Online Program

Multilevel factors influencing hepatitis B vaccination among Vietnamese Americans

Monday, November 4, 2013

Paula Frew, PhD, MA, MPH, Emory University School of Medicine & Rollins School of Public Health, Emory University, Decatur, GA

Linda Vo, MPH, CHES, Emory University School of Medicine, Emory University, Decatur, GA
Tranh Nguyen, MPH, BPSOS, Norcross, GA
Brooke Hixson, MPH, Biostatistics, Emory University Rollins School of Public Health, Atlanta, GA
Minh Ly Nguyen, MD, MPH, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA
Background: Chronic Hepatitis B virus (HBV) infection is a significant health problem associated with liver cirrhosis, chronic liver disease, and liver cancer. One in 12 Asian Americans/Pacific Islanders (AAPIs) are living with HBV despite the availability of HBV vaccination. This study investigated barriers to HBV vaccination among Vietnamese in Atlanta, Georgia. We sought to identify potential intervention approaches to increase HBV immunization in this population.

Methods: Venue-based sampling was utilized to survey 316 persons ages <18 years from diverse community locations. Bivariate and multivariate analyses assessed the impact of individual, dyadic-(patient/physician), and community-level factors on HBV vaccination. We also performed an exploratory principal components factor analysis and evaluated corresponding internal consistencies of resulting factors.

Results: This study found that less than 50% (n=146) of the sample population received at least one dose of HBV vaccine. Internal consistencies demonstrated high levels of reliability for scaled items included in the multivariate vaccination model(Cronbach alpha = 0.76-0.89). The bivariate model accounting for individual-, dyadic- and community-level factors revealed that HBV vaccination intent was associated with age <42 years (OR=0.96), perceived social approval (OR=1.57), physician approval (OR=1.57), and community recommendation (OR=1.46). Similarly, among those who received at least one dose of HBV vaccine, vaccination was associated with age <42 years (OR=0.94), perceived social approval (OR=1.30), community recommendation (OR=1.74), and disbelief in Hepatitis B vaccination myths (OR=0.52).

Conclusions: The findings support the hypothesis that multiple-level factors facilitate HBV vaccination in this population. Tailored, culturally-appropriate communication strategies for targeted age groups will positively influence greater immunization uptake. The importance of healthcare provider recommendation of HBV vaccine are highlighted.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Explain socioecological factors influencing Hepatitis B vaccination among Vietnamese Describe the factors underlying the vaccine uptake Discuss the role of social and cultural factors in Hepatitis B vaccine promotion

Keyword(s): Hepatitis B, Immunizations

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator of multiple federally and privately funded grants focusing on vaccine acceptance and refusal in racially and ethnically diverse communities. I served as the lead behavioral investigator for this study which was funded by a federal supplement to the ACTSI award. My work therefore entailed engagement with the Vietnamese community on issues related to Hepatitis B prevention including understanding barriers to increasing vaccination for intervention development.
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.