Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study

Leung, Angela Yee Man; Bo, Ai; Hsiao, Hsin-Yi; Wang, Song Song; Chi, Iris

doi:10.1136/bmjopen-2014-005294

Cited by 50 publications

(60 citation statements)

References 24 publications

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“…Many cultures are hierarchical in nature, with health practitioners having elevated, respected positions. For example, Chinese people will often refrain from asking health practitioners questions, believing that asking questions is impolite as it is perceived as "challenging doctors and nurses" or "putting burden on these professionals" [29]. A similar phenomenon was observed in many Chinese societies including Hong Kong, Taiwan and Chinese communities in Los Angeles, USA [29].…”

Section: Traditional Vs Western Cultures: Dissimilarities In Health mentioning

confidence: 95%

“…For example, Chinese people will often refrain from asking health practitioners questions, believing that asking questions is impolite as it is perceived as "challenging doctors and nurses" or "putting burden on these professionals" [29]. A similar phenomenon was observed in many Chinese societies including Hong Kong, Taiwan and Chinese communities in Los Angeles, USA [29]. Cultural preferences and lack of understanding of Western medicine can lead to delays in the diagnosis of important health conditions.…”

Section: Traditional Vs Western Cultures: Dissimilarities In Health mentioning

confidence: 97%

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Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective

Levin-Zamir

Leung

Dodson³

et al. 2017

ISU

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Abstract. International and cultural perspectives of health literacy help deepen the understanding of the global context within which health literacy plays an important role. Throughout this article, we explore the significance of health literacy initiatives, interventions, practices, and research for addressing health challenges on a variety of levels in the international and global context. More specifically, the notion of health literacy as a dynamic construct is introduced, after which we examine health literacy throughout the life course, emphasizing the impact of health literacy among children and the elderly in their families and in the community. Cultural norms and family interpersonal relations, and values influence health literacy and need to be considered when closing the health literacy disparities. Global trends of migration and immigration bring to the forefront the need for unravelling the complexity of health systems, for which health literacy plays a central role; health literacy initiatives address cultural differences between providers and patients to help narrow the communication gap. The importance of cultural competency among health care providers exemplifies how capacity building in health literacy is critical for maximizing the benefits to the public of the health care system. Health literacy provides a conceptual foundation for community participatory research, involving members of the public to take part in the planning, execution and evaluation of health education interventions. Selected case studies and picture boxes from around the globe, exemplify aforementioned topics of interest. Practical recommendations for policy makers, practitioners and research are offered based on the studies conducted in the international context.

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Section: Traditional Vs Western Cultures: Dissimilarities In Health mentioning

confidence: 95%

Section: Traditional Vs Western Cultures: Dissimilarities In Health mentioning

confidence: 97%

Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective

Levin-Zamir

Leung

Dodson³

et al. 2017

ISU

Self Cite

View full text Add to dashboard Cite

show abstract

“…Such monitoring could include assessment of medications adherence or cultural perceptions/acceptance regarding available therapies. 39 Protective associations noted for speakers with limited English proficiency compared with English speakers in the more complex disease groups compared with the DM-only group (ie, HbA1c at the index date in the DM ϩ DEP group and trajectory differential for the DM ϩ CVD group) may reflect more intensive monitoring or increased access to and effectiveness of culturally appropriate enabling services.…”

Section: Discussionmentioning

confidence: 99%

Impact of Social Determinants of Health on Patients with Complex Diabetes Who Are Served by National Safety-Net Health Centers

McBurnie

Simon

et al. 2016

The Journal of the American Board of Family Medicine

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Objective: Recent research demonstrates an increased need to understand the contribution of social determinants of health (SDHs) in shaping an individual's health status and outcomes. We studied patients with diabetes in safety-net centers and evaluated associations of their disease complexity, demographic characteristics, comorbidities, insurance status, and primary language with their HbA1c level over time.Methods: Adult patients with diabetes with at least 3 distinct primary care visits between January 1, 2006, and December 31, 2013, were identified in the CHARN data warehouse. These patients were categorized into 4 groups: those without a diagnosis of cardiovascular disease (CVD) or depression; those with CVD but not depression; those with depression but not CVD; and those with CVD and depression. Charlson score; demographic characteristics such as age, sex, and race/ethnicity; and SDHs such as primary language and insurance status were used as predictors. The outcome measure was HbA1c. Hypothesis testing was conducted using 3-level hierarchical linear models.Results: Baseline HbA1c differed significantly across the 4 diabetes groups and by race/ethnicity. The amount of HbA1c change over time differed by insurance status. Patients who were continuously insured tended to have lower baseline HbA1c and a smaller increase. Chinese-speaking patients tended to have lower baseline HbA1c but a larger increase over time compared with English speakers. There were various unexpected associations: compared with the diabetes-only group, mean HbA1c tended to be lower among the other more complex groups at baseline; women tended to have lower measures at baseline; older age and higher Charlson scores were associated with lower HbA1c.Conclusions: There is still unexplained variability relating to both baseline HbA1c values and change over time in the model. SDHs, such as insurance status and primary language, are associated with HbA1c, and results suggest that these relationships vary with disease status among patients with diabetes in safety-net centers. It is important to recognize that there are complex relationships among demographic and SDH measures in complex patients, and there is work to be done in correctly modeling and understanding these relationships. We also recommend prioritizing the collection of SDH and enabling services data for safety-net patients that would be instrumental in conducting a more comprehensive study. 3-7 Interest in studying and describing SDHs has increased over the past few decades, 8 -10 and it is clear that SDHs are associated with suboptimal health status or poor health-related outcomes, 11 such as higher rates of mental disorders and medical conditions. 12 In a meta-analysis conducted by Lorant and colleagues, 13 people with a low socioeconomic status were 1.8 times more likely to report being depressed than were people with higher status. Lett et al 14 also found that low social support was associated with a 1.5-to 2-times increased the risk of developing coronary heart disease or ex...

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“…In some developing countries, lack of a health insurance system was one of the predictors of irrational antibiotic use (71). Also, low insurance cover may affect migrants' access to health information (211,212). This suggests that the uptake of private insurance coverage could be a socio-economic indicator among migrant populations.…”

Section: Private Health Insurance Coveragementioning

confidence: 99%

“…Therefore, doctors, adult children, local television, spouse, local newspaper and radio were the most important health information sources (214). It has been reported that Chinese migrants in the USA found the translation of health education materials to be culturally and linguistically inappropriate and hence of limited use (211). It is important to understand the ways that migrants seek and access health information, also, the quality of health information accessed through various sources, including family and friends and online searching, should be further studied.…”

Section: Channels Of Health Information Seekingmentioning

confidence: 99%

Antibiotic utilisation amongst Australian Chinese migrants: a web-based bilingual health survey

Hu¹

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Health literacy issues in the care of Chinese American immigrants with diabetes: a qualitative study

Cited by 50 publications

References 24 publications

Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective

Health literacy in selected populations: Individuals, families, and communities from the international and cultural perspective

Impact of Social Determinants of Health on Patients with Complex Diabetes Who Are Served by National Safety-Net Health Centers

Antibiotic utilisation amongst Australian Chinese migrants: a web-based bilingual health survey

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