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iCON will give Chinese-Canadians customized diabetes information to help them manage the disease or prevent it - photo by Martin Dee
iCON will give Chinese-Canadians customized diabetes information to help them manage the disease or prevent it - photo by Martin Dee

UBC Reports | Vol. 53 | No. 8 | Aug 9, 2007

Cultural Barriers for Diabetes Care

Chinese-Canadians Have New Internet Tool

By Hilary Thomson

Chinese-Canadian diabetes patients will soon have access to customized health information with the launch of a Chinese language web site designed to reflect their unique diet and culture.

Called Chinese Online Health Network (iCON), the two-year project is co-led by UBC Faculty of Medicine Associate Dean Dr. Kendall Ho, director of the Division of Continuing Professional Development & Knowledge Translation; and Dr. Francis Ho, a UBC professor emeritus of Family Practice. The project is patient-driven and aims to create and distribute accurate and quality health information in Chinese for prevention or active self-management of diabetes.

“It’s vital to engage patients as partners in co-managing their disease with their doctor, both to reduce suffering and the significant health-care costs related to diabetes,” says Kendall Ho.

Chinese web-based health information does exist, but there are significant dietary and cultural differences for Chinese-speaking individuals living in Canada, says Ho. A more affluent life in Canada can mean larger meal portions and more processed, high-carbohydrate foods along with traveling via car rather than walking. In addition, elderly Chinese-Canadians may be living alone and experience significant barriers in shopping and preparing their own meals, a situation less common in China or Taiwan.

“Despite Vancouver’s large Asian population, these patients can be quite marginalized,” he says. “We need to reach out to and partner with these patients to help address their unique needs and situations.”

Reliable Internet health information is not necessarily reaching middle-aged and older Chinese-Canadian adults because of affordability of technology, low Internet skills, English language dominance on the Internet and online credibility of sources of Chinese health information, he adds.

From September 2006 to May 2007, the two physicians worked with Dr. Thomas Ho (none of the physicians are related) and Dr. Raymond Mah, along with second-year UBC medical students to create a pilot web site, in partnership with Chinese diabetes patients.

Each of the four students, originally from Hong Kong and Taiwan, visited three patients to ask them about their health and diet and evaluate their knowledge sources and understanding of the disease. They also asked about access to the Internet, their opinion of the usefulness of Chinese-language health information currently available online and perceived barriers to using online information for their own disease self-management.

The interviews were part of course work for the Doctor, Patient and Society block of the medical school curriculum.

Patients also provided feedback on the mock web site and their tips on diet and exercise have been incorporated into site information. An interactive section posts Q&As from patients and physicians and allows for peer-to-peer communication.

“Many patients are unaware of early symptoms of diabetes. They need to take care of themselves -- their destiny is in their hands,” says Francis Ho. “We also want to teach family members how they can help patients manage their disease.”

Third-year medical student Emily Pang says patients were eager to be part of the project, but it was hard to convince non-computer users to adopt the Internet.

“They did not yet realize its potential as an educational and interactive tool,” she says. “I hope this project can change that.” 

An interest in the psychosocial aspects of chronic disease is what motivated third-year med student Edmond Chau to get involved.

“Being fluent in Chinese, I saw the project as an opportunity for me to make a difference for these patients,” he says, adding that it was sometimes challenging to translate medical terms into Chinese to answer patient queries.

“I interviewed patients whose Internet skill ranged from almost non-existent to proficient,” says Chau. “Both groups were interested in using iCON.”

The researchers will be holding a town hall meeting next month to promote the web site and will communicate with physicians via journals and presentations. After further evaluation and development, they hope to collaborate with University of Hong Kong and Fu Dan University in Shanghai to make the web site appropriate for Chinese patients.

“These are exciting opportunities and I’m very grateful that UBC has given us a chance to explore them,” says Kendall Ho.

The web site can be found at www.iconproject.org.

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Last reviewed 10-Aug-2007

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