Sscreenshot from FIT Instructional Video

FIT Instructional Videos

Colon cancer is a leading cause of cancer-related deaths, but it is preventable with screening. The fecal immunochemical test (FIT) is the most used stool test for colon cancer screening. These videos demonstrate how to properly use a FIT kit to collect a stool sample for colon cancer screening. They are available in Cantonese, English, Somali, Spanish and Vietnamese.

A PDF document containing QR Codes that link directly to each video is provided in the sidebar.

Demonstration: Dr. Rachel Issaka
Videography: Dr. Carey Jackson
Cantonese & Vietnamese Interpreter: Lien T. La
Somali Interpreter: Mohamed Hashi
Spanish Interpreter: Araceli Gonzalez-Medel


Screenshot from Viral Swab Instructional Video

Viral Swab Instructional Videos

These instructional videos were created to help explain the viral swab procedure to patients presenting with coronavirus symptoms at Harborview Medical Center. The videos were created with interpreters and hospital staff who walk the patients through the nose-swab testing, and offer post-visit information. The videos are available in 7 languages: English interpreted into Amharic, Arabic, Cantonese, Oromo, Somali, Spanish and Vietnamese.

Each video has an accompanying easy-to-scan QR code. If the patient wants to review the video once they are back home, they can scan the QR code which will automatically take them to the video on YouTube. QR code pdfs are available for download under each video, and are also found in the sidebar.

Download Amharic QR code PDF
Download Arabic QR code PDF
Download Cantonese QR code PDF
Download Oromo QR code PDF
Download Somali QR code PDF
Download Spanish QR code PDF
Download Vietnamese QR code PDF

Steering Wheel of Self-Management

In my role as a cultural mediator and diabetes navigator over the last five years, I have recognized the need for simple messaging of abstract concepts for patients from all socio-economic backgrounds in order to be meaningful. There are Western concepts that, as a system, we may take for granted. These include “chronic disease”, “prevention”, and “primary care”. In addition, we have a non-trivial number of illiterate and/or indigenous language speakers that also have low numeracy and a completely different concept of time and scheduled appointments.

The idea behind the “Steering Wheel of Self-Management” is to have a visual tool to be used by providers and patients alike. Providers/ educators can teach patients, patients can teach other patients.

Concept of Self

Perhaps the most basic concept I share with patients is the notion of SELF within the patient-centered care model in a clinical setting. Many of our patients come from countries or health systems that discourage patient participation, questions, or self-empowerment. They come to clinic for a “cure” or “fix” from an educated expert. Once they learn there is no “cure” for a chronic condition like diabetes, they may quickly lose interest or feel that it is not within their rights to express misgivings to a doctor. Hence, I developed the idea of the steering wheel as a central metaphor for illustrating control over one’s chronic disease, instead of being a passive recipient of it.

Prevention: Know how to avoid complications by managing YOUR own personal steering wheel according to YOUR life situations.

Concepts of Journey and Time

For many immigrants and refugees, the concept of a long journey or travel is a familiar one. This implies both distance and time in a way that our patients can more easily connect with.

  • Conceptual Message: TIME, something managed over time
  • Implicit message: Drive your diabetes so it doesn’t drive you

Chronic = continuous: Recognize that your highway and terrain will change over time. Learn to navigate the curves keeping both hands on the your steering wheel.

Steering Wheel Metaphor

Through trial and error during clinical visits and discussions in the lobby, I developed a series of images relating to the one central metaphor that seemed to easily illustrate chronic disease as a tangible concept. Originally I used a stock clip art wheel (later, we developed this original illustration, below) with three spokes to signify the three basic impacts on blood glucose: medication, food and exercise. The two hands on the steering wheel indicating patient empowerment.


  • Steering Wheel of Self-Management, the tool to keep a handle on things (your health).
  • Steering wheel has 3 spokes or points: Exercise, Food, Medicines, all three used in combination,
  • to keep on the road and not drive over the edge or off a cliff.
  • Emphasizing it is not just one thing.

Highway Metaphor

Then over time I began to deepen the metaphor to include the “highway of life” and its curves and roadblocks encountered that can affect diabetes management.

Highway is your diabetes or your health in general, there are many curves and stops on the highway.

Practical Uses

Practical uses of the steering wheel include a version with text and a pictorial-only version for patients with illiteracy or low literacy. The wheel can be printed out and notes written for patients identifying short term goals in the areas of exercise, nutrition and medication management, and for visualizing a care plan. The wheel image can be sent in mailer reminders, as motivator, to patients.

Steering Wheel with Words

Steering Wheel with Spanish words for Exercise, Food, Medicines, and “Driving (Managing) the Course of Your Diabetes”

Steering Wheel – Pictures only

Steering Wheel with images (no words) for Exercise, Food, Medicines

Patient Feedback

Patient feedback has been very positive both in clinic and in community health worker settings. Through the teach-back method, patients have demonstrated a strong grasp of the concept of chronic disease, despite education level. Patients have been able to individualize care plans and select small tangible goals to work on for behavior change.

Copyright

The Steering Wheel of Self-Management operates under the Creative Commons License Attribution-Noncommercial-No Derivative Works 3.0 United States. You are free to copy, distribute, display this work under the following conditions:

  • Attribution: You must attribute the work to EthnoMed, and author Rose Cano.
  • Noncommercial: You may not use this work for commercial or for-profit purposes
  • Alterations: You may not alter, transform, or build upon this work.

For any reuse or distribution, you must make clear to others the license of this work. Any of these conditions can be waived if you get permission from the copyright holder.

Somali Food on Plate

2021 Diabetes Calendars

These are thirteen month calendars with photos and information about healthy eating and diabetes.

They are provided in Amharic (Ethiopian), Khmer (Cambodian), Somali, Spanish and Vietnamese. All calendars also include English. See sidebar for PDFs.

Print on both sides of paper (flip paper on long edge) and fold to make calendar.

Somali Food on Plate
The Brain

Brain Death: What It Means

This handout offers information for families and loved ones of patients. It explains how doctors determine that a person is dead based on their brain function.

Handout PDFs are available at UW Medicine Health Online in English, Arabic, Tigrinya, Russian, Chinese, Vietnamese, Amharic and Spanish languages.

For information for providers, see Determination of Brain Death/Death by Neurologic Criteria – The World Brain Death Project (article accessible with JAMA subscription).

The Brain
Photo by Francisco Bengoa (cc license).
The FITO Museum of Traditional Vietnamese Medicine

Using Traditional Medicines

This handout created by Harborview Medical Center addresses the use of traditional medicines, encouraging patients to discuss them with their doctor and pharmacist. It goes on to explain reasons why this is important.

The handout translated into a number of languages and each PDF includes both target language and English. Languages include: Arabic, Khmer (Cambodian), Somali, Spanish and Vietnamese. Audio narration is also available in each language.

PDFs and audio files are accessible in the sidebar.

These materials were funded by HealthReach.

The FITO Museum of Traditional Vietnamese Medicine
The FITO Museum of Traditional Vietnamese Medicine. Photo by Anthony Tong Lee (cc license).