Abstract
BackgroundSouth Asian Canadians are at high risk of developing cardiovascular disease and diabetes. Consumer-oriented health information technology may help mitigate lifestyle risk factors and improve chronic disease self-management.ObjectiveThis study aims to explore the prevalence, patterns, and predictors of the use of the internet, digital devices, and apps for health purposes as well as preferences for future use of eHealth support in South Asian Canadians.MethodsWe conducted a cross-sectional, mixed-mode survey in a convenience sample of 831 South Asian adults recruited at faith-based gathering places, health care settings, and community events in Edmonton, Alberta, in 2014. The 706 responders (mean age 47.1, SD 17.6 years; n=356, 50.4% female; n=509, 72.1% Sikh) who provided complete sociodemographic information were included in the analysis, and the denominators varied based on the completeness of responses to each question. Multivariate logistic regression was used to determine sociodemographic and health status predictors of internet use, being a web-based health information seeker, smartphone or tablet ownership, health app use, and willingness to use various modes of eHealth support.ResultsOf all respondents, 74.6% (527/706) were internet users and 47.8% (336/703) were web-based health information seekers. In addition, 74.9% (527/704) of respondents owned a smartphone or tablet and 30.7% (159/518) of these had a health and fitness app. Most internet users (441/527, 83.7%) expressed interest in using ≥1 mode of eHealth support. Older age, being female, having less than high school education, preferring written health information in languages other than English, and lacking confidence in completing medical forms predicted lack of internet use. Among internet users, factors that predicted web-based health information seeking were being female, use of the internet several times per day, being confident in completing medical forms, and preferring health information in English. Predictors of not owning a smartphone or tablet were being older, preferring health information in languages other than English, having less than high school education, living in Canada for <5 years, having a chronic health condition, and having diabetes. Increasing age was associated with lower odds of having a health app. Preferring health information in languages other than English consistently predicted lower interest in all modes of eHealth support.ConclusionseHealth-based chronic disease prevention and management interventions are feasible for South Asian adults, but digital divides exist according to language preference, education, age, sex, confidence in completing medical forms, and number of years lived in Canada. Community-based, culturally tailored strategies targeting these factors are required to address existing divides and increase the uptake of credible web-based and app-based resources for health purposes.
Highlights
South Asians originating from India, Pakistan, Bangladesh, and Sri Lanka are among the fastest growing and largest visible minority groups in Canada [1]
Conclusions: eHealth-based chronic disease prevention and management interventions are feasible for South Asian adults, but digital divides exist according to language preference, education, age, sex, confidence in completing medical forms, and number of years lived in Canada
Differences in genetic factors may explain some of the increased rates of Cardiovascular disease (CVD) risk factors, but existing evidence suggests that the biology of CVD is no different in South Asians compared with other ethnic groups [6]
Summary
South Asians originating from India, Pakistan, Bangladesh, and Sri Lanka are among the fastest growing and largest visible minority groups in Canada [1]. The increased risk of coronary artery disease is primarily driven by a higher incidence of known atherosclerotic CVD risk factors, type 2 diabetes and impaired glucose tolerance [6]. Both biological and nonbiological mechanisms are implicated in the increased risk of coronary artery disease and diabetes. Individual studies have shown that South Asians are 2 to 3 times more likely to develop type 2 diabetes compared with other populations and develop diabetes at a younger age; approximately 4.6 years younger than Chinese or White Canadians [7,8,9,10]. Consumer-oriented health information technology may help mitigate lifestyle risk factors and improve chronic disease self-management
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