Development of a Church-Based Small Group Intervention to Increase Hepatitis B (HBV) Screening Among Korean Americans

Chronic HBV causes 80-85% of liver cancer (Beasley, 1988; Blumberg, London, 1982; Chen et al., 1997), a disease Koreans are eight times more likely to develop than Caucasian Americans. Since over 60% of Korean Americans are foreign born (US Census, 2000) and chronic HBV rates among Asian immigrants are near 15% (CDC, 1991; Gjerdingen et al., 1997), programs to increase Koreans' HBV testing rates may significantly reduce the spread of HBV and liver disease.

To inform development of a culturally appropriate intervention to be administered in a randomized trial with 900 Korean Americans not tested for HBV, 6 focus groups were conducted in Korean with 60 participants recruited through Korean churches; 40 females,20 males, ages 22-75, with high school or greater education. Twenty-five participants had been tested for HBV.

Knowledge, attitudes and beliefs in the Korean community regarding HBV, HBV testing, and liver cancer were discussed. Few participants were aware of the HBV-liver cancer relationship or that, until advanced, HBV is asymptomatic. Beliefs of stress causing liver cancer and HBV being easily transmitted were predominant. A common misconception discussed was that routine blood work includes HBV testing. Reported barriers to testing included: lack of time, money, and health insurance, fear of testing positive, and feeling healthy. Overall, frustration navigating the healthcare system was expressed.

The utility of small group discussions to motivate HBV screening was confirmed. Participants were open to discussing health and expressed appreciation for information obtained. A unanimous intention to be screened was expressed by those not tested.