Despite significant advances in preventing HBV-related liver cancer, substantial 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. Our church-based randomized HBV intervention trial demonstrated the efficacy of a multifaceted culturally appropriate intervention using CHE-led group education, patient navigation and bilingual health provider engagement that significantly increased HBV screening and vaccination rates among underserved Korean Americans. It is important that we effectively disseminate this evidence-based intervention to improve HBV screening and vaccination behaviors to achieve a broad impact on the targeted underserved community. The dissemination study proposes the following aims:
Aim 1 : Examine the effectiveness of two dissemination strategies for implementing the evidence-based HBVI through: 1) in- person training and technical assistance (IPT/TA), and 2) e-Training and technical assistance (eT/TA) to increase HepB screening and vaccination rates among Korean Americans.
Aim 2 : Compare two dissemination strategies on their cost effectiveness per church and CHW who use it and church members who receive the program.
Aim 3 : Enhance research capacity of Korean church-based organizations to maintain the delivery and strengthen the sustainability of the evidence-based HBVI dissemination. We will use a scientifically rigorous randomized research design to determine the effectiveness and cost-effectiveness of two dissemination strategies: 1) IPT/TA, and 2) e-T/TA to increase HepB screening and vaccination rates among Korean Americans. We will enroll 20 Korean churches in PA, NJ and DEL (10 churches will be randomized to IPT/TA group and 10 churches to eT/TA group), train 60 church health workers (CHWs) who will implement the intervention among 1,000 eligible Korean participants (N=1,000). RE-AIM model will be used as an overarching conceptual framework to systematically disseminate and evaluate the quality and public health impact of integrating the evidence-based HBV intervention into the real-world practice within Korean churches.

Public Health Relevance

HBV-related liver cancer is one of the leading causes of cancer death in Korean and Asian Americans. The proposed study is expected to yield important findings to demonstrate the effectiveness of an evidence-based efficacious intervention, and to evaluate the adoption and utility of the intervention from research to real world practice. If implementation strategies prove effective and cost-effective, they can be used as a dissemination model program nationally.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Resource-Related Research Projects (R24)
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Special Emphasis Panel (ZMD1-RN (01))
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Dankwa-Mullan, Irene
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Temple University
Public Health & Prev Medicine
Schools of Allied Health Profes
United States
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Ma, Grace X; Lee, Minsun M; Tan, Yin et al. (2018) Efficacy of a community-based participatory and multilevel intervention to enhance hepatitis B virus screening and vaccination in underserved Korean Americans. Cancer 124:973-982
Ma, Grace X; Gao, Wanzhen; Tan, Yin et al. (2012) A community-based participatory approach to a hepatitis B intervention for Korean Americans. Prog Community Health Partnersh 6:7-16
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