Public Health Model for Prevention of Liver Cancer Among Asian Americans

Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, 704, Baltimore, MD 21205, USA.
Journal of Community Health (Impact Factor: 1.28). 09/2008; 33(4):199-205. DOI: 10.1007/s10900-008-9091-y
Source: PubMed

ABSTRACT Asian Americans and Pacific Islanders (AAPIs) account for over half of the 1.3 million chronic hepatitis B cases and for over half of the deaths resulting from chronic hepatitis B infection in United States. There are very few studies published about hepatitis B virus (HBV) data in the Baltimore-Washington metropolitan area. In 2003, the Hepatitis B Initiative-DC (HBI-DC) worked closely with a large Korean church, located in Vienna, Virginia. Their partnership included a pilot-test of a faith-based HBV program, which educates, screens and vaccinates for the HBV. This pilot program was later expanded to include a total of nine Korean and Chinese American churches in this region, plus a Pastor's Conference targeting Asian American pastors from around the United States. During 2003-2006, a total of 1,775 persons were tested for HBV infection through the HBI-DC program. Of all the participants, 2% (n=35) were tested HBV positive (HbsAg+, HbsAb-), 37% (n=651) were HBV negative but protected (HbsAg-, HbsAb+), and 61% (n=1089) were unprotected (HbsAg-, HbsAb-). Most of these unprotected individuals (n=924) received the first vaccination. The proportion of the second vaccination was 88.8% (n=824). About 79% completed 3-shot vaccine series. Our study contributes to the literature by providing an overview of the hepatitis B unprotected rate among Asian American adults. It indicates that culturally integrated liver cancer prevention program will reduce cancer health disparities in high risk immigrant populations.

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Available from: Hee-Soon Juon, Dec 12, 2013
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    • "thus reduce the disparity in liver cancer rates (Chen, 2005; Coronado et al., 2007; Hu, 2008; Juon et al., 2008; Kreps & Sparks, 2008; Ma, Shive, et al., 2007; Ma et al., 2008; T. T. Nguyen et al., 2010; Wu et al., 2007). A photonovel might be a culturally appropriate educational material to promote liver cancer prevention among Asian Americans because it is an educational storybook that incorporates culturally appropriate components, such as photos of faces familiar to the community featured as main characters of the story, daily dialogues used by the community people, and storylines drawn from common life experiences in the community. "
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    ABSTRACT: Asian Americans have disproportionately high prevalence of chronic hepatitis B virus infection in the United States and yet have low hepatitis B screening and vaccination rates. We developed three photonovels specifically designed for Chinese, Korean, and Vietnamese Americans and evaluated their cultural relevance and effectiveness in increasing self-efficacy and intention to have a hepatitis B screening. Photonovels' storylines were drawn from focus group themes, and lay people from each community played actors/actresses in community settings. Photonovels were pilot tested, revised, and distributed in a hepatitis B intervention. A two-page process evaluation questionnaire was mailed to 441 participants after one month. Descriptive analysis and multiple logistic regressions were conducted to assess the overall evaluation of the photonovel and to assess factors associated with self-efficacy and intention to have hepatitis B screening. Eighty-four percent of participants responded to the process evaluation. The majority of participants either strongly agreed or agreed that the cancer information in the photonovel was helpful, the story was written by someone who knows the community, and the information was easy to understand. Overall, more than 80% of them thought this photonovel was a good teaching tool. Favorable evaluation of the photonovel was associated with both having intention and self-efficacy to have a hepatitis B screening in the next 5 months. When stratified by level of education and income, the associations were stronger among the lower income and education groups. Culturally appropriate photonovels are useful tools to promote hepatitis B screening among Asian Americans, especially among those of lower socioeconomic status.
    Health Education &amp Behavior 01/2013; 40(6). DOI:10.1177/1090198112474003 · 1.54 Impact Factor
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    • "We took this opportunity to describe and report our findings of this survey. Our paper adds to the limited literature on faith-based health initiatives among Asian American populations (Juon et al., 2008; Ma et al., 2009; Teng and Friedman 2009; Jo et al., 2010; Kang and Romo 2010). We report interest in health promotion programs that could be offered at Korean American churches and preferences with respect to content and format of these programs among English and Korean-speaking retreat attendees. "
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    ABSTRACT: Little is known about interest in faith-based health promotion programs among Asian American populations. Among the Christian denominations, the Seventh-day Adventist (SDA) church is known to place a strong doctrinal emphasis on health. To understand appropriate ways to develop and implement health promotion programs and to conduct research among Korean American SDAs. We collaborated with the North American Division of Korean SDA Churches which sponsors annual week-long religious retreats for their church members. We developed and administered a 10-page questionnaire at their 2009 retreat in order to assess socio-demographic and church characteristics, religiosity, perceived relationship between health and religion, and interest and preferences for church-based health promotion programs. Overall, 223 participants completed our survey (123 in Korean and 100 in English). The sample consisted of regular churchgoers who were involved in a variety of helping activities, and many holding leadership positions in their home churches. The vast majority was interested in receiving health information at church (80%) in the form of seminars, cooking classes and workshops (50-60%). Fewer respondents were interested in support groups (27%). Some interests and preferences differed between English and Korean language groups. Korean American SDA church retreat participants from a large geographic area are very interested in receiving health information and promoting health at their churches and can potentially serve as "agents of influence" in their respective communities.
    Asian Pacific journal of cancer prevention: APJCP 06/2012; 13(6):2923-30. DOI:10.7314/APJCP.2012.13.6.2923 · 2.51 Impact Factor
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    • "In the U.S., about 80 percent of primary liver cancer (hepatocellular carcinoma, HCC) is etiologically associated with hepatitis B virus (HBV) infection (Juon et al., 2008). Asian Americans and Pacific Islanders (APIs) account for over half of the 1.3 million chronic hepatitis B cases and for over Knowledge, Awareness and Medical Practice of Asian Americans/Pacific Islanders on Chronic Hepatitis B Infection: Review of Current Psychosocial Evidence "
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    ABSTRACT: The purpose of this review is to conduct a concise review of the literature to evaluate the knowledge, awareness, and medical practice of Asian Americans/Pacific Islanders (API) supporting the relationship of chronic hepatitis B infection. Liver cancer is the fifth most common cause of cancer death in men and the ninth most common cause of death in women in the United States. On average, Asian Americans are three times more likely to die from liver cancer than other racial/ethnic groups, with Chinese Americans at six times, Koreans eight times and Vietnamese 13 times higher than non-Hispanic Whites. In the United States, about 80% of liver cancer is etiologically associated with hepatitis B virus (HBV) infection. Asian Americans and Pacific Islanders (API) account for over half of the 1.3 million chronic hepatitis B cases and for over half of the deaths resulting from chronic hepatitis B infection. Relevant studies were identified in PubMed (Medline) using the following search structure: (Hepatitis B or synonyms) AND (liver cancer or synonyms) AND (Asian Americans or synonyms). Further studies were identified by citations in retrieved papers and by consultation with experts. Twenty publications were included in this review. Compared to other racial/ethnic groups, Asians, especially those born in China or Southeast Asia, have significantly poorer knowledge regarding hepatitis B and liver cancer. Knowledge, awareness and medical practice among Asian Americans regarding HBV infection were dependent upon age, gender, race/ethnicity, immigrant status and length of residency. Despite increased risk for chronic hepatitis B and liver cancer, many Asian Americans are uninformed, untested, and unprotected against the disease.
    Pogŏn sahoe yŏn'gu 09/2011; 31(3):341-364. DOI:10.15709/hswr.2011.31.3.341
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