Evaluating a Culturally Tailored Public Health Forum in Improving the Knowledge and Understanding of Chronic Disease Management in the Chinese Population: A Mixed-methods Study
Abstract:
Chronic disease management is fraught with many challenges for ethnic minorities. Studies conducted in non-multicultural populations suggest that patient and community engaging initiatives can improve chronic disease management practices. However, literature on culturally specific community engaging programs is relatively sparse. The interCultural Online Health Network (iCON) is a culturally tailored, patient and community engaging health promotion program, which provides culturally specific health education to BC’s multicultural communities. We aimed to assess if the iCON 2020 Chinese Health Forum can improve the knowledge and understanding of chronic disease self-management in the Chinese community of Vancouver, BC.
To read the full journal article: https://journalofasianhealth.org/index.php/jasianh/article/view/33
Limbachia, J., Owens, H. ., Matean, M. ., Suen, I., Khan, S., Novak-Lauscher, H. ., Ho, B. ., & Ho, K. (2023). Evaluating a Culturally Tailored Public Health Forum in Improving the Knowledge and Understanding of Chronic Disease Management in the Chinese Population: A Mixed-methods Study. Journal of Asian Health, 3(2). https://doi.org/10.59448/jah.v3i2.33
Organizing a Mass Gathering Amidst a Rising COVID-19 Public Health Crisis: Lessons Learned From a Chinese Public Health Forum in Vancouver, BC
Abstract:
Introduction The coronavirus disease 2019 (COVID-19) evolved from a rising public health concern to a pandemic over mere weeks. Before March 11, 2020, the Public Health Agency of Canada had not advised against any mass gatherings. Herein, we highlight practical precautions taken by event organizers to adapt to the rising public health threat from COVID-19 and maintain public safety when conducting a health forum for the Chinese community of Vancouver, British Columbia on February 22, 2020. Materials and Methods In the pre-forum phase, we advertised the availability of virtual conferencing for remote participation in the forum and also had an official communication from the Ministry of Health available regarding COVID-19 on our website. At the forum, we ensured that attendees sanitized their hands at registration and had access to sanitizers throughout the forum. Additionally, we provided translated health literature on COVID-19 to participants and had our health professional speakers address COVID-19-related questions. Results This year, 231 older Chinese adults attended the forum in-person, while 150 participated remotely. The total number of 381 participants compares well to previous iterations of the forum, with twice the amount of participants on average attending online than before. Of the participants who attended the forum, 89% suggested that the forum would be effective in improving their overall health and 87% cited the forum’s utility in directing them to access community resources. None of the attendees had COVID-19 or are suspected to have contracted it at the forum. Conclusion Conducting a mass gathering during a crisis required closely following guidance from local public health authorities, constant and clear communication with attendees, and employing practical risk mitigation strategies.
To read the full journal article: https://pubmed.ncbi.nlm.nih.gov/33527047/
Limbachia J, Owens H, Matean M, et al. (December 29, 2020) Organizing a Mass Gathering Amidst a Rising COVID-19 Public Health Crisis: Lessons Learned From a Chinese Public Health Forum in Vancouver, BC. Cureus 12(12): e12365. DOI 10.7759/cureus.12365
Barriers and Facilitators to Accessing Digital Health Tools Faced by South Asian Canadians in Surrey, British Columbia: Community-Based Participatory Action Exploration Using Photovoice
Abstract:
Background: South Asian community members in Canada experience a higher burden of chronic disease than the general population. Digital health innovations provide a significant opportunity to address various health care challenges such as supporting patients in their disease self-management. However, South Asian community members are less likely to use digital tools for their health and face significant barriers in accessing them because of language or cultural factors. Objective: The aim of this study is to understand the barriers to and facilitators of digital health tool uptake experienced by South Asian community members residing in Canada. Methods: This study used a qualitative community-based participatory action research approach. Residents from Surrey, British Columbia, Canada, who spoke 1 of 4 South Asian languages (Hindi, Punjabi, Urdu, or Tamil) were invited to participate in focus group discussions. A subsample of the participants were invited to use photovoice methods in greater depth to explore the research topics. Results: A total of 197 participants consented to the focus group discussions, with 12 (6.1%) participating in the photovoice phase. The findings revealed several key obstacles (older age, lack of education, and poor digital health literacy) and facilitators (social support from family or community members and positive attitudes toward technology) to using digital health tools. Conclusions: The results support the value of using a community-based participatory action research approach and photovoice methods to engage the South Asian community in Canada to better understand digital health competencies and needs. There were several important implications for policy makers and future research, such as continued engagement of community leaders by health care providers and administrators to learn about attitudes and preferences.
To read the full journal article: https://pubmed.ncbi.nlm.nih.gov/35023842/
Hyman A, Stacy E, Mohsin H, Atkinson K, Stewart K, Novak Lauscher H, Ho K
Barriers and Facilitators to Accessing Digital Health Tools Faced by South Asian Canadians in Surrey, British Columbia: Community-Based Participatory Action Exploration Using Photovoice
J Med Internet Res 2022;24(1):e25863 (Funded by Vancouver Foundation)
Digital storytelling and dialogue to support culturally safe health care for Indigenous patients in British Columbi
Abstract:
The interCultural Online Health Network (iCON) at the University of British Columbia has been collaborating since 2010 with health authorities and Indigenous communities across the province to support the integration of traditional medicine practices into Western primary care and acute care settings. This is being done to fulfill recommendations contained in health policy frameworks and strategic documents, including the Truth and Reconciliation Commission report, the United Nations Declaration of the Rights of Indigenous Peoples, and the BC Declaration on Commitment to Cultural Safety and Humility in Health Services. With the help of an advisory committee, a video and a discussion guide were produced in 2016. The video features the stories, experiences, and insights of individuals who have used traditional medicine in different health care settings. A workshop was organized to share the video and guide with patients and communities. This event focused on identifying gaps and barriers within regions and the wider system and on proposing actions to enable change. Participant recommendations were grouped according to whether the actions proposed could be taken at the individual, advocacy, community, or health care system level. The iCON team continues to cohost discussions designed to share learnings and engage communities, administrators, decision-makers, and policymakers in transforming the health system to better serve all British Columbians. The team welcomes feedback about experiences with traditional healing practices and efforts made to improve access to culturally safe health care for Indigenous patients in BC.
To read the full journal article: https://bcmj.org/articles/digital-storytelling-and-dialogue-support-culturally-safe-health-care-indigenous-patients
Hyman A, Stacy E, Atkinson K, Novak Lauscher H, Rabeneck J, Oleman G, Cooper P, Young W, Kellman C, Ho K. Digital storytelling and dialogue to support culturally safe health care for Indigenous patients in British Columbia. BCMJ, vol. 62 , No. 3 , April 2020 , Pages 94-97
Testing a school-based program to promote digital health literacy and healthy lifestyle behaviours in intermediate elementary students: The Learning for Life program
Abstract:
Promoting digital health literacy and healthy lifestyle behaviours in children can lead to positive long-term health outcomes and prevent chronic diseases. However, there are few school-based interventions promoting this education to intermediate elementary students. The objective of this study was to test the effectiveness of a novel intervention to increase students’ digital health literacy and health knowledge. Learning for Life is a classroom-based education program, developed for grade 4-7 students and delivered by teachers over six weeks. Three Canadian schools were recruited to deliver the intervention in 2018. This study had a pre-post design and no control group. Students’ self-reported digital health literacy and healthy lifestyle behaviours were measured at pre-intervention (n = 126), post-intervention (n = 119), and two-month follow-up (n = 104). Students at pre-intervention had a mean (SD) age of 10.98 (0.56) years (57.1% females). Almost all (97%) students had unsupervised access to the Internet through a computer or smartphone. From pre- to post-intervention, students’ digital health literacy increased (p = 0.009), but decreased from post-intervention to follow-up (p < 0.001). Post-intervention, the majority of students could identify at least one healthy behaviour (e.g., exercising one hour/day) and reported making at least one healthy change in their lives (e.g., eating more fruits/vegetables). This study demonstrated that the Learning for Life intervention can improve intermediate elementary students’ digital health literacy over the short-term and help them learn and retain healthy lifestyle knowledge and behaviours. These findings affirm the need for interventions promoting digital healthy literacy and healthy lifestyle behaviours for this age group.
To read the full journal article: https://pubmed.ncbi.nlm.nih.gov/32670779/
Hyman A, Stewart K, Jamin A, Novak Lauscher H, Stacy E, Kasten G, Ho K. Testing a school-based program to promote digital health literacy and healthy lifestyle behaviours in intermediate elementary students: The Learning for Life program. Preventive Medicine Reports Volume 19, September 2020, 101149 (Funded by Lawson Foundation)
Let's Talk About B: Barriers to Hepatitis B Screening and Vaccination Among Asian and South Asian Immigrants in British Columbia
Abstract:
Introduction: Chronic hepatitis B (HBV) is prevalent among Asian immigrants in Canada with high morbidity and mortality rates. While some studies have identified barriers to health care and information access, few have studied the impact of culturally relevant information and addressed challenges with recommendations for effective public education and outreach programs. Methods: Culturally tailored HBV education workshops were delivered over a 12-month period to Chinese, Filipino, Korean and Punjabi immigrants in Lower Mainland, British Columbia (BC). Data from pre- and post-workshop surveys and 2-week and 1-month follow-up interviews were collected and analyzed to evaluate knowledge gaps and challenges around HBV prevention and screening. Barriers, health care service gaps and facilitators identified in the interviews were coded and analyzed. Results: Data were collected from 827 workshop participants. Our results show that targeted immigrants in Lower Mainland, BC face many barriers to accessing HBV screening and vaccination. Limited knowledge and awareness of HBV vaccination/prevention/treatment, limited English proficiency and eLiteracy skills, system and provider level barriers to accessing HBV care, and immigration related barriers are among the reported challenges. More than half of participants who took part in the HBV education workshops engaged in actions related to HBV prevention or management. Conclusion: Study findings support the need for culturally tailored HBV public education and outreach programs to further advance HBV immunization and awareness in BC. Addressing barriers and developing targeted programmatic strategies identified in this study will promote more effective HBV education programming and improve uptake of HBV screening and vaccination in BC’s immigrant populations.
To read the full journal article: https://pubmed.ncbi.nlm.nih.gov/29557047/
Zibrik, L., Huang, A., Wong, V. et al. Let’s Talk About B: Barriers to Hepatitis B Screening and Vaccination Among Asian and South Asian Immigrants in British Columbia. J. Racial and Ethnic Health Disparities 5, 1337–1345 (2018). https://doi.org/10.1007/s40615-018-0483-0 (Funded by SUCCESS)
mobile Digital Access to a Web-enhanced Network (mDAWN): Assessing the Feasibility of Mobile Health Tools for Self-Management of Type-2 Diabetes
Abstract:
The mobile Digital Access to a Web-enhanced Network (mDAWN) program was implemented as an online, mobile self-management system to support patients with type-2 diabetes and their informal caregivers. Patients used wireless physiological sensors, received text messages, and had access to a secure web platform with health resources and semi-facilitated discussion forum. Outcomes were evaluated using (1) pre and post self-reported health behavior measures, (2) physiological outcomes, (3) program cost, and (4) in-depth participant interviews. The group had significantly decreased health distress, HbA1c levels, and systolic blood pressure. Participants largely saw the mDAWN as providing good value for the costs involved and found the program to be empowering in gaining control over their diabetes. mHealth programs have the potential to improve clinical outcomes through cost effective patient-led care for chronic illness. Further evaluation needs to examine integration of similar mHealth programs into the patient-physician relationship.
To read the full journal article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765618/
Ho K, Newton L, Boothe A, Novak-Lauscher H. mobile Digital Access to a Web-enhanced Network (mDAWN): Assessing the Feasibility of Mobile Health Tools for Self-Management of Type-2 Diabetes. AMIA Annu Symp Proc. 2015 Nov 5;2015:621-9. PMID: 26958197; PMCID: PMC4765618. (Funded by Lawson Foundation)
Using social media to reach Chinese and South Asian communities in British Columbia: the story of a peer–led diabetes prevention programme on Facebook
Abstract:
Minority populations can face cultural and accessibility barriers when seeking education and support for diabetes self–management. While culturally adapted education programmes have been studied, it has not been combined with the benefit of peer–support and the accessibility of social media. This project aimed to create and assess the feasibility, acceptability, and usability of a peer–led, culturally relevant diabetes prevention programme to be delivered over a popular social networking platform, Facebook, using mixed methods. Six participants of Chinese and South Asian ethnicities completed the 12–week programme led by a peer leader for each group. Interviews and scales were conducted before, during, and after the programme. Results indicated that the delivery of health information over Facebook is feasible and acceptable for those who are comfortable with social media. The peer leaders were engaged and the ability to view discussions was useful, though a larger group would have led to more robust discussions.
To read the full journal article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4765618/
Amari E, Barry R, Chong X, Novak Lauscher H, Ho K. Using social media to reach Chinese and South Asian communities in British Columbia: the story of a peer-led diabetes prevention programme on Facebook. International Journal of Social Media and Interactive Learning Environments (IJSMILE), Vol. 3, No. 1, 2015 (Funded by Public Health Agency of Canada)
Patient and community centered eHealth: Exploring eHealth barriers and facilitators for chronic disease self-management within British Columbia's immigrant Chinese and Punjabi seniors
Abstract:
Objectives: While eHealth – the transfer of health care and health resources via information and communication technologies – has been recognized for increasing access to and quality of health services, not all eHealth interventions have been successful in reaching and engaging patients. eHealth uptake is often stunted by sociotechnical challenges, misalignment between designs and user needs/realities as well as other adoption barriers specific to vulnerable and at-risk populations including immigrants and seniors. This paper is a case study examination of barriers and enablers to using eHealth for chronic disease self-management within British Columbia’s immigrant Chinese and Punjabi senior populations. Outlined policy recommendations address the unique challenges these populations face in accessing and using online tools for self-management and health improvement. Methods: 896 participants were surveyed at nine Chinese and Punjabi public health education events in British Columbia in 2013 and 2014. The eHealth Literacy Scale (eHEALS) and focus groups were used to assess eHealth literacy. Descriptive and ordinal logistic regression analyses were conducted on the data sets. Results: Findings reveal that age, gender, income and education are significantly related to eHEALS outcomes. Language, accessibility, attitude and cultural barriers compound eHealth literacy barriers in these populations. Conclusion: eHealth tools for self-management must be culturally-tailored and designed to serve diverse populations. These tools must be designed to meet users’ needs and address their challenges related to language, culture, accessibility, and literacy levels. Partnership with community organizations is an appropriate platform to facilitate eHealth driven knowledge translation within multicultural communities.
To read the full journal article: https://www.researchgate.net/publication/283897254_Patient_and_community_centered_eHealth_Exploring_eHealth_barriers_and_facilitators_for_chronic_disease_self-management_within_British_Columbia’s_immigrant_Chinese_and_Punjabi_seniors
Zibrik L, Khan S, Bangar N, Stacy E, Novak Lauscher H, Ho K. Patient and community centered eHealth: Exploring eHealth barriers and facilitators for chronic disease self-management within British Columbia’s immigrant Chinese and Punjabi seniors. Health Policy Technol., 4 (4) (2015), pp. 348-356
iCON: Supporting Chinese and South Asian BC citizens for optimal self-management
To read the full journal article: https://bcmj.org/articles/digital-storytelling-and-dialogue-support-culturally-safe-health-care-indigenous-patients
Zibrik L, Khan S, Novak Lauscher H, PhD Cheema G, B. Ho B, J. Bains J, Harper C, Ho K. iCON: Supporting Chinese and South Asian BC citizens for optimal self-management. BCMJ, vol. 57, No. 6, July August 2015, pp. 244-245
InterCultural Online Health Network (iCON): Technology: Enabled wellness support for dementia patients and caregivers
To read the full journal article: https://journal.gerontechnology.org/archives/1245-1245-1-PB.pdf
Ho, H. Novak Lauscher, E. Stacy, R. Jagdis (2010). InterCultural Online Health Network (iCON): Technology: Enabled wellness support for dementia patients and caregivers. Gerontechnology, 9(2), 215-215 https://doi.org/10.4017/gt.2010.09.02.296.00