Lay health workers increased screening rates for hepatitis B virus and knowledge about the disease among Sacramento-area Hmong Americans, UC Davis researchers have found.
Hmong Americans are at elevated risk for chronic hepatitis B — the major risk factor for liver cancer. Although Hmong Americans often have health insurance, cultural and language barriers can prevent access to adequate screening for hepatitis B and liver cancer, according to study author Moon Chen Jr., a professor and associate director for cancer control, who led the research effort.
“Compared to other Asian Americans, liver cancer tends to be found at a later stage among the Hmong, and the survival rate is very low. While the overall survival rate for liver cancer is 10 percent, Hmong people who are diagnosed with the disease usually live for less than a year, and often for as little as a month or two,” said Chen.
“We wanted to decrease the probability of earlier death from liver cancer among the Hmong and increase the probability of earlier detection.”
In the study, 260 Hmong residents of Sacramento were randomly assigned to two groups. One group received home-based health education about hepatitis B and liver cancer during two visits from workers fluent in Hmong and knowledgeable about the Hmong culture. A second group learned about healthy nutrition and physical activity.
Six months later, 24 percent of Hmong subjects who learned about HBV and liver cancer were later screened for HBV, compared to only 10 percent of those in the nutrition and exercise group.
Chronic HBV is endemic in Asia, parts of Africa and Alaska, according to the U.S. Centers for Disease Control and Prevention. However, the concept of an infectious disease such as hepatitis B is foreign to the Hmong, since there are few terms in their language for biological agents that are not visible to the naked eye.
Although the health-care worker visits boosted screening rates, use of this approach as an outreach tool would require an intensive effort, Chen said. Another effective way to increase the screening rates may be to work with healthcare providers to encourage them to suggest screenings to Hmong patients, he said.
The study appeared this week in Cancer Epidemiology, Biomarkers and Prevention.
— UC Davis Health News Office