Asian-eCHAT: A primary Care-based Programme to Improve Identification and Stepped Care Support of Asians with Mental Health and Lifestyle Issues

Abstract

The overall aim of this thesis was to tailor Electronic Case Finding and Help Assessment Tool (eCHAT) for New Zealand Asian communities by translating it to Korean and Chinese (Asian-eCHAT) and to assess its acceptability and feasibility within a primary health care setting as a screening tool for lifestyle issues in the Asian population. The Asian population is the fastest growing group in New Zealand today. In 2013, 10.8% of the New Zealand population identified as Asian, and this proportion is projected to increase to 16% by 2026. eCHAT is a rapid mental health and lifestyle screening tool that has shown to work in identifying issues. It has a 14 years history of development in primary care and has been successfully piloted in primary health care settings. eCHAT yet to be tested in translated version as screening tool amongst the Asian population. Participants completed the eCHAT screener prior to GP consultation. eCHAT results were reviewed and if appropriate, supports were discussed. Following the consultations, participants completed surveys about their experience with eCHAT. Feedback on the acceptability and utility of eCHAT from the clinician’s perspective was collected via interviews and focus groups towards the end of the data collection period. Quantitative results: A total of 302 Asian patients were invited to participate in the study; 277 accepted an acceptance rate of 95%. Participants represented Chinese (n=123; 49.8%), Korean (n=119; 48.2 %) and other Asians (n=5; 2%). The majority were female (n=175; 70.9%). Among this sample, many screened positive for mental health concerns. For example, 26% screened positive for anxiety and 47% of these requested help, and almost 10% reported some level of depression, with 60% of these requesting help. Qualitative findings: Asian-eCHAT was well accepted as a screening tool. It helped to identify mental health and lifestyle issues and improved patient’s and clinician’s knowledge about mental health issues. The results indicate that Asian-eCHAT is an acceptable and useful tool for screening and supporting Asians with mental health and lifestyle concerns. It has the potential to enable better detection of issues facing Asians who are often reluctant to seek help for mental health concerns. It also has the potential to support clinicians in providing efficient and appropriately directed stepped-care support.