Liver Cancer Control Among North American Chinese

描述(申请人提供)：对在北美的中国人的疾病预防行为知之甚少，也很少有研究涉及这一群体的癌症控制。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。这种额外的风险可归因于高乙肝病毒感染率和低水平的乙肝疫苗接种覆盖率。这项研究的目标是增加接受过乙肝检测的文化程度较低的中国成年人的比例(因此，要么接种了疫苗，要么筛查了肝癌，要么知道自己对这种疾病有免疫力)。目标是：获得有关华裔美国人和加拿大人肝癌预防行为的定性和定量信息；开发针对中国人乙肝和肝癌的文化和语言上合适的外展干预措施；并进行随机对照试验，以评估干预计划的有效性、可行性和可接受性。为了增加我们发现的概括性，这项研究将在两个城市进行：华盛顿州西雅图和不列颠哥伦比亚省温哥华。该项目将强调社区参与。将使用前置和定性方法(即40次深度访谈和8个焦点小组)来制定定量调查工具和干预内容。600名年龄在18岁-之间的中国男性和女性没有接受乙肝病毒血清学检测，他们将从一项基于社区的1,200人调查中确定出来，并随机进入干预或控制状态。试验组的个人将接受外展工作人员的干预(包括家访和后续电话，量身定做的咨询和后勤援助，以及使用视听和印刷材料)。结果评估将基于后续调查和医疗记录核实的数据。如果有效，我们的外展干预措施可以被北美的卫生保健机构和社区组织使用，这些机构和社区组织服务于不太适应文化的中国人。

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.