Health Information Seeking Partially Mediated the Association between Socioeconomic Status and Self-Rated Health among Hong Kong Chinese

Background: Poor self-rated health (SRH) is socially patterned with health communication inequalities, arguably, serving as one mechanisms. This study investigated the effects of health information seeking on SRH, and its mediation effects on disparities in SRH. Methods: We conducted probability-based telephone surveys administered over telephone in 2009, 2010/11 and 2012 to monitor health information use among 4553 Chinese adults in Hong Kong. Frequency of information seeking from television, radio, newspapers/magazines and Internet was dichotomised as <1 time/month and ≥1 time/month. Adjusted odds ratios (aOR) for poor SRH were calculated for health information seeking from different sources and socioeconomic status (education and income). Mediation effects of health information seeking on the association between SES and poor SRH was estimated. Results: Poor SRH was associated with lower socioeconomic status (P for trend <0.001), and less than monthly health information seeking from newspapers/magazines (aOR = 1.23, 95% CI 1.07–1.42) and Internet (aOR = 1.13, 95% CI 0.98–1.31). Increasing combined frequency of health information seeking from newspapers/magazines and Internet was linearly associated with better SRH (P for trend <0.01). Health information seeking from these two sources contributed 9.2% and 7.9% of the total mediation effects of education and household income on poor SRH, respectively. Conclusions: Poor SRH was associated with lower socioeconomic status, and infrequent health information seeking from newspapers/magazines and Internet among Hong Kong Chinese. Disparities in SRH may be partially mediated by health information seeking from newspapers/magazines and Internet

Social Determinants of Health Information Seeking among Chinese Adults in Hong Kong

Background: Health communication inequalities were observed in Western population but less is known about them among the Chinese. We investigated health information seeking behaviours and its social determinants among Chinese adults in Hong Kong. Methods: Probability-based sample surveys over telephone were conducted in 2009, 2010/11 and 2012 to monitor family health and information use. Frequency of health information seeking from television, radio, newspapers/magazines and Internet were recorded and dichotomised as ≥1 time/month and <1 time/month (reference). Logistic regression was used to yield adjusted odds ratios (aOR) of health information seeking for different demographic characteristics, socioeconomic status (education, employment and income), chronic disease and behaviours (smoking, drinking and physical activity). Results: Among 4553 subjects in all surveys, most (85.1%) had sought health information monthly from newspapers/magazines (66.2%), television (61.4%), radio (35.6%) or Internet (33.2%). Overall, being male, lower education attainment, lower household income, ever-smoking and physical inactivity were associated with less frequent health information seeking (all P <0.05). Compared with younger people, older people were less likely to search health information from Internet but more like to obtain it from radio (both P for trend <0.001). Having chronic diseases was associated with frequent health information seeking from television (aOR = 1.25, 95% CI: 1.07–1.47) and Internet (aOR = 1.46, 95% CI: 1.24–1.73). Conclusions: This study has provided the first evidence on health information inequalities from a non-Western population with advanced mass media and Internet penetration. Socioeconomic inequalities and behavioural clustering of health information seeking suggested more resources are needed for improving health communication in disadvantage groups

The teaching of Chinese characters : a case study of Mandarin teachers' understanding of career-long professional learning in the UK

Due to the growing status of Mandarin as a foreign language in schools, the number of Mandarin teachers has been on the rise worldwide in the last decade. However, the development of pedagogical approaches for teaching Mandarin in the UK context is still at its initial stage. Moreover, research shows that there are often inadequate career-long professional learning opportunities for in-service Mandarin teachers. Drawing on interviews and documentary data gathered during a one-day workshop on the teaching of Chinese characters (N=50), this paper reports on Mandarin teachers’ professional learning needs and their perceptions of teaching Chinese characters. The study argues for the importance of re-contextualising metacognition in developing language teachers’ knowledge and understanding about subject specific pedagogy. The findings also hope to contribute to the ongoing discussion on the theoretical and practical issues relating to the interconnectedness between Mandarin teachers’ self-efficacy and career-long professional learning

Challenging Mandarin teachers' pedagogical approaches to the teaching of Chinese characters

While there has been a rise in the demand of learning Mandarin in the United Kingdom in the last decade, the development of teaching Mandarin as a foreign language is still at its initial stage. In particular, research shows that there is inadequate continuous professional learning opportunities for in-service Mandarin teachers. Furthermore, as many of the Mandarin teachers are native-speakers without formal training prior to taking up their posts, they might not have the relevant Mandarin-specific pedagogical knowledge. This study aims to explore the impact of professional learning for Mandarin teachers using an intervention approach. Participants (N=50) will attend a whole day workshop on the teaching of Chinese characters. The workshop will be conducted in England and Scotland. Focusing on understanding teacher efficacy and possible changes of their pedagogical approaches, the data will be collected by administering surveys before and after the workshops and conducting semi-structured interviews of the teachers after the workshop as well as the artefacts developed by these teachers during the workshop. The design of the study was guided by Gregoire’s (2003) cognitive-affective model of conceptual change (CAMCC), which teacher efficacy plays a key role in mediating teachers’ conceptual change by the enhancement of subject knowledge. It is hoped that the findings can reveal the professional learning needs of in-service Mandarin teachers and provide insights into the different ways of improving in-service Mandarin teachers’ efficacy as well as their knowledge and skills of teaching Chinese characters in the classroom

Television Viewing Time in Hong Kong Adult Population: Associations with Body Mass Index and Obesity

Background: Obesity is increasing dramatically in the Asia-Pacific region particularly China. The population of Hong Kong was exposed to modernization far earlier than the rest of China, reflecting conditions that are likely to be replicated as other Chinese cities undergo rapid change. This study examined the relationship between television viewing and obesity in a Hong Kong sample. Information about the relationship between a key sedentary behavior, TV viewing, and obesity, and its moderation by demographic characteristics may identify sectors of the population at highest risk for excess weight. Methods: Data were from Hong Kong Family and Health Information Trends Survey (2009–2010), a population-based survey on the public's use of media for health information and family communication by telephone interviews with 3,016 Hong Kong adults (age≥18 years). TV viewing time, body mass index (BMI), physical activity and other lifestyle variables were analyzed. Results: Viewing time was longer in women, increased with age but decreased with education level and vigorous physical activity (all P<0.01). Longer TV viewing time was significantly associated with higher BMI (Coefficients B = 0.17, 95% CI: 0.11, 0.24) after adjusting for age, gender, employment status, marital status, education level, smoking activity and vigorous physical activity. This association was stronger in women than men (Coefficients B: 0.19 versus 0.15) and strongest in those aged 18 to 34 years (Coefficients B = 0.35). Furthermore, an hour increase in daily TV viewing was associated with 10% greater odds of being obese. Conclusions: A significant socioeconomic gradient in television viewing time was observed. TV viewing time positively associated with BMI and obesity. The TV viewing – BMI associations were strongest in women and young adults, suggesting vulnerable groups to target for obesity prevention by decreasing TV viewing

Anatomic location and mortality of pancreatic adenocarcinoma: A single institution study

In pancreatic adenocarcinoma, it is believed that patients with proximal tumors (head) have earlier diagnosis and higher survival due to anatomic location compared to patients with distal tumors (body/tail). We hypothesized that differences in tumor biology would contribute to poorer survival in body/tail tumors compared to head tumors when diagnosed at the same stage. We performed a retrospective chart review on 324 patients with pancreatic adenocarcinoma (236 head and 88 body/tail) diagnosed from 2011-2017. We gathered electronic health records from a single center with a high volume of pancreatic cancer directed surgery. We compared median patient survival from onset of diagnosis based on cancer staging and tumor location. The overall body/tail cancer survival was significantly less than pancreatic head cancer (11.2 months body/tail compared to 16 months head, p=0.015). When broken down individually by stage at diagnosis or surgery, the survival for body/tail cases was not statistically significant to pancreatic head cases (p\u3e0.05). After adjusting for both stage and surgery, the hazard ratio of body/tail reduced from 1.42 to 0.96. The overall survival of pancreatic head cancer was significantly higher than that of the body/tail cancer, which was attributed to the head group being diagnosed earlier and/or underwent surgery. The head group’s survival advantage diminishes when corrected by stage and surgery and has a similar survival to the body/tail cancer. This result less likely supports a difference in tumor biology on survival

Bringing scientific rigor to community-developed programs in Hong Kong

BACKGROUND: This paper describes efforts to generate evidence for community-developed programs to enhance family relationships in the Chinese culture of Hong Kong, within the framework of community-based participatory research (CBPR). METHODS: The CBPR framework was applied to help maximize the development of the intervention and the public health impact of the studies, while enhancing the capabilities of the social service sector partners. RESULTS: Four academic-community research teams explored the process of designing and implementing randomized controlled trials in the community. In addition to the expected cultural barriers between teams of academics and community practitioners, with their different outlooks, concerns and languages, the team navigated issues in utilizing the principles of CBPR unique to this Chinese culture. Eventually the team developed tools for adaptation, such as an emphasis on building the relationship while respecting role delineation and an iterative process of defining the non-negotiable parameters of research design while maintaining scientific rigor. Lessons learned include the risk of underemphasizing the size of the operational and skills shift between usual agency practices and research studies, the importance of minimizing non-negotiable parameters in implementing rigorous research designs in the community, and the need to view community capacity enhancement as a long term process. CONCLUSIONS: The four pilot studies under the FAMILY Project demonstrated that nuanced design adaptations, such as wait list controls and shorter assessments, better served the needs of the community and led to the successful development and vigorous evaluation of a series of preventive, family-oriented interventions in the Chinese culture of Hong Kong

A Single Academic Center\u27s Experience with Direct Access Colonoscopy

Introduction: Direct Access Colonoscopy (DAC) does not require pre-colonoscopy consultation and may improve access for patients needing screening and surveillance. DAC eligibility criteria vary widely, and we developed a novel, DAC program using EMR patient data to assess appropriateness for inclusion. This study aimed to evaluate the efficacy and quality of our DAC program and compare to traditional, Office-Scheduled Colonoscopy (OSC). Methods: We conducted a retrospective, single-center study of OSC and DAC patients ages 45-75 with a screening or surveillance indication over 13 months. Primary outcome was Complete Colonoscopy (CC): to cecum/ileum/anastomosis, adequate prep, \u3c 90 days from gastroenterology contact. Patients not meeting CC criteria were classified as Incomplete Colonoscopy (IC). Secondary endpoints: time to CC, adenoma detection rate (ADR). Results: 2,651 patients met inclusion criteria: mean age 58, 57% female, 65% non-White, 86% neither Hispanic/Latino. 1,143 DAC patients (62%) vs. 473 OSC patients (57%) achieved CC: average interval 36 days (DAC) vs. 42 days (OSC), mean prep score 7.94/10 (DAC) vs. 7.45/10 (OSC), and ADR 38% (DAC) vs. 43% (OSC). Top reasons for IC: patient cancellation (35%), no show (28%), inadequate prep (9%). Non-Whites were less likely than Whites (59% vs. 69%; p \u3c 0.001) to achieve CC. Discussion: DAC is non-inferior to OSC for primary endpoint of CC (p \u3c 0.001) with no significant differences across age, gender, and indication. Failure to attend colonoscopy accounted for most ICs, and non-Whites were less likely to have a CC. Further work is needed to maximize CC rate across all demographics