Determinants of hepatitis B awareness and prevention in Chinese Americans
Chronic HBV infection accounts for most of the worldwide incidence of hepatocellular carcinoma (HCC), particularly in natives and migrants from HBV-endemic areas of eastern and southeastern Asia, where the prevalence of chronic HBV infection is 35 times higher than that in the overall U.S. The incidence rate of HCC in Chinese Americans is also significantly higher than in non-Asian Americans, making HCC a major racial/ethnic health disparity-one that is largely preventable through HBV vaccination. Therefore, preventing HBV infection and HCC incidence in Chinese Americans, the largest and rapidly growing subgroup of Asians in the U.S., is an important and increasingly prominent public health priority.
Despite the existence of effective methods to test for and prevent HBV infection, there are no official guidelines for HBV screening and vaccination in Asian American adults, and many Chinese Americans are not aware of or protected against their elevated risk of chronic HBV infection and liver disease. Special attention to language and cultural issues is needed to design effective, culturally tailored interventions to promote HBV screening, vaccination, and clinical follow-up of chronic HBV infection in Chinese Americans. Therefore, as a precursor to designing and implementing a community-based intervention to increase HBV screening, vaccination, and follow-up in San Francisco Chinese Americans, we are conducting a pilot study using focus groups in the Chinese American community to identify motivational factors for general and HBV-specific health care and preventive activity, as well as barriers to and facilitators of HBV prevention.
The aims of this pilot study are: to identify motivations for seeking health care and taking preventive action against disease, including hepatitis B, in the Chinese American community; to identify factors that impede or enable HBV preventive activity in the Chinese American community; and to use this information to develop culturally appropriate motivational methods to promote HBV screening, vaccination, and clinical follow-up of chronic HBV infection, as well as knowledge/behavior surveys, for a Chinese American community intervention study.
The first aim will inform the marketing strategy of our planned intervention, while the second will inform its delivery strategy. The results of this pilot study will be used to develop a program to provide free HBV screening and low-cost HBV vaccination, guide chronic HBV carriers to appropriate health care providers, and formulate a sustainability plan for long-term provision of HBV screening and vaccination in partnership with community-based organizations and health care providers, with the long-term objective of reducing the disproportionate burden of liver disease in Chinese Americans.
NCCC Principal Investigator: Ellen Chang, Sc.D.
Co-investigators: Bang Nguyen, Dr.P.H., NCCC , Samuel So, M.D., F.A.C.S., Stanford University School of Medicine and the Asian Liver Center at Stanford University
Funding: 2006 Stanford Comprehensive Cancer Center Developmental Grant in Population Sciences Research |
