Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2018 Mar 1;124(5):973-982.
doi: 10.1002/cncr.31134. Epub 2017 Nov 13.

Efficacy of a community-based participatory and multilevel intervention to enhance hepatitis B virus screening and vaccination in underserved Korean Americans

Grace X Ma  1   2 , Minsun M Lee  1 , Yin Tan  1 , Alexandra L Hanlon  3 , Ziding Feng  4 , Theresa I Shireman  5 , Joanne Rhee  1 , Zhengyu Wei  1 , Frank Wong  6 , Han Seung Koh  7 , Charles Kim  1 , Whitney York  3
Affiliations
Randomized Controlled Trial

Efficacy of a community-based participatory and multilevel intervention to enhance hepatitis B virus screening and vaccination in underserved Korean Americans

Grace X Ma et al. Cancer. .

Abstract

Background: The primary objective of the current study was to evaluate the efficacy of a community-based participatory intervention program in improving hepatitis B virus (HBV) screening and vaccination among Korean Americans who were not previously screened.

Methods: A cluster randomized trial involving 32 Korean church-based community organizations (1834 participants) was conducted. Sixteen churches were randomly assigned to an HBV screening and vaccination multicomponent intervention condition (972 participants) and 16 were assigned to a general cancer education control condition (862 participants). The main components of the intervention program included interactive group education; patient navigation; and the engagement of health care providers, church leadership, and church members in the medical field. The application of community-based participatory research principles was monitored and evaluated. HBV screening and vaccination rates (self-reported and medical record verification) were assessed at 6-month and 12-month follow-ups, respectively.

Results: The results of the current study demonstrated significant efficacy in the HBV screening rate (92.5% in the intervention group vs 5.5% in the control group), 3-series HBV vaccination completion rate (84% in the intervention group vs 17.6% in the control group), and overall screening and vaccination compliance rate (87% in the intervention group vs 3.8% in the control group). Participants in the intervention group were significantly more likely to receive HBV screening (92.5%) compared with those in the control group (5.5%). In multivariate mixed-effect logistic regression analysis, the odds ratio for an intervention effect on HBV screening was 512.3 after adjusting for cluster effect and other demographic variables. With regard to vaccination rates, of the 332 participants who were screened with no immunity in the intervention group, 308 (92.8%) received at least 1 HBV vaccination, 300 (90.4%) received at least 2 shots, and 279 participants (84%) received all 3 shots.

Conclusions: A combination of community-based participatory research and a multilevel approach may produce the most optimal results and be essential in producing a considerable effect for enhancing HBV screening and vaccination, particularly for Korean American populations with limited language proficiency and insurance coverage. Cancer 2018;124:973-82. © 2017 American Cancer Society.

Keywords: Korean Americans; Korean churches; community-based participatory research (CBPR); hepatitis B virus (HBV) screening and vaccination; intervention.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None

Figures

Figure 1
Figure 1
Korean CBPR HBV Intervention Study Flow Diagram
See this image and copyright information in PMC

References

    1. Chen CJ, Yang H, Su J. Risk of hepatocellular carcinoma cross a biological gradient of serum Hepatitis B virus DNA level. JAMA. 2006;295:65–73. - PubMed
    1. Cantarini MC, Trevisani F, Morselli-Labate A. Effect of the etiology of viral cirrhosis on the survival of patients with hepatocellular carcinoma. Am J Gastroenterol 101. 2006:91–98. - PubMed
    1. Centers for Disease Control and Prevention. Table 3.4: Reported cases of chronic hepatitis B, by demographic characteristics and laboratory tests. 2013:2013–801937.
    1. Pollack H, Wan K, Ramos R. Screening for chronic hepatitis B among Asian/Pacific Islander populations - New York City, 2005. MMWR Morb Mortal Wkly Rep. 2006;55:505–509. - PubMed
    1. Wasley A, Kruszon-Moran D, Kuhnert W. The prevalence of hepatitis B virus infection in the United States in the era of vaccination. J Infect Dis. 2010:192–201. - PubMed

Publication types

Substances