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

Background: 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.   Methods: We conducted a sequential mixed-methods study by administering pre- and post- validated questionnaires, followed by semi-structured interviews conducted one-two months after the forum. We assessed our primary outcome of difference in self-efficacy scores post-forum using paired t-tests and further illuminated our research question through a thematic analysis of the semi-structured interviews.   Results: From the 381 participants that attended the Health Forum, 131 consented to completing the pre- and/or post- surveys, and seven provided consent to participate in the follow-up interview. There was a statistically significant difference in self-efficacy scores pre- and post- forum participation (Mean difference = 0.58, S.D. = 1.42; [95% CI: 0.26 – 0.90], t(77) = 3.60; P = 0.001, d = 0.41). Participants attributed the effectiveness of the Health Forum to its accessible yet engaging programming and focus on culturally tailored health education.   Conclusion: A culturally tailored, patient engagement and community outreach program effectively improved Chinese community members self-efficacy in managing their chronic diseases and was well received by participants. iCON’s 2020 Chinese Health Forum presents a model with associated principles of approach for similar culturally specific health education and community engagement programs that need to be developed to reduce the burden of chronic diseases in multicultural populations.