Lay Health Worker Intervention Improved Compliance with Hepatitis B Vaccination in Asian Americans: Randomized Controlled Trial
Lay Health Worker Intervention Improved Compliance with Hepatitis B Vaccination in Asian Americans: Randomized Controlled Trial
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DOI：
10.1371/journal.pone.0162683
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发表时间：
2016-09-12
期刊：
影响因子：
3.7
通讯作者：
Lee, Sunmin
中科院分区：
文献类型：
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作者：
Juon, Hee-Soon;Strong, Carol;Lee, Sunmin
BackgroundThis study aimed to evaluate the effect of a lay health workers（LHW）telephone intervention on completing a series of hepatitis B virus（HBV）vaccinations among foreign born Asian Americans in the Baltimore-Washington Metropolitan area.MethodsDuring the period of April 2013 and March 2014，we recruited the Asian Americans who were 18 years old and older in the community-based organizations.在645名合格的参与者中，600名（201名中国人，198名韩国人，201名越南人）完成了预测试调查并接受了B肝炎筛查。根据筛查结果，我们在未保护的（HBsAg-/HBsAg-）人群中进行了一项随机对照试验，将他们分为干预组（n = 124）和对照组（n = 108）。干预组通过邮件收到一份资源清单，告诉他们在哪里可以获得免费疫苗接种，以及受过培训的LHWs的疫苗接种提醒电话，而对照组只通过邮件收到一份资源清单。在邮寄HBV筛查结果7个月后，经过培训的LHWs通过电话随访所有参与者，询问他们接受了推荐的3种疫苗中的多少种：没有，1种或2种，或全部3种（完成）。他们自我报告的疫苗接种情况与医疗记录相符。多项逻辑回归用于检查LHW干预的效果。过程评价进行干预组中的研究参与者，以评估的LHWs.Results7个月后的性能，在干预组中的那些更有可能有1个或更多的疫苗比对照组，相比，没有接种疫苗组（OR = 3.04，95%CI，1.16，8.00）。此外，与未接种疫苗组相比，干预组比对照组更有可能完成一系列疫苗接种（OR = 7.29，95% CI 3.39，15.67）。阻止他们寻求B肝炎疫苗接种的最重要障碍是没有时间接种疫苗。在接种疫苗的人（n = 89）中，最重要的促进因素是我们的干预计划（70.8%）和自我激励（49.4%）。大多数参与者在干预组收到的电话从LHWs（93%），几乎所有的人都得到了提醒，接受疫苗（98%）。这项研究表明，这种文化整合的干预计划可能有助于减少肝癌的差异，从慢性HBV感染的高风险亚裔美国人。
BackgroundThis study aimed to evaluate the effect of a lay health worker (LHW) telephone intervention on completing a series of hepatitis B virus (HBV) vaccinations among foreign-born Asian Americans in the Baltimore-Washington Metropolitan area.MethodsDuring the period of April 2013 and March 2014, we recruited Asian Americans who were 18 years of age and older in the community-based organizations. Of the 645 eligible participants, 600 (201 Chinese, 198 Korean, 201 Vietnamese) completed a pretest survey and received hepatitis B screening. Based on the screening results, we conducted a randomized controlled trial among those unprotected (HBsAg-/HBsAB-) by assigning them either to an intervention group (n = 124) or control group (n = 108). The intervention group received a list of resources by mails for where to get free vaccinations as well as reminder calls for vaccinations from trained LHWs, while the control group received only list of resources by mail. Seven months after mailing the HBV screening results, trained LHWs followed up with all participantsby phone to ask how many of the recommended series of 3 vaccinations they had received: none, 1 or 2, or all 3 (complete). Their self-reported vaccinations were verified with the medical records. Multinomial logistic regressions were used to examine the effect of the LHW intervention. Process evaluation was conducted by asking study participants in the intervention group to evaluate the performance of the LHWs.ResultsAfter seven months, those in the intervention group were more likely to have 1 or more vaccines than the control group, compared to the no vaccination group (OR = 3.04, 95% CI, 1.16, 8.00). Also, those in the intervention group were more likely to complete a series of vaccinations than the control group, compared to the no vaccination group (OR = 7.29, 95% CI 3.39, 15.67). The most important barrier preventing them from seeking hepatitis B vaccinations was lack of time to get the vaccination. The most important promoters to getting vaccinations, among those who had vaccinations (n = 89), were our intervention program (70.8%) and self-motivation (49.4%). The majority of participants in the intervention group received the phone calls from LHWs (93%) and almost all of them got the reminder to receive vaccines (98%).ConclusionThe LHW intervention was successful at increasing HBV vaccinations rates among foreign-born Asian Americans. This study suggests that this culturally integrated intervention program may be useful for reducing liver cancer disparities from chronic HBV infection in high risk Asian Americans.