评估一个文化定制的公共卫生论坛在提高中国人口对慢性病管理的知识和理解方面的作用:一项混合方法研究

J. Limbachia, Hollis Owens, Maryam Matean, Imelda Suen, Sophia Khan, Helen Novak-Lauscher, B. Ho, K. Ho
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摘要

背景:慢性病管理对少数民族来说充满了许多挑战。在非多元文化人群中进行的研究表明,患者和社区参与的举措可以改善慢性病管理实践。然而,关于特定文化的社区参与项目的文献相对较少。跨文化在线健康网络(iCON)是一个针对文化的、患者和社区参与的健康促进计划,为不列颠哥伦比亚省的多元文化社区提供特定文化的健康教育。我们旨在评估iCON 2020中国健康论坛是否能够提高不列颠哥伦比亚省温哥华华人社区对慢性病自我管理的知识和理解。方法:我们进行了一项连续的混合方法研究,通过使用前后验证的问卷,然后在论坛结束后一个月和两个月进行半结构化访谈。我们使用配对t检验评估了论坛后自我效能感得分差异的主要结果,并通过半结构化访谈的主题分析进一步阐明了我们的研究问题。结果:在参加健康论坛的381名参与者中,131人同意完成前和/或后调查,7人同意参加后续访谈。论坛前和论坛后的自我效能感得分存在统计学显著差异(平均差异=0.58,S.D.=1.42;[95%CI:0.26-0.90],t(77)=3.60;P=0.001,d=0.41)。与会者将健康论坛的有效性归因于其可访问但引人入胜的方案编制和对有文化特色的健康教育的关注。结论:一项针对文化的、患者参与和社区外展计划有效地提高了中国社区成员在管理慢性病方面的自我效能,受到了参与者的好评。iCON的2020中国健康论坛为类似的针对特定文化的健康教育和社区参与计划提供了一个模式和相关的方法原则,这些计划需要制定,以减轻多元文化人群的慢性病负担。
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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
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.
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