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Randomized Controlled Trial
. 2013 May;22(5):782-91.
doi: 10.1158/1055-9965.EPI-12-1399. Epub 2013 Apr 23.

Increasing hepatitis B screening for hmong adults: results from a randomized controlled community-based study

Moon S Chen Jr  1 , Dao M Fang, Susan L Stewart, May Ying Ly, Serge Lee, Julie H T Dang, Tram T Nguyen, Annette E Maxwell, Christopher L Bowlus, Roshan Bastani, Tung T Nguyen
Affiliations
Randomized Controlled Trial

Increasing hepatitis B screening for hmong adults: results from a randomized controlled community-based study

Moon S Chen Jr et al. Cancer Epidemiol Biomarkers Prev. 2013 May.

Abstract

Background: Hepatitis B-linked liver cancer disproportionately affects Hmong Americans. With an incidence rate of 18.9 per 100,000, Hmong Americans experience liver cancer at a rate that is 6 to 7 times more than that of non-Hispanic Whites. Serologic testing for the hepatitis B virus (HBV) is a principal means to prevent liver cancer-related deaths through earlier identification of those at risk.

Methods: Academic researchers and Hmong leaders collaborated in the design, conduct, and evaluation of a 5-year randomized controlled trial testing a lay health worker (LHW) intervention to promote HBV testing among 260 Hmong adults through in-home education and patient navigation.

Results: Intervention group participants were more likely to report receiving serologic testing for HBV (24% vs. 10%, P = 0.0056) and showed a greater mean increase in knowledge score (1.3 vs. 0.3 points, P = 0.0003) than control group participants. Multivariable modeling indicated that self-reported test receipt was associated with intervention group assignment [OR 3.5; 95% confidence interval (CI) 1.3-9.2], improvement in knowledge score (OR 1.3 per point; 95% CI 1.02-1.7), female gender (OR 5.3; 95% CI 1.7-16.6), and having seen a doctor in the past year at baseline (OR 4.8; 95% CI 1.3-17.6). The most often cited reason for testing was a doctor's recommendation.

Conclusions: LHWs were effective in bringing about HBV screening. Doctor visits and adherence to doctors' recommendations were pivotal. Participation of health care providers is essential to increase HBV testing.

Impact: LHWs can significantly increase HBV screening rates for Hmong but their doctors' recommendation is highly influential and should be pursued.

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Conflict of interest statement

Conflicts of interest: Dr. Christopher L. Bowlus receives research support and consulting fees from Bristol Myers Squibb and Gilead.

Figures

Figure 1
Figure 1
CONSORT Flow Diagram, HBV Screening Intervention
See this image and copyright information in PMC

References

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