244575 Hepatitis B Screening and Immunization is Critical for Early Clinical Management of HBV Infection for Asian Americans in Ohio

Sunday, October 30, 2011

Ranjita Misra, PhD , Health and Kinesiology, Texas A&M University, College Station, TX
Karen Jiobu, BA, MA , Ohio Asian American Health Coalition, Regional Coordinator, Health through Action, Columbus, OH
Johnathan Zhang, BS , College of Medicine, Ohio State University Medical Center, Columbus, OH
Joanna Liu, BS , College of Medicine, Ohio State University Medical Center, Columbus, OH
Feng Li, BA , College of Medicine, Ohio State University Medical Center, Lexington, KY
Robert Kirkpatrick, MD , Department of Gastroenterology, Ohio State University Medical Center, Columbus, OH
Jason Ho, BS , College of Medicine, Ohio State University Medical Center, Columbus, OH
Payal Kahar, MPH , Doctoral Student, Department of Health and Kinesiology, Texas A&M University, College Station, TX
Disproportionately higher rate of chronic Hepatitis B virus (HBV) infection and liver cancer mortality among Asian Americans represent a neglected health disparity.This project examined knowledge, family history, past screening, current infection and treatment of HBV among a diverse group of 1180 Franklin Country,Ohio residents (85% Asians, 7.5% African American, and 6.5% White). Community health workers (CHW) helped in recruiting underserved and hard-to-reach Asians for screenings and follow-up. HBV screening was completed at health fairs, restaurants, churches and temples over a four year period. Results from the survey and blood serum analyses showed HBV infection rate was 5.5% (5.3% Asian, 0.3% non-Asians). Asians had significantly higher rates of HBV infection and family history of liver as compared to other racial ethnic groups (P=.001). Disparity in HBV infection also existed within the Asian community, with Cambodian (10.5%), Vietnamese (10.2%) and Chinese (8.1%) participants disproportionately infected with the virus than other Asian subgroups (P<.001). Although vaccine eligible Asians were provided vouchers by Columbus Public Health Department to receive free vaccinations, compliance was only 11.5% in 2009-2010. CHW follow-ups showed time, low English Proficiency, and fear of side effects were common barriers to compliance. Further, many did realize the immunization involved a series of 3 shots. Hence, outreach education using CHWs for screenings, and vaccination/ treatment is vital for this high risk group. Advocacy and policy changes have resulted in the establishment of a hepatitis free clinic for providing culturally and linguistically appropriate treatment for low income Asian Americans in Franklin County.

Learning Areas:
Advocacy for health and health education
Assessment of individual and community needs for health education
Chronic disease management and prevention
Clinical medicine applied in public health
Communication and informatics
Diversity and culture

Learning Objectives:
1.Describe the HBV infection among Asian Americans in Franklin county. 2.List the differences in HBV infection and vaccine eligible cases by subgroups. 3.Discuss the advocacy efforts that improved awareness and access to HBV vaccination for high risk Asian adults.

Keywords: Hepatitis B, Community Preventive Services

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was instrumental in organizing and coordinating Hepatitis B screening at the various community forums.
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.