Skip to main content

Advertisement

SpringerLink
Log in

Ethnic Differences in Prevalence and Barriers of HBV Screening and Vaccination Among Asian Americans

  • Original Paper
  • Published:
Journal of Community Health Aims and scope Submit manuscript

Abstract

Our study identifies the prevalence of HBV virus (HBV) screening and vaccination among Asian Americans, and ethnic differences for factors associated with screening and vaccination behaviors. In 2009–2010 we recruited 877 Korean, Chinese, and Vietnamese Americans 18 years of age and above through several community organizations, churches and local ethnic businesses in Maryland for a health education intervention and a self-administered survey. Prevalence of HBV screening, screening result and vaccinations were compared by each ethnic group. We used logistic regression analysis to understand how sociodemographics, familial factors, patient-, provider-, and resource-related barriers are associated with screening and vaccination behaviors, using the total sample and separate analysis for each ethnic group. Forty-seven percent of participants reported that they had received HBV screening and 38% had received vaccinations. Among the three groups, the Chinese participants had the highest screening prevalence, but lowest self-reported infection rate; Vietnamese has the lowest screening and vaccination prevalence. In multivariate analysis, having better knowledge of HBV, and family and physician recommendations was significantly associated with screening and vaccination behaviors. Immigrants who had lived in the US for more than a quarter of their lifetime were less likely to report ever having been screened (OR = 0.39, 95% CI: 0.28–0.55) or vaccinated (OR = 0.62, 95% CI: 0.44–0.88). In ethnic-specific analysis, having a regular physician (OR = 4.46, 95% CI: 1.62–12.25) and doctor’s recommendation (OR = 2.11, 95% CI: 1.05–4.22) are significantly associated with Korean’s vaccination behaviors. Health insurance was associated with vaccination behaviors only among Vietnamese (OR = 2.66, 95% CI: 1.21–5.83), but not among others.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Ganem, D., & Prince, A. M. (2004). Hepatitis B virus infection–natural history and clinical consequences. New England Journal of Medicine, 350(11), 1118–1129.

    Article  PubMed  CAS  Google Scholar 

  2. Beasley, R. P. (1988). Hepatitis B virus. The major etiology of hepatocellular carcinoma. Cancer, 61(10), 1942–1956.

    Article  PubMed  CAS  Google Scholar 

  3. McMahon, B. J. (2009). The natural history of chronic hepatitis B virus infection. Hepatology, 49(5 suppl), S45–S55.

    Article  PubMed  CAS  Google Scholar 

  4. Altekruse, S. F., McGlynn, K. A., & Reichman, M. E. (2009). Hepatocellular carcinoma incidence, mortality, and survival trends in the United States from 1975 to 2005. Journal of Clinical Oncology, 27(9), 1485–1491.

    Article  PubMed  Google Scholar 

  5. Centers for Disease Control and Prevention (CDC). (2006). Screening for chronic hepatitis B among Asian/Pacific Islander populations–New York City, 2005. MMWR Morbidity Mortality Weekly Report, 55(18), 505–509.

    Google Scholar 

  6. Lee, H., Hontz, I., Warner, A., & Park, S. J. (2005). Hepatitis B infection among Asian American Pacific Islanders in the Rocky Mountain area. Applied Nursing Research, 18(1), 2–6.

    Article  PubMed  Google Scholar 

  7. Ma, G. X., Shive, S. E., Fang, C. Y., Feng, Z., Parameswaran, L., Pham, A., et al. (2007). Knowledge, attitudes, and behaviors of hepatitis B screening and vaccination and liver cancer risks among vietnamese Americans. Journal of Health Care for the Poor and Underserved, 18(1), 62–73.

    Article  PubMed  Google Scholar 

  8. Choe, J. H., Taylor, V. M., Yasui, Y., Burke, N., Nguyen, T., Acorda, E., et al. (2006). Health care access and sociodemographic factors associated with hepatitis B testing in Vietnamese American men. Journal of Immigrant and Minority Health, 8(3), 193–201.

    Article  PubMed  Google Scholar 

  9. Taylor, V. M., Jackson, J. C., Chan, N., Kuniyuki, A., & Yasui, Y. (2002). Hepatitis B knowledge and practices among Cambodian American women in Seattle, Washington. Journal of Community Health, 27(3), 151–163.

    Article  PubMed  Google Scholar 

  10. Hu, K. Q. (2008). Hepatitis B virus (HBV) infection in Asian and Pacific Islander Americans (APIAs): How can we do better for this special population? American Journal of Gastroenterology, 103(7), 1824–1833.

    Article  PubMed  Google Scholar 

  11. Liang, W., Wang, J. H., Chen, M. Y., & Mandelblatt, J. S. (2009). Language use and the receipt of cancer screening recommendations by immigrant Chinese American women. Journal of Womens Health (Larchmt), 18(2), 201–207.

    Article  Google Scholar 

  12. Juon, H.-, Kim, M., Shankar, S., & Han, W. (2004). Predictors of adherence to screening mammography among Korean American women. Preventive Medicine, 39(3), 474–481.

    Article  PubMed  Google Scholar 

  13. Coronado, G. D., Taylor, V. M., Tu, S. P., Yasui, Y., Acorda, E., Woodall, E., et al. (2007). Correlates of hepatitis B testing among Chinese Americans. Journal of Community Health, 32(6), 379–390.

    Article  PubMed  Google Scholar 

  14. Taylor, V. M., Yasui, Y., Burke, N., Nguyen, T., Chen, A., Acorda, E., et al. (2004). Hepatitis B testing among Vietnamese American men. Cancer Detection and Prevention, 28(3), 170–177.

    Article  PubMed  Google Scholar 

  15. Nguyen, T. T., McPhee, S. J., Stewart, S., Gildengorin, G., Zhang, L., Wong, C., et al. (2010). Factors associated with hepatitis B testing among Vietnamese Americans. Journal of General Internal Medicine, 25(7), 694–700.

    Article  PubMed  Google Scholar 

  16. Huang, K., & Carrasquillo, O. (2008). The role of citizenship, employment, and socioeconomic characteristics in health insurance coverage among Asian subgroups in the United States. Medical Care, 46(10), 1093–1098.

    Article  PubMed  Google Scholar 

  17. Ward, E., Halpern, M., Schrag, N., Cokkinides, V., DeSantis, C., Bandi, P., et al. (2008). Association of insurance with cancer care utilization and outcomes. CA Cancer Journal for Clinicians, 58(1), 9–31.

    Article  Google Scholar 

  18. Taylor, V. M., Yasui, Y., Burke, N., Choe, J. H., Acorda, E., & Jackson, J. C. (2005). Hepatitis B knowledge and testing among Vietnamese-American women. Ethnicity and Disease, 15(4), 761–767.

    PubMed  Google Scholar 

  19. Alter, M. J. (2003). Epidemiology and prevention of hepatitis B. Seminars in Liver Disease, 23(1), 39–46.

    Article  PubMed  Google Scholar 

  20. Ayers, J. W., Juon, H. S., Lee, S., & Park, E. (2010). Hepatitis B vaccination prevalence and its predictors among Asian, Pacific Islander, Native American, and multiracial adults in the national health and nutrition examination survey. Journal of Immigrant and Minority Health, 12(6), 847–852.

    Article  PubMed  Google Scholar 

  21. Kwong, S. L., Stewart, S. L., Aoki, C. A., & Chen, M. S., Jr. (2010). Disparities in hepatocellular carcinoma survival among Californians of Asian ancestry, 1988 to 2007. Cancer Epidemiology, Biomarkers and Prevention, 19(11), 2747–2757.

    Article  PubMed  Google Scholar 

  22. Murakami, H., Van Cuong, N., Huynh, L., & Hipgrave, D. B. (2008). Implementation of and costs associated with providing a birth-dose of hepatitis B vaccine in Viet Nam. Vaccine, 26(11), 1411–1419.

    Article  PubMed  Google Scholar 

  23. Centers for Disease Control and Prevention (CDC). (2007). Progress in hepatitis B prevention through universal infant vaccination–China, 1997–2006. MMWR Morbidity and Mortality Weekly Report, 56(18), 441–445.

    Google Scholar 

  24. Chen, L., Juon, H. S., & Lee, S. (2011). Acculturation and BMI among Chinese, Korean and Vietnamese adults. Journal of Community Health. doi:10.1007/s10900-011-9476-1.

  25. Taylor, V. M., Seng, P., Acorda, E., Sawn, L., & Li, L. (2009). Hepatitis B knowledge and practices among Cambodian immigrants. Journal of Cancer Education, 24(2), 100–104.

    Article  PubMed  Google Scholar 

  26. Taylor, V. M., Jackson, J. C., Pineda, M., Pham, P., Fischer, M., & Yasui, Y. (2000). Hepatitis B knowledge among Vietnamese immigrants: Implications for prevention of hepatocellular carcinoma. Journal of Cancer Education, 15(1), 51–55.

    PubMed  CAS  Google Scholar 

  27. StataCorp. (2009). Stata Statistical Software. Release 11, 2009.

  28. Cohen, C., Holmberg, S. D., McMahon, B. J., Block, J. M., Brosgart, C. L., Gish, R. G., et al. (2011). Is chronic hepatitis B being undertreated in the United States? Journal of Viral Hepatitis, 18(6), 377–383.

    Article  PubMed  CAS  Google Scholar 

  29. Lai, A. C., & Salili, F. (1996). Stress in parents whose children are hepatitis B virus (HBV) carriers: a comparison of three groups in Guangzhou, China. Child: Care, Health and Development, 22(6), 381–396.

    Article  CAS  Google Scholar 

  30. Juan, S. (2009). Hepatitis B tests for jobs set to stop. Available at: http://www.chinadaily.com.cn/china/2009-12/30/content_9244044.htm. Accessed 5/11, 2011.

  31. Juan, S. (2011). Stop screening would-be workers. Available at: http://www.chinadaily.com.cn/china/2011-02/14/content_11998999.htm. Accessed 5/11, 2011.

  32. Lesmana, L., Leung, N., Mahachai, V., Phiet, P., Suh, D., Yao, G., et al. (2006). Hepatitis B: Overview of the burden of disease in the Asia-Pacific region. Liver International, 26, 3–10.

    Article  Google Scholar 

  33. Chen, J. Y., Swonger, S., Kominski, G., Liu, H., Lee, J. E., & Diamant, A. (2009). Cost-effectiveness of insuring the uninsured: The case of Korean American children. Medical Decision Making, 29(1), 51–60.

    Article  PubMed  CAS  Google Scholar 

  34. Daley, M. F., Hennessey, K. A., Weinbaum, C. M., Stokley, S., Hurley, L. P., Crane, L. A., et al. (2009). Physician practices regarding adult hepatitis B vaccination: A national survey. American Journal of Prevention and Medicine, 36(6), 491–496.

    Article  Google Scholar 

Download references

Acknowledgments

We thank all participants of this study. We appreciate the dedicated work in the field from the research team: Hyeyeon Yoon, Yang Wu, Hien Tran, Lu Chen, Byung Joon Park, Anh H. Huynh, Jun Sang Park, Kim-Vy Nguyen-Ngoc, and Woochul Park. Funding for this study was provided by National Cancer Institute Grant R25CA129042. NCI had no further role in study design, data collection, analysis, or interpretation, in the writing of the report, or in the decision to submit the paper for publication.

Author information

Authors and Affiliations

  1. Institute of Sociology, Academia Sinica, 128 Sec. 2 Academia Rd., Nankang, Taipei, 11529, Taiwan

    Carol Strong

  2. Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, 2234C SPH Bldg, College Park, MD, 20742, USA

    Sunmin Lee

  3. Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624N. Broadway, Room # 704, Baltimore, MD, 21205, USA

    Miho Tanaka & Hee-Soon Juon

Authors
  1. Carol Strong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sunmin Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miho Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hee-Soon Juon
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hee-Soon Juon.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Strong, C., Lee, S., Tanaka, M. et al. Ethnic Differences in Prevalence and Barriers of HBV Screening and Vaccination Among Asian Americans. J Community Health 37, 1071–1080 (2012). https://doi.org/10.1007/s10900-012-9541-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10900-012-9541-4

Keywords

Search

Navigation