Research

Design

Capacity Building

A Sisterhood upon an Unspoken Health Anxiety

A sisterhood upon an unspoken pain

I dedicated a year and a half to fostering sisterhood among bicultural Chinese-American women. Together, we contemplated and carried each other through the complexities of a sexual and reproductive health journey, spanning two vastly different social environments, support systems, cultural contexts, and healthcare systems.

Unpacking the complexity of cross-cultural women migrants seeking sexual and reproductive health support

As a Chinese woman, I used to feel reluctant to seek help for sexual and reproductive health issues. Many U.S.-based Chinese women share my feelings in this regard. The health-seeking journey involves several private, vulnerable, and sensitive moments that require more than just medical technical support.

My goal is to gain a deep understanding of the root causes of low utilization of medical services and develop solutions to re-engage Chinese women in the new healthcare system.

DID YOU KNOW…?

Breast and cervical cancers are especially significant causes of mortality and morbidity for Asian women, due in part to underutilization of screening practices (Chen, 2009).


History before they entered the clinics

Through diary studies and interviews with 17 Chinese migrants across the U.S., I wanted to understand how they shaped their views on sexuality and reproductive health — and how those cultural discourse followed them into health clinics.

Inspired by their fascinating stories, I co-visualized with my participants in a storyboard on how early beliefs shaped and manifested into health decisions in the adulthood as a common patterns.

Beyond lived experiences and patterns, the analysis delved into core — a three-tier behavioral diagnostic(Belief&Discourse - Knowledge - Behavior), tracing how cultural discourse and belief systems shape knowledge attitudes and ultimately drive health-seeking behaviors.

Belief & Discourse Level

Belief on the taboo of sex

“Sex is shameful, vulgar, and hedonistic—these should not be discussed in public.”

Moral values rooted in an outdated culture

“Gynecologic issues are something only married women experience; otherwise, it would seem filthy or abnormal.”

Knowledge Level

False Health Attitudes

“SRH is lower priority in my life/health. It's more about pleasure, yet less about health.”

Self-censorship

“I can’t help criticizing and blaming myself during the whole examination.”

Delayed Health Seeking

“I’m so busy. Maybe I can go to the doctors when things get serious.”

Distrust Health Providers

“Doctors never know me that well. I can self-cure by having a certain diet.”

Avoidance of Disclose

& Support-seeking

“What if others judge me and have a negative stereotype of me?”

Behavior Level


Change: How Does It Happen?

With deep-seated behavioral patterns identified, I explored in both a broader and an actionable sense how we might drive health behavior change among Chinese migrants and tied assumptions to support each approach.

Not all of the ideas I’ve outlined above are equally feasible. Behavioral Change Wheel(BCW) and my research insights together identify the spaces where my project, HeyLady, eventually can intervene in the behavioral change. Some participants shared that the interviews and storyboard co-drawing themselves had helped them realize that some of their approaches to health issues could be improved. Thus, my final interventions leaned towards conversational and community-oriented approaches.


ACTION ON KNOWLEDGE CO-CREATION

Partnering with Asian Creative Collective(now Asian Creative Foundation), I hosted a series of co-creation workshops with U.S.-based Chinese migrant across different fields to reimagine the form of sexual and reproductive health knowledge, and co-create the toolkits for our community.

ACTION ON OPEN REFLECTIVE SPACE

With positive feedback from workshop, I started to build a community hub serving as open reflective space regarding women health and cultural beliefs on Facebook fan page(@heyladyforsrh) and Instagram(@heylady_for_srh) by March, 2021.

Guided by trauma-informed thinking, I developed a visual narratives that both softens the shame and conveys a lingering sadness.

ACTION ON COMMUNITY ENABLEMENT

To further encourage community engagement, I hosted 'Secret Support Week' activities among the Chinese American community. Through matching support seekers with supporters during a week, I further connected more U.S.-based Chinese women to build a mutual support network.

Through messaging on the Hey Lady textline, the backend staff directed messages between participants based on topics. During the 'Secret Support Week', we had 17 texters engaged, and received and transferred 80+ support messages between participants.

I card-sorted with health professionals and some migrants to define the common women’s health support scope and topics, improving hotline efficiency.

(Note: Due to HIPAA policies, the hotline cannot provide professional medical advice or collect personal health information.)

Operations behind the scenes that help seekers and supporters connect to each other


One community, two creative events, thirty-five members, and over 200 followers

HeyLady eventually grew into a community with over 35 active members in New York City, Pittsburgh, and Jersey City, and 200 followers online. We hosted two workshops, one textline, and received and transferred 80+ support messages in our community. Though the project has come to a temporary pause in May 2021, according to participant feedback in early 2022, their willingness to discuss sexual and reproductive health topics in public settings and within intimate relationships had increased. Two of them have become actively involved in the field of sexual and reproductive health through participation in local NGOs and support groups.

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