Hepatitis B ESL Education for Chinese

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Little is known about the disease prevention behavior of Chinese in North America, and relatively few studies have addressed cancer control in this group. However, Chinese Americans/Canadians have a much higher incidence of liver cancer than non-Latino Whites. This excess risk is attributable to high rates of hepatitis B virus (HBV) infection combined with low levels of hepatitis B vaccination coverage. One critical area for the strategic development of health literacy among Asian and other immigrant groups is the design and evaluation of culturally appropriate English as a second language (ESL) curricula. The goal of our research is to increase the proportion of Chinese adults who have been tested for evidence of HBV infection. Our objective is to conduct a group-randomized controlled trial to evaluate the acceptability, feasibility, and effectiveness of a liver cancer control educational intervention for Chinese attending ESL classes. Our study will be conducted in Seattle, Washington and Vancouver, British Columbia. The Health Behavior Framework, findings from a previous hepatitis B qualitative study, and focus groups of ESL teachers as well as students will be used to develop the hepatitis B educational program. An intervention trial will be conducted with ESL classes as the unit of randomization. Sixty ESL classes will be randomized to experimental or control status. Six hundred Chinese men and women aged 18-64 years will participate in the trial. The experimental group will receive a hepatitis B intervention and the control group will receive a heart disease intervention. Educational components will include an ESL curriculum as well as a pamphlet. Participants will complete a self-administered baseline survey, just prior to receiving health education. Outcome evaluation will be based on data from an in-person follow-up survey and medical record verification. Our primary outcome will be HBV serologic testing. Knowledge about key hepatitis B facts will be examined as a secondary outcome.