Increasing Hepatitis B Screening Among Korean Church Attendees

Roshan Bastani, PhDRoshan Bastani, PhD Principal Investigator Principal Investigator

Vicky Taylor, MD, MPH Vicky Taylor, MD, MPH Co-Principal Investigator (FHCC)Co-Principal Investigator (FHCC)

Beth Glenn, PhDBeth Glenn, PhD Co-Investigator Co-Investigator

Annette Maxwell, DrPH Co-Investigator Annette Maxwell, DrPH Co-Investigator

Angela Jo, MD, MPHAngela Jo, MD, MPH Co-Investigator Co-Investigator

Weng Kee Wong, PhD Co-InvestigatorWeng Kee Wong, PhD Co-Investigator

UCLA School of Public Health, Jonsson Comprehensive Cancer Center, Division of Cancer Prevention & Control Research

Study funded by the National Cancer Institute

Focus on Korean AmericansFocus on Korean Americans

Up to 12% of Koreans chronically infected

with hep B

No liver cancer prevention efforts targeting Koreans

2nd highest liver cancer rates among Asians

Low hep B serologic testing rates

3rd most populous Asian group

Immigrant population =greater hep B risk

Results of Pilot Study in Results of Pilot Study in Korean CommunityKorean Community

141 Korean Americans from churches and a clinic

Only 56% ever had a hepatitis B test

34% did not know Koreans at higher risk for hepatitis B

Only 36% knew hepatitis B infection can be lifelong

Common barriers to testing Fear of a bad diagnosis (75%)

Cost of test (61%)

Time (46%)

Church preferred site to receive health information vs. worksite, clinic, health fair

Rationale for Church-Based Rationale for Church-Based InterventionIntervention

80% of Koreans attend church

regularly

Church-based programs successful

in other minorities

No evidence based programs for hepatitis B

Small group: Cost-efficient &

consistent

Adaptation necessary: for

content & ethnicity

More likely to be sustained

after grant

Study DesignStudy Design

Intervention ChurchesN=20

6-Month TelephoneFollow-up Interview

Identification of Churches (n = 40)

In-Person Baseline Interview

N = 448

Hepatitis B

Small Group Session

Comparison ChurchesN=20

In-Person Baseline Interview

N = 448

Physical Activity/Nutrition

Small Group Session

The Health Behavior FrameworkThe Health Behavior Framework

Barriers/Supports

IntentionsHepatitis B serologic

testing

• Demographics• Medical History• Insurance

Institutional FactorsLanguage differencesNavigation problems

I N T E R V E N T I O N S

Individual FactorsKnowledge

Communication & rapport with provider

Health Beliefs Social Support Cultural Factors

Group Intervention Session: Group Intervention Session: ProcessProcess

Information presented verbally, visually Information presented verbally, visually and in-print to enhance interest and in-print to enhance interest & retention& retention

Blend of discussion group Blend of discussion group & educational presentation& educational presentation

Group formatGroup formatSocial norms &Social norms &Active participationActive participation

Culturally competent Culturally competent interventionintervention

Assures acceptance Assures acceptance & effectiveness& effectiveness

Strengths of ProjectsStrengths of ProjectsAdaptation of existing church based programs focused on increasing hepatitis B testing

Opportunity to document process of adaptation

Utilizing a rigorous evaluation

Collaboration across CPCRN network sites will allow for:

Sharing of complementary expertise and experiences

Understanding of similarities and differences between Koreans and Chinese

Lessons learned can be used to adapt programs for other ethnic groups at risk for hepatitis B and liver cancer