Despite significant advances in preventing HBV-related liver cancer, disparities remain in incidence and mortality rates between Korean and the general population. Koreans experience the second highest incidence rate of HBV and liver cancer in the US. (Korean males 6.7 times higher than that of White males, suffer from undetected and untreated liver cancer). Our studies in PA and NJ revealed low rates of HBV screening and vaccination, identified multiple barriers to screening and vaccination, and a lack of programs tailored to the needs of this underserved population. Research to date on Korean hepB intervention is limited. The proposed project will build on an 8-year unique and historic infrastructure of a collaborative community-academic clinical partnership that includes Temple U (TU) (institutional partners of Center for Asian Health, TU Hospital and Dept of Statistics), and five community and church partners. Specifically, the project will use a CBPR approach to engage Korean church leaders in a culturally and linguistically appropriate intervention to evaluate its effectiveness in increasing hepB screening and vaccination for underserved Koreans. The study will examine whether a CBPR hepB intervention is more effective in increasing knowledge about, perceived risks of and susceptibility to hepB and benefits of screening and vaccination, as well as reduced health system barriers to screening and vaccination. CBPR principles will be used to guide the process of involving partners in all phases of the research to develop and implement project plans, procedures, intervention, evaluation and dissemination. The logic model will be used as a tool to plan, implement and evaluate the proposed intervention. We will work with 30 Korean churches in PA and NJ, 15 churches will be randomized to an immediate intervention and 15 to a general cancer education plus delayed intervention (50 members per church, N=1500). The proposed intervention, guided by an integrative framework of Health Belief Model and Social Cognitive Theory, addresses both individual and healthcare system barriers through multifaceted innovative approaches. Key components include: a) group education by trained bilingual community health educators and church health workers;b) patient navigation by CHEs and CHWs;and c) engaging community bilingual physicians in hepB screening, vaccination and referral. The proposed study is expected to yield important and new data on the intervention effects. If this CBPR hepB intervention proves effective, it can be used as a model program that has potential transportability to and sustainability in Korean and other Asian communities nationally, hence make a substantial contribution toward reducing health disparities.
|Ma, Grace X; Lee, Sunmin; Wang, Min et al. (2011) Role of sociocultural factors in hepatitis B screening among Asian Americans. South Med J 104:466-72|