Cluster-Randomized Trial to Increase Hepatitis B Testing among Koreans in Los Angeles.
Cluster-Randomized Trial to Increase Hepatitis B Testing among Koreans in Los Angeles.
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集群随机试验，以增加洛杉矶韩国人的乙型肝炎测试。
DOI：
10.1158/1055-9965.epi-14-1396
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发表时间：
2015-09
期刊：
影响因子：
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通讯作者：
Taylor VM
中科院分区：
文献类型：
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作者：
Bastani R;Glenn BA;Maxwell AE;Jo AM;Herrmann AK;Crespi CM;Wong WK;Chang LC;Stewart SL;Nguyen TT;Chen MS Jr;Taylor VM
在美国，与一般人群相比，韩国移民经历了不成比例的慢性B肝炎（HBV）病毒感染和相关肝癌的高负担。然而，尽管有明确的临床指南，HBV血清学检测在韩国人仍然持续次优。我们进行了一项随机分组试验，以评估以教会为基础的小组干预，以改善洛杉矶韩国人的HBV检测。52个韩国教会，分层的大小（小，中，大）和位置（韩国城与其他），随机干预或控制条件。干预教会的参与者参加了一个关于肝癌和HBV检测的单次小组讨论，对照教会的参与者参加了一个关于体育活动和营养的类似会议。结果数据包括通过6个月的电话随访访谈获得的自我报告的HBV检测。我们招募了1123人，年龄在18-64岁之间，来自52个教会。92%的样本参加了指定的干预会议，86%完成了6个月的随访。样本特征包括：平均年龄46岁，65%为女性，97%出生在韩国，69%完成了一些大学，43%投保。在意向治疗分析中，干预产生了统计学显著性影响（OR = 4.9，p <0.001），19%的干预组和6%的对照组参与者报告了HBV检测。我们的干预在HBV感染和后遗症高危人群中成功地取得了巨大而稳健的效果。干预是相当有效的资源，因此有很高的潜力，在其他高风险的亚洲群体复制。
In the United States, Korean immigrants experience a disproportionately high burden of chronic hepatitis B (HBV) viral infection and associated liver cancer compared to the general population. However, despite clear clinical guidelines, HBV serologic testing among Koreans remains persistently sub-optimal. We conducted a cluster-randomized trial to evaluate a church-based small group intervention to improve HBV testing among Koreans in Los Angeles. Fifty-two Korean churches, stratified by size (small, medium, large) and location (Koreatown versus other), were randomized to intervention or control conditions. Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing and control church participants attended a similar session on physical activity and nutrition. Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews. We recruited 1123 individuals, 18-64 years of age, across the 52 churches. Ninety-two percent of the sample attended the assigned intervention session and 86% completed the 6-month follow-up. Sample characteristics included: mean age 46 years, 65% female, 97% born in Korea, 69% completed some college, and 43% insured. In an intent-to-treat analysis, the intervention produced a statistically significant effect (OR = 4.9, p < .001), with 19% of intervention and 6% of control group participants reporting a HBV test. Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae. The intervention was fairly resource efficient and thus has high potential for replication in other high-risk Asian groups.