Towards improving cardiovascular disease care among Arabic-speaking immigrants in Australia

Cardiovascular disease (CVD) is recognised as a major health issue with global prevalence increasing at epidemic rates. There is a substantial risk of CVD event recurrence or death among patients with existing CVD.
Evidence shows that there is a higher prevalence of CVD and recurrent CVD events among Arabic-speaking immigrants (in this thesis Arabic-speaking immigrants refer to immigrants from the Middle East, or North Africa) than among other patient groups. However, there is a paucity of studies exploring the health care challenges facing Arabic-speaking immigrants with CVD in undertaking secondary prevention measures, and their needs in order to address these challenges. In turn, there is lack of studies to determine a suitable health care model that addresses the health care needs of this patient population. A suitable health care model could improve patients’ self-management, secondary prevention and health outcomes.
The central premise of this project was to gain insight into the health care challenges and needs of Arabic-speaking immigrants with CVD in Australia (from their perspective) in order to identify their challenges in undertaking secondary prevention measures, and their needs in addressing these challenges. This knowledge contributed to recommendations for the development of a suitable health care model for Arabic-speaking immigrants with CVD.
In three stages, this research investigated Arabic-speaking participants’ views on their health care challenges and needs, using semi-structured interviews. It also investigated their dominant health locus of control (HLC) profile, which plays a significant role in disease management (using a multicentre, cross-sectional questionnaire). Further, it explored their preferences for a model of care that addresses their health care challenges and needs, using a multicentre, cross-sectional questionnaire.
Study results suggest that Arabic-speaking immigrants may have unique health care needs, including assured privacy and pharmacist–physician collaboration. The results also indicate that Arabic-speaking immigrants have low Internal HLC. Given that low Internal HLC is associated with poor disease management and poor health outcomes, the study highlights the need to include Internal HLC as a dimension of any health care model for this patient group. The study results also indicate that Arabic-speaking immigrants with CVD need a culturally mindful, customised care (CMCC) model. This is because this type of model may promote socio-cultural competence (acknowledging culture and health literacy level, and communicating at a level that is easy for the patient to comprehend).
This research makes a significant contribution to CVD secondary prevention research among the Arabic-speaking immigrant population. The findings provide detailed information on the health care challenges and needs of Arabic-speaking immigrants with CVD, and the type of health care model that best addresses these challenges and needs. The thesis concludes with recommendations for the development of a suitable health care model for Arabic-speaking immigrants with CVD, one that may improve cardiovascular care among them. This, in turn, may improve secondary prevention among Arabic-speaking immigrants with CVD and improve their health outcomes. Ultimately, this will not only reduce the heavy economic burden existing due to CVD but will also reduce mortality rates among patients with CVD.