iCON: Supporting Chinese and South Asian BC citizens for optimal self-management

Health research has consistently demonstrated that active patient engagement and participation in chronic disease self-management results in significant and measurable health outcome improvements.[1] However, cultural minorities can be disadvantaged in accessing information and services to support them in their optimal self-management,[2,3] limited by their ability to fully participate in their health care due to barriers in language, literacy levels, and lack of culturally relevant health resources.[2-6] To bridge the health care disparities in British Columbia, the UBC Faculty of Medicine eHealth Strategy Office launched the Inter-Cultural Online Health Network (iCON) in 2007.

What is iCON?
The Inter-Cultural Online Health Network supports multicultural communities, patients, and caregivers across BC to optimize chronic disease prevention and self-management.[7-9] We work in partnership with the BC Ministry of Health Patients as Partners initiative, health authorities, and community health professionals to advance patient- and family-centred care. Together with other programs within the Patients as Partners network, iCON supports patients and families to become active in self-care and engage in health care improvement. For more information see the BC Ministry of Health Patients as Partners Annual Report, 2012–2013 (www.patientsaspartners.ca/sites/default/files/attachments/2012-annual_report_digital.pdf).

Through skills-building workshops and public health forums, we provide culturally relevant and language-appropriate health information on a variety of chronic diseases along with resources to help patients and families navigate the BC health system. To reach a wider audience, health information is also shared via webcasts, a website (iconproject.org), and community television and radio programming.

Since 2007 iCON has hosted 28 public health forums and workshops with Chinese- and Punjabi-speaking communities on a range of health topics. These events have engaged over 14 260 in-person and webcast participants, and have attracted 94 428 unique visitors to the website (61% of whom are unique first-time users).

What does iCON do?
With the goal of helping patients improve health outcomes through behavior change, risk reduction, and lifestyle modification, iCON’s delivery model focuses on four pillars to ensure programming is responsive to community needs:

Culturally tailored outreach
iCON features culturally adapted programming in the community’s native language to improve access to chronic disease management education. 

Partnerships and collaboration
iCON collaborates with community health care providers along with partners from health authorities, community organizations, educational institutions, government, and media to promote best practices in chronic disease prevention and management. iCON also partners with students and health professional trainees to design and deliver community outreach activities while gaining insight into culturally competent care. 

Evaluation
Anchoring on the Institute for Healthcare Improvement’s triple-aim framework,[10] iCON measures program impact on patients and mobilization, tracking patient activation, intention for behavior change, and e-health literacy for self-care over time.

Health information technology in patient self-management
iCON works with communities to assess the preparedness of individuals to adopt e-health, such as appropriately using web-based health information for chronic disease prevention and self-management (e.g., 8-1-1 HealthLinkBC, health apps, and the myehealth.ca portal). Our programming integrates activities to build e-health awareness, raise e-health literacy levels, and share best practices in using e-health tools to support health and wellness. 

Interested in getting involved?
We invite all readers, doctors, and practitioners in BC who are interested in supporting our multicultural populations in their excellence in health and wellness to get in touch. How can we work together to optimally engage community members and their families and actualize patient-centred, family-focused, and community-engaged care in BC? We welcome your thoughts and participation. For further information contact Dr Kendall Ho via e-mail at Kendall.Ho@ubc.ca or at 604 875-4111, ext. 6-9153.

References

1.    Gordon C, Galloway T. Review of findings on chronic disease self-management program (CDSMP) outcomes: Physical, emotional, health-related quality of life, healthcare utilization and costs. Centers for Disease Control and Prevention and National Council on Aging, 2008. Accessed 2 February 2015. http://patienteducation.stanford.edu/research/Review_Findings_CDSMP_Outc....
2.    Bacigalupe G, Askari S. e-Health innovations, collaboration, and healthcare disparities: Developing criteria for culturally competent evaluation. Fam Syst Health 2013;31:248-263.
3.    Montague E, Perchonok J. Health and wellness technology use by historically underserved health consumers: Systematic review. J Med Internet Res 2012;14:e78.
4.    Clarke G, Yarborough BJ. Evaluating the promise of health IT to enhance/expand the reach of mental health services. Gen Hosp Psychiatry 2013;35:339-344.
5.    Hardiker NR, Grant MJ. Factors that influence public engagement with eHealth: A literature review. Int J Med Inform 2011;80:1-12.
6.    Hilty DM, Ferrer DC, Parish MB, et al. The effectiveness of telemental health: A 2013 review. Telemed J E Health 2013;19:444-454.
7.    Novak Lauscher H, Stacy E, Cordeiro J, et al. Perceptions of electronic personal health records and the connection to self-care: Considerations for design and implementation within a multicultural population. Technology Enabled Knowledge Translation for eHealth: Principles and Practice. New York: Springer; 2012. p. 189-207.
8.    Novak Lauscher H, Stacy E, Ho K. iCON–multicultural public health education: Bringing the latest on dementia to Metro Vancouver communities. Visions 2010;6:20. 
9.    Ho K, Novak Lauscher H, Stacy E, et al. InterCultural Online Health Network: Technology enabled wellness support for dementia patients and caregivers. Gerontechnology 2010;9:215.
10.    Berwick, DM, Nolan TW, Whittington J. 2008. The triple aim: Care, health, and cost. Health Aff 2008;27:759-769.

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Ms Zibrik is a research project manager for the Inter-Cultural Online Health Network (iCON). Ms Khan is the iCON project manager. Dr Novak Lauscher is assistant director of research in the eHealth Strategy Office. Dr Cheema is a clinical instructor for the Department of Family Practice at UBC and medical director for the iCON South Asian Division. Ms Ho is health director of the iCON Chinese Division. Mr Bains is health director, public engagement, and community liaison for the iCON South Asian Division, and the provincial coordinator of South-Asian Chronic Disease and Diabetes Self-Management Programs with the University of Victoria Centre on Aging. Ms Harper is the provincial director for Patients as Partners with the BC Ministry of Health. Dr Ho is a practising emergency medicine specialist, founding director of the eHealth Strategy Office, and a professor with the UBC Department of Emergency Medicine.