Correlates of Hepatitis B Testing Among Chinese Americans

Coronado, Gloria D.; Taylor, Victoria M.; Tu, Shin Ping; Yasui, Yutaka; Acorda, Elizabeth; Woodall, Erica; Yip, Mei Po; Li, Lin; Hislop, T. Gregory

doi:10.1007/s10900-007-9060-x

Cited by 49 publications

(87 citation statements)

References 21 publications

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“…20 Despite these efforts, rates of HBV screening and vaccination were suboptimal. Consistent with prior reports of HBV screening rates ranging from 35 % to 65 %, [13][14][15][16][17] our data show that only 43.6 % of API patients underwent appropriate HBV screening with both HBsAg and anti-HBs. Similar to prior estimates, 21 a high proportion (9.1 %) of APIs in the safety net were HBV-infected.…”

Section: Discussionsupporting

confidence: 92%

“…Given the presence of a national program for prevention of vertical HBV transmission, it would be anticipated that a higher percentage of females, particularly of childbearing age, would be screened for HBV. Although most prior studies have not shown an association between patient sex and HBV screening, 14,21,22 in one study, female sex was indeed associated with higher rates of HBV testing. 23 In our study, however, women were less likely to be screened than men, particularly among patients less than 45 years of age.…”

Section: Discussionmentioning

confidence: 68%

“…Limited studies based largely on provider self-report suggest suboptimal HBV screening and vaccination among API patients, with rates as low as 35-65 %. [13][14][15][16][17] However, provider self-reporting of clinical practice and preventive services is of limited reliability. 18 To our knowledge, there are no reports evaluating HBV screening and vaccination practices by both patient record review and provider self-report.…”

Section: Introductionmentioning

confidence: 99%

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Assessment of HBV Preventive Services in a Medically Underserved Asian and Pacific Islander Population Using Provider and Patient Data

et al. 2014

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BACKGROUND: Hepatitis B (HBV) represents a significant health disparity among medically underserved Asian and Hawaiian/Pacific Islander (API) populations. Studies evaluating adherence to HBV screening and vaccination guidelines in this population are limited. OBJECTIVE: The purpose of this study was to evaluate HBV screening and vaccination practices using both provider self-report and patient records. DESIGN: Medical records for 20,574 API adults were reviewed retrospectively and primary care providers were surveyed to evaluate rates and adherence to HBV screening and vaccination guidelines. PARTICIPANTS: The study included primary care providers and their adult API patients in the San Francisco safety-net healthcare system. MAIN MEASURES: Patient, practice, and provider factors, as well as HBV screening and vaccination practices, were assessed using provider survey constructs and patient laboratory and clinical data. Generalized linear mixed models and multivariate logistic regression analyses were used to identify factors associated with recommended HBV screening and vaccination. KEY RESULTS: The mean age of patients was 52 years, and 63.4 % of patients were female. Only 61.5 % underwent HBV testing, and 47.4 % of HBV-susceptible patients were vaccinated. Of 148 (44.8 %) responding providers, most were knowledgeable and had a favorable attitude towards screening, but 43.2 % were unfamiliar with HBV guidelines. HBV screening was positively associated with favorable provider attitude score (OR per unit 1.80, 95 % CI 1.18-2.74) and negatively associated with female patient sex (OR 0.82, 95 % CI 0.73-0.92), a higher number of clinic patients per week (OR per 20 patients 0.46, 95 % CI 0.28-0.76), and provider barrier score (OR per unit 0.45, 95 % CI 0.24-0.87). HBV vaccination was negatively associated with provider barrier score (OR per unit 0.48, 95 % CI 0.25-0.91). CONCLUSIONS:Rates of HBV screening and vaccination of API patients in this safety-net system are suboptimal, and provider factors play a significant role. Efforts to cultivate positive attitudes among providers and expand healthcare system resources to reduce provider barriers to HBV care are warranted. 1 Asian and Hawaiian/Pacific Islanders (API) represent a particularly high-risk population, with reported prevalence rates of 10-15 %, and are estimated to account for over 40 % of chronic HBV cases in the U.S. 2HBV is associated with increased morbidity and mortality; 15-40 % of patients will develop cirrhosis, liver failure, or hepatocellular carcinoma (HCC).3 The recent U.S. Institute of Medicine report highlights the need for increasing efforts in the United States to screen for, prevent, and treat HBV infection. 4 To meet this goal, it is imperative that we have a better understanding of the complex interplay between patient, provider, and health system factors limiting preventive care and progress towards HBV eradication. whose parents are from regions of high HBV endemicity, and persons with high-risk behaviors, among others. 1,5 While the 2004...

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

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Assessment of HBV Preventive Services in a Medically Underserved Asian and Pacific Islander Population Using Provider and Patient Data

et al. 2014

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“…In one study, nearly one-half (56 percent) of the Cambodian respondents were not familiar with "the disease or virus called hepatitis B" until it was explained to them in terms of "a liver problem that makes the skin and eyes go yellow" (Taylor et al, 2002). In many of the studies, knowledge and attitudes were assessed by the following: HBV can be transmitted during sexual intercourse with an infected person, from mother to child during childbirth, by sharing toothbrushes with an infected person, by eating food that has been pre-chewed by an infected person, by someone who looks and feels healthy, HBV is more easily spread than AIDS, people with HBV can be infected for life, HBV can cause liver cancer, people can die from HBV, and ethnic group is more likely to get HBV than Whites (Chang et al, 2008;Choe et al, 2005;Coronado et al, 2007;Hsu et al, 2007;Hwang et al, 2008;Juon et al, 2008;Lin et al, 2007;Ma et al, 2007;Taylor et al, 2002Taylor et al, , 2004Wu et al, 2007).…”

Section: Hbv Awareness and Knowledgementioning

confidence: 99%

“…Many of the study participants in the reviewed articles were born outside of the U.S. (>90%) (Chang et al, 2008;Coronado et al, 2007;Grytdal et al, 2009;Ma et al, 2007;Ma et al, 2008;. Of those who were born outside of the U.S., the average length of residency in the U.S. ranged from 10 to 19 years (Chang et al, 2008;Coronado et al, 2007;Grytdal et al, 2009;Ma et al, 2007;Ma et al, 2008. Hsu et al (2007) found that infection rates increased by the length of U.S. residency.…”

Section: Hbv Screening and Vaccinationsmentioning

confidence: 99%

Knowledge, Awareness and Medical Practice of Asian Americans/Pacific Islanders on Chronic Hepatitis B Infection: Review of Current Psychosocial Evidence

ThuyQuynh

Nam

2011

healthandsocialwelfarereview

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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.

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Hepatitis B knowledge and preventive practices of Chinese American immigrants in Southern California

Zhao

Edwards

Patel

et al. 2015

Journal of the American Association of Nurse Practitioners

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Purpose Chinese American immigrants have higher rates of chronic hepatitis B virus (HBV) infections and consequently higher rates of liver cancer compared to the general U.S. population. The need to assess this vulnerable population's knowledge and health practices is important to prevent HBV infections and improve outcomes. The purpose of this study was to describe HBV knowledge and preventive practices among Chinese American immigrants in Southern California. Data sources Convenience sample of 179 Chinese American immigrants age ≥18 years from Los Angeles County (CA) participated in the study by completing a modified version of the B Free CEED's Hepatitis B Needs Assessment survey. Conclusions Most participants were knowledgeable of HBV (91.6%) or HBV vaccination (70.5%), yet screening and vaccination for the virus were low (36.9% and 26.3%, respectively). Low knowledge was also found regarding modes of disease transmission. Barriers to engage preventive practices included: “feeling well/no health problems” and “not suggested by a doctor.” These findings suggest the need for further education. Implications for practice Nurse practitioners can play a significant role in assessing risk and implementing programs that are community focused, culturally sensitive, and evidence based to improve knowledge, screening, and preventive behaviors on HBV infections for this vulnerable population.

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Correlates of Hepatitis B Testing Among Chinese Americans

Cited by 49 publications

References 21 publications

Assessment of HBV Preventive Services in a Medically Underserved Asian and Pacific Islander Population Using Provider and Patient Data

Assessment of HBV Preventive Services in a Medically Underserved Asian and Pacific Islander Population Using Provider and Patient Data

Knowledge, Awareness and Medical Practice of Asian Americans/Pacific Islanders on Chronic Hepatitis B Infection: Review of Current Psychosocial Evidence

Hepatitis B knowledge and preventive practices of Chinese American immigrants in Southern California

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