Evaluation of a Hepatitis B Outreach Intervention for Cambodians

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PROJECT SUMMARY/ABSTRACT 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% of Cambodian immigrants are chronically infected with the hepatitis B virus, compared to less than 0.5% 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 SeattleTacoma 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. PROJECT NARRATIVE 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.