Being from a culturally and linguistically diverse community is a factor in awareness of pulmonary rehabilitation for people with chronic obstructive pulmonary disease

Rationale: Encouraging people with Chronic Obstructive Pulmonary Disease (COPD) to attend and complete pulmonary rehabilitation (PR) is a challenge, with low rates of attendance and completion. Despite the effectiveness of PR, it has been observed that people with COPD from a culturally and linguistically diverse (CALD) community rarely attend PR. However, the extent of cultural and linguistic diversity among people with COPD, and implication of diversity for the design of PR remains unclear. Method: This prospective cohort study recruited patients diagnosed with COPD who attended the respiratory outpatient clinic at a metropolitan health service in Australia. Participants completed a study-specific questionnaire, which included questions related to self-identified ethno-cultural identity, socioeconomic status, respiratory health status and self-reported awareness of PR. Language assistance to complete the questionnaire was provided by interpreters when deemed required by the participant. Additionally, the treating respiratory physicians were asked to complete a short survey regarding referral to PR. Attendance and completion rates of PR were recorded when participants accepted the PR referral at time of consultation. Descriptive analysis was conducted using either Chi-Square analysis, odds ratio or T-test. Results Ninety seven participants were recruited in this study. Thirty-nine participants (40%) self-identified to be from a CALD community (Table). The three most common cultural groups were the Maltese (n=8, 20%), Vietnamese (n=4, 10%) and Maori (n=4, 10%). Being from a CALD community was a factor which impacted on the awareness of PR (χ2(df)=4.1 (1), p=0.045), with participants from the CALD group being less likely to be aware of PR as compared to the non-CALD group (OR=2.5, p=0.048). While the level of English proficiency differed between the two groups (χ2(df)=28.4(2), p=0.00)(Table), level of English proficiency did not correlate to self-reported awareness of PR (χ2(df)=1.3(3), p=0.7). Socioeconomic status (χ2(df)=0.5 (2), p=0.8) and level of education (χ2(df)=4.1(2), p=0.1) also did not relate to self-reported awareness. There were no significant between group differences in the number of observed accepted referrals (F=1.3, p=0.3), attendance (F=0.7, p=0.4) and completions of PR (F=2.6, P=0.2). Conclusion Despite the prevalance of COPD among people from a CALD community, people who self-identify as being from a CALD community were less likely to report any awareness of PR. Contrary to common perceptions, language proficiency did not influence the likelihood of the awareness of PR. Targetted strategies to raise awareness of PR among people with COPD from a CALD community is required.