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In the past three decades, rapidly changing demographic characteristics have been witnessed in western society. Concurrently, numerous culture-related studies have attested to the disparity in health services among different ethnic groups. Reports have shown contributing factors that can render main stream services inaccessible to immigrants include cultural and language barriers, adaptation difficulties, racial discrimination and lack of culturally appropriate psychosocial services. Inadequate training of health professionals regarding cross-cultural issues may hinder patient compliance and therapeutic alliances. In a paediatric practice in Montreal, prevalent health problems among Chinese families were identified to be related to cultural beliefs and psychosocial factors. These included a low breastfeeding rate (8%) among Chinese newborns, prevalent iron deficiency anemia (12%), nursing caries, social isolation, delayed diagnosis of developmental delay, learning disabilities and psychosocial problems. The participation in community research and advocacy, the development of health promotional projects with an interdisciplinary approach and the preparation of Chinese health information such as perinatal programs, infant nutrition, dental hygiene and immunization, were described. Subsequent studies in this population illustrated an increased breastfeeding rate (48%), decreased incidence of iron deficiency (2.8%) and improved self-health maintenance practices. More culturally appropriate allied health services, including the Multiculturalism Department in the Montreal Children's Hospital, have subsequently been developed for the community.In summary, identifying prevalent health problems of ethnic propensity may be the initiatives needed to develop research and health promotional projects for a target population. Comprehensive health care to different ethnic groups requires health professionals to incorporate cross-cultural issues in their services.

Health promotion and research in the Chinese community in Montreal: A model of culturally appropriate health care