Liver Cancer Control Among North American Chinese

描述（由申请人提供）：我们对北美华人的疾病预防行为知之甚少，很少有研究涉及该群体的癌症控制。然而，华裔美国男性和女性被诊断为肝癌的可能性是非拉丁裔白人的四倍。这种过度风险是由于乙型肝炎病毒（HBV）感染率高，同时乙型肝炎疫苗接种覆盖率低。本研究的目的是增加接受HBV检测的中国不太适应文化的成年人的比例（因此，要么接种过疫苗，要么进行过肝癌筛查，要么知道自己对这种疾病有免疫力）。目的：获得美籍华人和加拿大华人肝癌预防行为的定性和定量信息；针对中国人的乙型肝炎和肝癌制定文化和语言上适当的外展干预措施；并进行随机对照试验，评估干预方案的有效性、可行性和可接受性。为了增加我们研究结果的普遍性，研究将在两个城市进行：华盛顿州的西雅图和不列颠哥伦比亚省的温哥华。该项目将强调社区参与。将使用先验和定性方法（即40次深入访谈和8个焦点小组）来制定定量调查工具和干预组成部分。600名未进行HBV血清学检测的18-64岁的中国男性和女性将从一项基于社区的1200人调查中确定，并随机分为干预组或对照组。实验组中的个人将接受外展工作者的干预（包括家访和后续电话，量身定制的咨询和后勤援助，以及使用视听和印刷材料）。结果评估将基于随访调查的数据以及医疗记录验证。如果有效，我们的外展干预可以被北美的医疗机构和社区组织使用，这些组织为不太适应文化的中国人服务。

DESCRIPTION (provided by applicant): Little is known about the disease prevention behavior of Chinese in North America, and few studies have addressed cancer control in this group. However, Chinese American men and women are four times more likely to be diagnosed with liver cancer than their non-Latino White counterparts. This excess risk is attributable to high rates of hepatitis B virus (HBV) infection combined with low levels of hepatitis B vaccination coverage. The goal of this research is to increase the proportion of less acculturated Chinese adults who have been tested for HBV (and, therefore, either have been vaccinated, are screened for liver cancer, or know they are immune to the disease). Objectives are to: obtain qualitative and quantitative information about the liver cancer prevention behavior of Chinese Americans and Canadians; develop a culturally and linguistically appropriate outreach intervention targeting hepatitis B and liver cancer among Chinese; and conduct a randomized controlled trial to evaluate the effectiveness, feasibility, and acceptability of the intervention program. To increase the generalizability of our findings, the research will be conducted in two cities: Seattle, Washington and Vancouver, British Columbia. The project will emphasize community involvement. PRECEDE and qualitative methods (i.e., forty in-depth interviews and eight focus groups) will be used to develop a quantitative survey instrument as well as intervention components. Six hundred Chinese men and women aged 18-64 who have not been serologically tested for HBV will be identified from a community-based survey of 1,200 individuals, and randomized to intervention or control status. Individuals in the experimental group will receive an outreach worker intervention (which will include a home visit and follow-up telephone call, tailored counseling and logistic assistance, and the use of audiovisual and print materials). Outcome evaluation will be based on data from a follow-up survey as well as medical record verification. If effective, our outreach intervention could be used by health care facilities and community organizations serving less acculturated Chinese in North America.