A Community-Based Approach to improving Hepatitis B Screening in West Africans in the US

慢性乙肝病毒感染是导致肝脏疾病和肝细胞癌的主要原因 (肝细胞癌)，这是世界上第二大癌症死亡原因。在美国，在那里 大约75%的乙肝病毒感染(220万)是未确诊的，慢性乙肝病毒集中在 边缘化人口，最明显的是移民(60%)。移民，特别是西非出生的人 (&gt；10%)在美国承担着很大的乙肝病毒感染负担，其中许多人没有进行筛查。 需要了解文化的战略，以增加对在美国的西非移民的筛查。一个 积极主动的方法尤其重要，因为早期诊断和治疗是最有效的方法 减少与乙肝相关的肝功能衰竭和肝细胞癌。通过简单的血液测试和抗病毒药物就可以检测出乙肝病毒 治疗可以延缓疾病的发展。该项目的中心假设是在西方进行乙肝筛查 非洲出生的人可以通过定义与文化、健康素养(HL)和有限的 英语熟练程度(LEP)，并将这些信息转化为干预。这个项目在我们的基础上扩展了 在西部研究不足的人群中增加乙肝病毒筛查的先前工作和先驱新方法 通过社区参与居住在美国的非洲人。制定增加乙肝病毒的策略 在这一人群中进行筛查可以为在全球范围内增加乙肝病毒检测提供一个框架，其中 约有2.4亿人是慢性感染者。具体目标是：目标1：测试 西非人(英语和法语)的社会文化因素与对乙肝病毒的积极看法的关系 筛查和接受筛查的意向；目标2：制定和完善增加乙肝病毒筛查的计划 它将与低HL人群沟通的最佳做法与具有文化针对性的消息传递结合在一起； 目标3：在西非社区试行教育方案(英语和法语)，以 确定其可接受性和可行性。 长期目标是减轻慢性乙肝相关肝病和肝癌的负担。 西非移民和减少在筛查乙肝和最终肝脏方面的健康差距 癌症在美国和全球都是如此。及早发现及更有效地管理受感染人士 乙肝病毒将降低总体上与乙肝病毒相关的发病率和死亡率，并减少已知的癌症差异。这个 眼前的目标是更好地定义社会文化因素，以开发和试点第一个社区- 以理论为基础的计划，最终增加西非人的乙肝筛查。与目标保持一致 PAR-17-150来确定LEP和HL的作用以及医疗保健利用的障碍 服务不足的高危人群，制定增加乙肝筛查和治疗的战略 服务业可能会对公共卫生产生深远的影响。

Chronic hepatitis B virus (HBV) infection is a leading cause of liver disease and hepatocellular carcinoma (HCC), the second most common cause of cancer death in the world. In the United States (US), where approximately 75% of all HBV infections (2.2 million) are undiagnosed, chronic HBV is concentrated in marginalized populations, most notably, immigrants (60%). Immigrants, particularly West African-born persons (>10%) bear a great burden of HBV infection in the US, many of whom have not been screened. Culturally-informed strategies are needed to increase screening in West African immigrants in the US. A proactive approach is particularly important because early diagnosis and treatment is the most effective way to reduce HBV-related liver failure and HCC. HBV can be detected with a simple blood test and antiviral treatment reduces disease progression. The project's central hypothesis is that HBV screening in West African-born persons can be improved by defining factors tied to culture, health literacy (HL) and limited English proficiency (LEP), and translating this information into an intervention. This project expands upon our prior work and pioneers novel approaches to increase HBV screening in an understudied population of West Africans residing in the US through community engagement. Development of strategies to increase HBV screening among this population could provide a framework for increasing HBV testing globally, where approximately 240 million persons are chronically infected. The Specific Aims are to: Aim 1: Test the association of sociocultural factors in West Africans (both in English and French) with positive views on HBV screening and intent to undergo screening; Aim 2: Develop and refine a program to increase HBV screening that integrates best practices for communication with low HL populations with culturally targeted messaging; Aim 3: Pilot test the education program (both in English and French) in West African communities to determine its acceptability and feasibility. The long-term goal is to reduce the burden of chronic HBV-related liver disease and HCC in West African immigrants and to reduce health disparities in screening for hepatitis B and ultimately liver cancer in the US and globally. Earlier detection and more effective management of persons infected with HBV will reduce overall HBV-related morbidity and mortality, and decrease known cancer disparities. The immediate goals are to better define sociocultural factors to develop and pilot test the first community- based, theory-informed program to eventually increase HBV screening in West Africans. In line with the goals of PAR-17-150 to determine the role of LEP and HL and barriers to utilization of care among medical underserved high-risk populations, the development of strategies to increase HBV screening and treatment services could have a profound public health impact.