218023 How self-efficacy can assist in translating knowledge into behavior: Promoting liver cancer prevention through Hepatitis B screening among Asian immigrants in Maryland

Tuesday, November 9, 2010

Rajiv N. Rimal, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Sunmin Lee, ScD, MPH , Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD
Yang Wu, MA , Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Hee-Soon Juon, PhD , Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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.

Learning Areas:
Administer health education strategies, interventions and programs
Assessment of individual and community needs for health education
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Apply concepts from health behavior change theory in an intervention setting. 2. Discuss how to link formative research with intervention strategy.

Keywords: Screening, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conducted the literature review, analyzed data, and wrote parts of the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.