Lessons learned in engaging Chinese and South Asians in mental health dialogue in B.C

Dr. Kendall Ho, MD FRCPCAssociate Professor, Emergency MedicineDirector, eHealth Strategy Office

CCMH

S Conference October 6th, 2011

2

“Dizzy Gillespie”: lessons

• They're not particular about whether you're playing a flatted fifth or a ruptured 129th as long as they can dance to it.

• How do you know they like your music? If I got their toes tapping, then I know I’ve got them

Essence of

Engagement

Agenda

• Describe “iCON”• Commonly queries• Insights and paths forward• Questions, Discussion

Language & the Web

Effective:English

Chronic Disease mxTechnological literacyAccurate information

Chinese & Punjabi?UntestedLanguage barriersTechnical challengesSources of informationSocio-cultural factors

Understanding the Problem• Accurate & quality health information

• Enable self-care & health partnerships– Impact on chronic disease management– Health consumers & health professionals– Between generations & care givers– Peer to peer

• Serving multicultural public– Internet language marginalization– Computer skills– Hunger for health knowledge

InterCultural Online Health Network (iCON)

1. Provide 24/7 access to culturally relevant health information to support self management & wellness

2. Use multi-channel engagement to reach a variety of community members’ needs/ preferences

3. Unique technological opportunities to support mental wellness

Common Queries

evaluation

Diabetes events & on line 2010-11

• sample size• Over 138,000 data points

• Meaningful translations• Strong Parallel Reliability

between languages

• Variety of available avenues of analysis

415 Punjabi

256Chinese

671Surveys

Demographic Profile

Punjabi Forums: Sex and Age Chinese Forums: Sex and Age

Common Queries

1. Is there interest?

11Health Forum, Vancouver

http://www.cbc.ca/video/#/News/Canada/BC/1258521056/ID=1757875862

Live Forum ComponentLanguage/Community Topic When Reach

Chinese – Vancouver Diabetes Sep 2007 ~700

Chinese – Vancouver Healthy Heart Apr 2008 ~1000

Chinese – Vancouver Dementia Oct 2008 ~700

Punjabi – Surrey Dementia Mar 2009 ~750

Chinese – Vancouver Liver Disease Nov 2010 ~1450

1. Community “health fair” – open house, familiar setting2. Community based interprofessional panel, Q&A 3. Volunteers – students and community4. Companion website links to live event in various ways

Public Engagement - Highlights

• Approx 95% of the surveys turned in first language

• Female 65% Male 35%

• Average 65 years (youth to late 90s)

Health Status

Punjabi: Diabetes Status

Chinese: Diabetes Status

Not Diabetic46%

Pre-Diabetic24%

Diabetic29%

N = 241

Not Diabetic51%

Pre-Diabetic10%

Diabetic39%

N = 410

Common Queries

1. Is there interest?2. Would the Internet be useful?

Internet SkillsPunjabi: Internet Skills byEnglish Language skills

Chinese: Internet Skills byEnglish Language skills

www.iconproject.org42,958

as of 8/2011

Live Forum – “e” OutreachLanguage/Community Topic When Reach at Event

Chinese VC workshop – Van, PG, Victoria, Kelowna

Diabetes Jun 2010 ~125

Punjabi VC workshop – Van, New West, PG Diabetes Jun 2010 ~125

Punjabi live and webcast – Surrey Diabetes Nov 2010 ~900 + 294

Chinese live and webcast –Vancouver Diabetes Dec 2010 ~750 + 744

Chinese live and webcast – Richmond Mental Health Mar 2011 ~1100 + 373

Punjabi live and webcast – Abbotsford Diabetes/Mental Health

Mar 2011 ~450 + 168

Punjabi live and webcast - Kelowna Diabetes Oct 2011 ~300 + 15

1. Videoconference pilots – FoM and Health Authority VC sites2. Webcast to the whole province and beyond3. Connecting with social media

Blogging & texting

Common Queries

1. Is there interest?2. Would the Internet be useful?3. Would self management apply?

Findings: Motivation to ActionWhat motivates self care?

• Desire to be an “informed patient”• Desire to learn more about prevention and

symptoms of illnesses• Recognition of limited access to time with

physicians

Findings: What does Self Care Mean?• Trying to make healthy choices but need culturally relevant

resources available in own language• Becoming better informed so they will “use the system

less”• Having sufficient knowledge to be conversant with health

professionals• Helping family members care for themselves

“The problem with doctors is that we only go for a check-up once, but our condition may change before or after, even if we are well at our appointment…and he says “ok” – we don’t know for sure….”

Necessary Ingredient: Culturally relevant resources available

in own language

Common Queries

1. Is there interest?2. Would the Internet be useful?3. Would self management apply?4. Would this motivate change?

Feedback• Surveys indicated that the events stimulated

participants’ willingness for positive behavioural change

“I’ll change the way I would cook my food, change my lifestyle.”

Over 90% indicated they will attend the

next event

95% responded that the forum provided new

information they will use to help cope with stress or

worry

www.iconproject.org

Mental Health: CMHA Synergy

• March 5, 2011: Aberdeen Mall, Richmond• Chinese Bounce Back program collaboration

DVD: Skits

Common situations• Immigration,isolation• Chidren’s future/Internet• Relationships, care giving• Chronic diseases, own

health

Recognition, mx skills, seek help

What’s the Magic?

• Flour• Butter• Milk• Eggs• Sugar• Salt• Yeast

Success in Virtual Engagement

eKnowledge

ePresence

eTrust

Stepwise Strategy: 4 yr journey…

1. Create in-person forums2. Establish on line presence3. Introduce on line tools4. Add virtual interactivity

Building Partnerships

iCON: What’s Next?• New content areas….Navigating the system,

Informing the system, other?• Building on social media, social drama and other

“channels”• Mobile phone communication• Opportunity to co-create “e-Peer support”• Engaging health professional trainees

“…And what can you add to a classic? Your passionate interpretation to keep it even more contemporary.”

Lang Lang

in Mont Blanc Ad

eOpportunities for Mental Health

• Understanding the virtual social reality• Appreciating the cultural perspectives• Identifying tactics of intervention• Plan, Do, Study, Act• Engage the audience to co-create• Create modern classics in mental wellness!

AcknowledgmentsCo-authors•Helen Novak Lauscher•Sophia Khan•Eizabeth Stacy•Nelson Shen•Janice Tian

Funding Support•BC Ministry of Health Services•Lawson Foundation•Public Health Agency of Canada•Canadian Health Services Research Foundation•Irving K Barber Learning Centre, UBC

Thank you to our partners, community sponsors, volunteers, and the eHealth Strategy Office staff team

PartnersProvincial Health Services AuthorityFraser Health AuthorityVancouver Coastal Health AuthoritySUCCESS Canadian Mental Health Association, Bounce BackHealthLink BCSafeway PharmacyOmni TelevisionAberdeen CentreFairchild TelevisionFairchild RadioCanadian Diabetes AssociationMing PaoTsing TaoDepartment of Medicine, UBC Telus CorporationUBC Learning Circle

e H e a l t h S t r a t e g y O f f i c e

Web: www.eHealth.med.ubc.caFacebook: on.fb.me/ehealthstrategyTwitter: www.twitter.com/ehealhtstrategy