ObjectivesThe aims of our study were to describe current hepatitis B prevalence among Vietnamese Americans and to examine predictors of hepatitis B risk in this specific ethnic community.DesignCross-sectional analysis of data from a community-based screening program.SettingThis analysis was based on hepatitis screening community events in Southern California.Participants2508 Vietnamese Americans in Southern California.Outcome measuresSerological tests for hepatitis B surface antigen, hepatitis B surface antibody, and total hepatitis B core antibody were used to classify participants as one of four hepatitis B infection statuses: currently infected, previously infected, susceptible, or immune due to a previous hepatitis B vaccination.ResultsAcross 2508 participants, 9.0% were currently infected with hepatitis B and 17.7% were at risk for hepatitis B. Females and those reporting a previous hepatitis B vaccination were at significant decreased risk of hepatitis B (OR=0.48, 95% CI 0.33 to 0.69 and OR=0.53, 95% CI 0.31 to 0.93, respectively) whereas those born outside of the USA and with a family history of the disease showed substantial increased risk (OR=13.36, 95% CI 1.62 to 110.05 and OR=4.68, 95% CI 2.66 to 8.22, respectively). Among those who reported a previous hepatitis B vaccination, less than half (42.9%) possessed the protective antibodies that result from a hepatitis B vaccination.ConclusionsVietnamese Americans remain disproportionately burdened by hepatitis B. Public health efforts that focus on improving hepatitis B awareness and vaccination knowledge and that are tailored to specific high-risk subgroups, such as immigrants and those with infected family members, could help in addressing the disease’s burden in this high-prevalence population.
Background Prevalence of hepatitis C virus (HCV) infection among Vietnamese Americans is reportedly high. Understanding the profile of those at greater risk of HCV in this ethnic population is a vital step to addressing this high prevalence. We hypothesize that certain sociodemographic characteristics increase the likelihood of having HCV in Vietnamese Americans. Methods Cross-sectional data from 2,497 Vietnamese Americans in Southern California who participated in a series of community hepatitis screening events organized by the Vietnamese American Cancer Foundation (VACF) were analyzed. Serological tests via immunoassays were used to determine whether the participant had hepatitis C antibodies (anti-HCV) to indicate a HCV infection. Sociodemographic characteristics as well as participants’ reasons for screening were collected from questionnaires, and logistic regression models with odds ratios (ORs) and 95% confidence intervals (CIs) were used to quantify their associations with HCV infection. Results Approximately 5.8% of the study population was infected with HCV. Older adults and male participants had higher odds of being infected with HCV (e.g. OR = 2.90, 95% CI 1.25–6.76 for ages 70+ versus ages <40; OR = 2.57, 95% CI 1.79–3.69 for male versus female participants) as were those with a family history of HCV infection (OR = 2.74, 95% CI 1.57–4.78). In addition, perceived self-risk as a motivation for screening was significantly associated with HCV infection (OR = 1.88, 95% CI 1.26–2.78). Conclusions This study identifies specific subgroups in the Vietnamese American community who would largely benefit from targeted interventions given their higher likelihood of having HCV. These interventions should emphasize improving HCV knowledge and promoting HCV self-risk assessment since awareness of one’s own risk may motivate those likely to be infected to get screened.
Introduction: Orange County (OC) is home to the third-largest population of Asian Americans in the U.S., including the largest population of Vietnamese outside of Vietnam. While breast, lung and colorectal cancers are the top overall causes of cancer incidence and mortality in OC, unique cancers are prevalent among Asian and Pacific Islanders including liver and stomach cancers. The University of California, Irvine Chao Family Comprehensive Cancer Center (UCI CFCCC) adapted a hub-and- spoke model of care (Elrod & Fortenberry, 2017) to increase efficiency among underserved Asian Americans who continue to experience disparities in screening, early detection, and access to cancer treatment. Methods: Our hub-and-spoke model arranges service delivery assets into a network between community organizations through culturally/linguistically competent and trained community health navigators, OC medicaid primary and specialty care providers for low/moderate complexity patients, and UCI CFCCC for high-complexity cancer treatment. UCI CFCCC serves as the anchor establishment (hub) which offers a full array of services. This is complemented by community providers and care coordinators at local Federally Qualified Health Centers (spokes) which offer culturally-tailored primary prevention services. The community patient navigators (rim) located at community-based organizations, routes patients needing more tailored services to the spokes or hub for screening or treatment. Results: Patient Navigators at OC Herald Center, OC Asian Pacific Islander Community Alliance, and Vietnamese American Cancer Foundation have educated 2,246 Korean, Vietnamese, and Chinese individuals on cancer prevention and screening guidelines. Of those, 320 medicaid members have been routed to KCS Health Centers (Korean-serving FQHC lookalike), Southland Integrated Services, Inc (Vietnamese and Chinese-serving FQHC), or Medicaid community providers for cancer screening and/or follow-up. 64 community providers have been trained on NCCN guideline adherent care for Korean, Vietnamese, and Chinese. UCI CFCCC has developed an algorithm/pathway for Medicaid-serving community physicians to easily refer qualified Vietnamese, Chinese, or Korean patients to the hub for complex care or clinical trials. Conclusions: The current COVID-19 pandemic has exacerbated disparities in screening and early detection, and compounds the uncertainty about the importance of optimizing cancer care quality (i.e. access proportion and timeliness, adherence to guidelines, patient satisfaction). Disparities being highlighted in COVID-19 has shown us the power and need of community engagement models to rapidly catalyze and create unique community-based efforts that strengthen capacities and infrastructures, and promote best practices in cancer prevention and early detection designed to decrease cancer incidence and/or mortality in the communities we serve. Citation Format: Cevadne Lee, Ellen Ahn, Mary Anne Foo, Sherry Huang, Becky Nguyen, Tricia Nguyen, Jacqueline Tran, Robert Bristow, Sora Park Tanjasiri. A hub and spoke model to improve cancer care quality: Advancing Cancer Care Together (ACCT) for Asian American Medicaid beneficiaries in Orange County, California [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-021.
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