Grace X. Ma¹, Yin Tan², Min Qi Wang³, Ying Yuan⁴ and Wang Gyu Chae⁵

¹Professor of Public Health, Department of Public Health, Director of Center for Asian Health, College of Health Professions, Temple University, 913 Ritter Annex, 1301 Cecil B. Moore Ave, Philadelphia, PA, USA. ²Senior Research Manager, Center for Asian Health, Department of Public Health, College of Health Professions, Temple University, Philadelphia, PA, USA. ³Professor, Department of Public and Community Health, University of Maryland, College Park, Maryland, USA. ⁴Community Research Coordinator, Center for Asian Health, Temple University, ⁵Director of Inter-Ethnic Relations, Asian Community Health Coalition, Philadelphia, PA, USA.

Abstract

Objective: The purpose of this community-based study was to determine factors associated with hepatitis B virus (HBV) screening compliance and non-compliance among Chinese, Korean, Vietnamese and Cambodian adults with varying levels of English language proficiency.

Methods: A cross-sectional design was used consisting of a sample of 1,603 Asian adult men and women.

Results: Overall, 71.4% of the sample reported having never been screened and 28.6% reported being screened for HBV. Demographic, acculturation, and barrier factors were differentially associated with screening rates among the subgroups. Demographic factors associated with never-screened were: lower education, younger age, being male, and no insurance for Chinese; lower education, lower income and no insurance for Cambodians; younger age and unmarried for Koreans; and no health insurance for Vietnamese; Acculturation factors associated with never-screened were: not speaking English for Chinese; not speaking English, not reading newspapers in English, and watching TV in one’s native language for Cambodians; not speaking English for Koreans; while no significant factors were found for Vietnamese. All barriers were associated with never-screened for Cambodians and Chinese. Those who lacked knowledge about HBV and had language and transportation barrier were more likely to be never-screened for Koreans. There were no significant relationships between the barriers and the screening status for Vietnamese.

Conclusions: High incidence of HBV and liver cancer in Asian Americans mandates a more vigorous and more culturally and linguistically appropriate educational effort to increase screening and vaccination for HBV in these underserved and mostly uninsured populations.