Health-seeking Patterns Among Chinese Immigrant Patients Enrolled in the Directly Observed Therapy Program in New York City

Setting: Outreach services and chest clinics of the Department of Health in New York City.

Objective: To investigate the health-seeking behavior patterns of Chinese immigrant patients enrolled in the directly observed therapy (DOT) program in New York City, and to suggest service provision strategies.

Design: Data were collected by means of participant observation, semi-structured interviews, and patient narratives. These data were then analyzed statistically as well as qualitatively, based on grounded theory.

Results: Of 60 patient informants, 38 had sought treatment for the relief of symptoms, and 22 were diagnosed by physical examination. Among 125 consultations made by 38 symptomatic patients during the period of their illness, there were more Chinatown physicians, including traditional Chinese practitioners, than other types of health providers, but they proportionally made the fewest referrals to the DOT program.

Conclusions: Chinatown physicians are the main health providers to whom Chinese immigrants with tuberculosis resort. Education and collaboration with Chinese doctors, practitioners of both biomedical and traditional Chinese medicine, in New York City's Chinatown, are essential to reduce enrolment delays in the DOT program. The free services of the DOT program should be made more widely known to the Chinese immigrant population.