1Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, UCLA Fielding School of Public Health firstname.lastname@example.org.
2Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, UCLA Fielding School of Public Health.
3Family and Community Medicine, University of New Mexico.
4Department of Public Health Sciences, University of California, Davis.
5Division of General Internal Medicine, Department of Medicine, University of California, San Francisco.
6Department of Public Health Sciences, School of Medicine, University of California Davis.
7Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center.
In the United States, Korean immigrants experience a disproportionately high burden of chronic hepatitis B (HBV) viral infection and associated liver cancer compared to the general population. However, despite clear clinical guidelines, HBV serologic testing among Koreans remains persistently sub-optimal.
We conducted a cluster-randomized trial to evaluate a church-based small group intervention to improve HBV testing among Koreans in Los Angeles. Fifty-two Korean churches, stratified by size (small, medium, large) and location (Koreatown versus other), were randomized to intervention or control conditions. Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing and control church participants attended a similar session on physical activity and nutrition. Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews.
We recruited 1123 individuals, 18-64 years of age, across the 52 churches. Ninety-two percent of the sample attended the assigned intervention session and 86% completed the 6-month follow-up. Sample characteristics included: mean age 46 years, 65% female, 97% born in Korea, 69% completed some college, and 43% insured. In an intent-to-treat analysis, the intervention produced a statistically significant effect (OR = 4.9, p < .001), with 19% of intervention and 6% of control group participants reporting a HBV test.
Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae.
The intervention was fairly resource efficient and thus has high potential for replication in other high-risk Asian groups.