How self-efficacy can assist in translating knowledge into behavior: Promoting liver cancer prevention through Hepatitis B screening among Asian immigrants in Maryland

Background Liver cancer is a leading cause of mortality in Asian and western Pacific countries and chronic hepatitis B virus (HBV) infection is its most common cause. Knowledge about the disease and screening uptake are low. Research shows that that knowledge is a necessary though not sufficient condition for behavior change; self-efficacy is required to translate knowledge into action.

Methods Data come from a longitudinal study in Maryland to promote HBV screening behaviors by enhancing knowledge and efficacy. Participants were recruited through community-based organizations. Participants (N=277) completed a self-administered pretest and posttest questionnaire following a 60-minute educational program. Respondents were immigrants from China (55%) and Korea (44%). Average age was 46.8 years (SD=12), two-thirds had at least some college education, and 40% were male.

Results Knowledge about HBV infection: average score 45.4% (SD=22.5). Significant predictors of knowledge were age (β=-.14, P<.05) and education (β=.19, P<.01), but not gender or income. Knowledge (β=.20, P<.001) was a predictor of liver cancer screening, as were self-efficacy (β=.25, P<.001) and the knowledgeXefficacy interaction term (β=.13, P<.05) (such that the knowledge-behavior relationship was stronger among those with higher efficacy).

Conclusion Immigrants with higher levels of efficacy were better able to translate knowledge about HBV into screening behaviors. When efficacy was low, the association between knowledge and behavior was also low. Public health interventions should focus on imparting knowledge, but it is critical to enhance self-efficacy to promote screening behaviors. On the basis of social cognitive theory, the presentation will provide guidance on enhancing efficacy.