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Increasing hepatitis B screening for hmong adults: results from a randomized controlled community-based study

TitleIncreasing hepatitis B screening for hmong adults: results from a randomized controlled community-based study
Publication TypeJournal Article
Year of Publication2013
AuthorsChen, Jr., MS, Fang, DM, Stewart, SL, Ly, MY, Lee, S, Dang, JH, Nguyen, TT, Maxwell, AE, Bowlus, CL, Bastani, R
JournalCancer Epidemiol Biomarkers PrevCancer Epidemiol Biomarkers Prev
Volume22
Pagination782-91
Date PublishedMay
ISBN Number1538-7755 (Electronic)<br/>1055-9965 (Linking)
Accession Number23613027
KeywordsAdolescent, Adult, Asian Americans/ethnology, Community Health Workers, Female, Hepatitis B/ diagnosis/epidemiology/ ethnology/prevention & control, Humans, Male, Mass Screening/ methods, Middle Aged, United States/epidemiology, Young Adult
AbstractBACKGROUND: Hepatitis B-linked liver cancer disproportionately affects Hmong Americans. With an incidence rate of 18.9 per 100,000, Hmong Americans experience liver cancer at a rate that is 6 to 7 times more than that of non-Hispanic Whites. Serologic testing for the hepatitis B virus (HBV) is a principal means to prevent liver cancer-related deaths through earlier identification of those at risk. METHODS: Academic researchers and Hmong leaders collaborated in the design, conduct, and evaluation of a 5-year randomized controlled trial testing a lay health worker (LHW) intervention to promote HBV testing among 260 Hmong adults through in-home education and patient navigation. RESULTS: Intervention group participants were more likely to report receiving serologic testing for HBV (24% vs. 10%, P = 0.0056) and showed a greater mean increase in knowledge score (1.3 vs. 0.3 points, P = 0.0003) than control group participants. Multivariable modeling indicated that self-reported test receipt was associated with intervention group assignment [OR 3.5; 95% confidence interval (CI) 1.3-9.2], improvement in knowledge score (OR 1.3 per point; 95% CI 1.02-1.7), female gender (OR 5.3; 95% CI 1.7-16.6), and having seen a doctor in the past year at baseline (OR 4.8; 95% CI 1.3-17.6). The most often cited reason for testing was a doctor's recommendation. CONCLUSIONS: LHWs were effective in bringing about HBV screening. Doctor visits and adherence to doctors' recommendations were pivotal. Participation of health care providers is essential to increase HBV testing. IMPACT: LHWs can significantly increase HBV screening rates for Hmong but their doctors' recommendation is highly influential and should be pursued.
Ethno Med: