Evaluation of a Hepatitis B Outreach Intervention for Cambodians

描述（由申请人提供）：原发性肝癌在美国（US）的东南亚人中比在任何其他种族/民族的个体中更常见。这种健康差异可归因于乙型肝炎病毒感染率高，而乙型肝炎疫苗接种覆盖率低。超过10%的柬埔寨移民患有慢性乙型肝炎病毒，而在美国总人口中，这一比例不到0.5%。实践指南明确指出，所有来自世界各地乙型肝炎流行地区的移民都应接受血清学检测。然而，现有数据表明，只有不到一半的柬埔寨裔美国人接受了乙肝检测。我们的研究目的是进行一项随机对照试验，以评估在文化和语言上适当的非专业卫生工作者外展干预在提高柬埔寨人乙肝检测完成水平方面的有效性。这个以社区为基础的参与性研究项目将在华盛顿州西部的西雅图-塔科马大都市区进行，研究人员将与现有的柬埔寨社区联盟合作。我们的研究将使用健康行为框架的理论视角。焦点小组的调查结果将用于开发乙型肝炎调查工具和我们的乙型肝炎外展干预。外联活动将由非专业卫生工作者提供，并将包括以下内容：家访、使用教育小册子和激励DVD，以及量身定制的咨询和后勤援助。我们将对500名20-64岁的柬埔寨人进行社区调查。从未接受过乙型肝炎检测的调查应答者（250人）将被随机分为干预组或对照组。主要的随机对照试验结果将是乙型肝炎血清学检测。次要结果将包括未来的乙肝检测意图和乙肝相关知识。结果评估将基于后续调查，以及自我报告的乙型肝炎检测的医疗记录验证。公共卫生相关性：该项目将与柬埔寨社区合作，为柬埔寨成年人制定和评估在文化和语言上适当的乙型肝炎外联干预措施。外联活动将由非专业卫生工作者提供，并将包括以下内容：家访、使用教育小册子和激励DVD，以及量身定制的咨询和后勤援助。

DESCRIPTION (provided by applicant): Primary liver cancer occurs more frequently among Southeast Asians in the United States (US) than among individuals of any other race/ethnicity. This health disparity can be attributed to high rates of hepatitis B virus infection combined with low levels of hepatitis B vaccination coverage. Over 10 percent of Cambodian immigrants are chronically infected with the hepatitis B virus, compared to less than 0.5 percent of the general US population. Practice guidelines specify that all immigrants from areas of the world with endemic hepatitis B should receive serologic testing. However, available data indicate that less than one-half of Cambodian Americans have received testing for hepatitis B. Our study objective is to conduct a randomized controlled trial to evaluate the effectiveness of a culturally and linguistically appropriate lay health worker outreach intervention in improving levels of hepatitis B testing completion among Cambodians. This community-based participatory research project will be conducted in the Seattle-Tacoma metropolitan area of Western Washington and the researchers will collaborate with an existing Cambodian Community Coalition. Our research will use the theoretical perspective of the Health Behavior Framework. Focus group findings will be used to develop a hepatitis B survey instrument and our hepatitis B outreach intervention. The outreach will be delivered by lay health workers and will include the following components: A home visit, use of an educational pamphlet and a motivational DVD, and tailored counseling and logistic assistance. We will conduct a community-based survey of 500 Cambodians aged 20-64 years. Survey respondents who have never been tested for hepatitis B (250 individuals) will be randomized to intervention or control status. The primary randomized controlled trial outcome will be hepatitis B serologic testing. Secondary outcomes will include future hepatitis B testing intentions and hepatitis B-related knowledge. Outcome evaluation will be based on a follow-up survey, as well as medical record verification of self-reported hepatitis B testing. PUBLIC HEALTH RELEVANCE: This project will collaborate with the Cambodian community to develop and evaluate a culturally and linguistically appropriate hepatitis B outreach intervention for Cambodian adults. The outreach will be delivered by lay health workers and will include the following components: A home visit, use of an educational pamphlet and a motivational DVD, and tailored counseling and logistic assistance.