Abstract
Background
Immigrant populations often have poor access to cardiovascular disease (CVD) secondary prevention due to linguistic and cultural barriers. Web-based interventions are effective in risk reduction and lifestyle modification and may reach those hard-to-reach populations such as Chinese immigrants. However, less is known about the current use of web-based health information and confidence in use.
Purposes
We compared the use of web-based health information and confidence in use between Chinese immigrants with CVD to those with and without another chronic condition; and explored the factors associated with the confidence in utilization.
Methods
Chinese immigrants with CVD, musculoskeletal conditions, or no chronic condition were recruited from Chinese communities across New South Wales, Australia. E-health literacy scale was used to explore the perceptions of web-based health information and confidence in use. Demographic, clinical data and use of web-based health information were collected and health literacy was measured using a validated single screening question.
Results
Participants (n = 90 CVD, n = 87 musculoskeletal, n = 154 no chronic conditions) were aged mean 59 ± 16 years, mostly female (69%), 75% reported fair to poor English proficiency, and 51% had completed university. The most accessed web-based health information concerned lifestyle (60%), health resources (45%), diseases (35%), and medications (30%). More than half (54%) were confident in using web-based health information.
Participants with CVD were the oldest (71 vs 65 vs 49 years, p<.001) and participants with any chronic condition had less education (p<.001) and English proficiency (p<.001) than the healthy group. Approximately half of the participants with CVD perceived web-based health information as useful (48%) and important (46%), and the most accessed information concerned lifestyle and medication (56% and 32%). Participants with CVD accessed medication information more often than musculoskeletal group (32% vs 23%), but there was no difference in accessing other information. Both chronic groups showed no difference in accessing web-based medication and lifestyle information compared with the healthy group. Confidence in using web-based health information was similar for CVD and musculoskeletal groups and lower than the healthy group (p<.001).
Participants with the least confidence to use web-based health information were older (p=.016), female (p=.014), had less than university level education (p<.001), and lower health literacy (p=.001) after adjusting for age, gender, education, English proficiency, employment status, social support, health literacy, and number of chronic conditions.
Conclusions
There is a strong potential to provide web-based medication and lifestyle information for Chinese immigrants with CVD if support is provided to improve confidence in this technology for older, women, and those with less education and/or health literacy.
Issues and political implications for health literacy research and practice in South Korea
