Improving Long-Term Adherence to Monitoring/Treatment in Underserved Asian Americans with Chronic Hepatitis B (CHB) through a Multicomponent Culturally Tailored Intervention: A Randomized Controlled Trial.
Improving Long-Term Adherence to Monitoring/Treatment in Underserved Asian Americans with Chronic Hepatitis B (CHB) through a Multicomponent Culturally Tailored Intervention: A Randomized Controlled Trial.
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DOI：
10.3390/healthcare10101944
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发表时间：
2022-10-05
期刊：
影响因子：
--
通讯作者：
Nguyen MT
中科院分区：
文献类型：
--
作者：
Ma GX;Zhu L;Lu W;Handorf E;Tan Y;Yeh MC;Johnson C;Guerrier G;Nguyen MT
背景：虽然亚裔美国人只占美国人口的6%，但他们却占美国慢性乙型肝炎（CHB）患者的58%。然而，亚裔美国慢性乙型肝炎患者对监测和抗病毒治疗指南的依从性仍然不理想。方法：本研究的目的是评估多组分干预对美籍亚裔慢性乙型肝炎患者慢性乙型肝炎监测依从性的效果。干预内容包括虚拟患者教育、患者导航和双语社区健康教育者提供的移动健康提醒。采用卡方检验和t检验比较12个月随访评估时的人口学特征和两种CHB措施：CHB临床随访和CHB实验室监测。采用广义线性混合效应模型（GLMM）评估干预的有效性。结果：研究样本为358例美籍华裔和越南裔慢性乙型肝炎患者，其中干预组181例，对照组177例。干预组CHB临床随访率（86.2%）和CHB实验室监测率（79.0%）显著高于对照组（54.2%和45.2%）。GLMM对CHB临床随访（优势比= 7.35,95%可信区间= 4.06 ~ 13.33）和CHB实验室监测（优势比= 6.60,95%可信区间= 3.77 ~ 11.56）12个月随访评估结果显示干预效果显著。结论：多组分干预在改善亚裔美国人慢性乙型肝炎监测依从性方面是有效的。需要进行更多的实施研究，以便更好地了解并将有效的干预措施应用于其他服务不足的人群。
Background: Although Asian Americans make up 6% of the U.S. population, they account for 58% of Americans with chronic hepatitis B (CHB). Yet, adherence to monitoring and antiviral treatment guidelines among Asian American CHB patients remains suboptimal. Methods: The purpose of this study was to evaluate the efficacy of a multicomponent intervention on adherence to CHB monitoring among Asian Americans with CHB. The intervention components included virtual patient education, patient navigation, and mobile health reminders delivered by bilingual community health educators. Chi-square test and t-test were used to compare demographic characteristics and two CHB measures: CHB clinical follow-up and CHB laboratory monitoring by the time of the 12-month follow-up assessment. A generalized linear mixed-effects model (GLMM) was fitted to assess the effectiveness of the intervention. Results: The study sample consisted of 358 Chinese and Vietnamese Americans living with CHB, including 181 in the intervention group and 177 in the control group. The intervention group had a significantly higher rate of CHB clinical follow-up (86.2%) and CHB laboratory monitoring (79.0%) than did the control group (54.2% and 45.2%, respectively). Results of the GLMM showed significant intervention effects on CHB clinical follow-up (odds ratio = 7.35, 95% confidence interval = 4.06–13.33) and CHB laboratory monitoring (odds ratio = 6.60, 95% confidence interval = 3.77–11.56) at the 12-month follow-up assessment. Conclusion: The multicomponent intervention was effective in improving adherence to CHB monitoring among Asian Americans. Additional implementation research is needed to better understand and apply effective interventions to other underserved populations.
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影响因子：
3.7
作者：
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