Behavioral mediators of hepatitis B screening in a randomized controlled intervention trial for Vietnamese Americans

Background: Chronic hepatitis b (HepB) is a major health disparity among Vietnamese Americans. It is important to understand mediators of behavioral change for the optimization of screening intervention strategies.

Objective: To evaluate the effects of behavioral mediators on HepB screening intervention in a randomized controlled trial.

Method: A community-based, randomized controlled trial at 36 Vietnamese community organizations was conducted in the eastern region of PA and NJ. The intervention, based on a conceptual framework derived from the Health Belief Model and Social Cognitive Theory, targeted knowledge of HepB, health beliefs, social support and barriers to screening and vaccination.  The general linear models with repeated measures were conducted to examine the difference in self-efficacy scores between the intervention and control groups at 6-month follow up.  

Results: Consistent with the HBM and SCT Model, results indicated that all cognitive scores (i.e., self-efficacy, knowledge, perceived barrier, perceived-benefits, perceived severity, and perceived risks and susceptibility) improved significantly more for the intervention group than the control group, p<.001. Finally, a logistic regression was conducted with the change scores of cognitive variables and the group variable as the predictor and the HepB screening at the 6 month follow-up as the dependent variable.  Results of each cognitive variable individually was significantly related to the HepB screening (p<.01).  However, when all cognitive variables were included in the multivariate logistic model, only perceived severity and perceived risks and susceptibility, significant, p<.05.

Conclusion: HepB screening programs targets perceived severity and perceived risks and susceptibility can improve screening in at-risk community.