arabic, Assyrian, Vietnamese and Mandarin. (See Reaching migrant women during COVID-19 – Prevention Victoria)
- Broad community reach: Participation in more than 43 in-language radio segments across eight languages to disseminate COVID-19 information.
- Effective outreach to high-risk populations: Contacting 1,337 public housing residents in 19 languages, resulting in 83% agreeing to COVID-19 testing – demonstrating strong behaviour-change outcomes through trust-based communication.
- Development of migrant-women-led programs such as WoMHEn and the national Health in My Language, ensuring access to accurate information in women’s own languages, reinforcing community empowerment.
Similarly in Aboriginal and Torres Strait Islander communities, a lack of consideration of the diverse backgrounds and natures of communities led to a lag in the uptake of COVID testing and trust in vaccines, according to Mike Stephens, Director of Medicines Policy and Programs at the National Aboriginal Community Controlled Health Organisation (NACCHO).
“We really find that the experiences and needs of different communities are so varied and they’re not necessarily identical based on rurality or remoteness,” Mr Stephens said. “But where individual community representatives participate in improving their knowledge they can translate that knowledge back to that setting and the needs that that community has.
“That’s how the NACCHO Antimicrobial Stewardship Academy works. We can’t always be privy or across what the specific needs are of every community, but the idea is that the participants in the program build their skills that they can then apply in their local environment.”
The importance of communication with Elders in both the Aboriginal and Torres Strait Islander communities and CALD communities was emphasised by both Mr Stephens and Dr Torres-Quiazon.
Mr Stephens said: “I think elders in any health promotion or health policy activity for a community are very important, especially in terms of prioritisation and understanding what the needs are. There is also implementation of what is the right way to consult and to implement a particular program or a health promotion campaign, for example. So I think the role is often central but still probably quite varied depending on the community and the way that a community works with their Elders too.”
Dr Torres-Quiazon agreed: “Evidence across COVID-19 work shows that it’s essential to focus on and include Elders and the older population more broadly. While ‘elders’ or respected community leaders are crucial to shaping health behaviours and influencing trust in health systems, we need to acknowledge and rise above the ageist driven policies that resulted in the disproportionate number of deaths in nursing homes during the pandemic.
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We really find that the experiences and needs of different communities are so varied and they’re not necessarily identical based on rurality or remoteness.”
Mike Stephens
“This was and is especially true when it comes to women. MCWH’s work centres on Australia’s migrant and refugee women because women are key health decision-makers, caregivers and information leaders within families and communities. COVID-19 showed gendered impacts, making women’s involvement essential in both receiving and disseminating health information.”
Mr Stephens said some practical and reproducible lessons came out of the pandemic that could be reapplied in AMR education and health promotion.
“I think it’s a good example of where the government were very keen to invest in delivering community-based solutions, whether that was a sausage sizzle for health promotion or other workforce related activities.
“I think one thing we did see with improving COVID antiviral uptake as well as broader vaccine uptake was around commissioning or funding activities at the community level. I certainly think there’s good evidence that the community-based approach led to quality outcomes.
“It would be good to consider using these approaches again given COVID obviously is an infectious disease and what we learned could be applied to other infectious disease programs, including AMR.”
Dr Torres-Quiazon again emphasised the need to ensure women are consulted and included in AMR messaging as a priority.
“It’s not just about translation: it’s about culturally and linguistically responsive and appropriate communication led by a trained and trusted bilingual health education workforce,” she said.
“This was the core strength of MCWH’s COVID response. In addition, community-led programs where women are included in the design and delivery of programs are central to successful community health interventions as they improve uptake and engagement.”
Rebecca Thorpe is a journalist and communications specialist with decades of experience both in Australia and Europe.
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