BackgroundThis study aimed to evaluate the effect of a lay health worker (LHW) telephone intervention on completing a series of hepatitis B virus (HBV) vaccinations among foreign-born Asian Americans in the Baltimore-Washington Metropolitan area.MethodsDuring the period of April 2013 and March 2014, we recruited Asian Americans who were 18 years of age and older in the community-based organizations. Of the 645 eligible participants, 600 (201 Chinese, 198 Korean, 201 Vietnamese) completed a pretest survey and received hepatitis B screening. Based on the screening results, we conducted a randomized controlled trial among those unprotected (HBsAg-/HBsAB-) by assigning them either to an intervention group (n = 124) or control group (n = 108). The intervention group received a list of resources by mails for where to get free vaccinations as well as reminder calls for vaccinations from trained LHWs, while the control group received only list of resources by mail. Seven months after mailing the HBV screening results, trained LHWs followed up with all participants by phone to ask how many of the recommended series of 3 vaccinations they had received: none, 1 or 2, or all 3 (complete). Their self-reported vaccinations were verified with the medical records. Multinomial logistic regressions were used to examine the effect of the LHW intervention. Process evaluation was conducted by asking study participants in the intervention group to evaluate the performance of the LHWs.ResultsAfter seven months, those in the intervention group were more likely to have 1 or more vaccines than the control group, compared to the no vaccination group (OR = 3.04, 95% CI, 1.16, 8.00). Also, those in the intervention group were more likely to complete a series of vaccinations than the control group, compared to the no vaccination group (OR = 7.29, 95% CI 3.39, 15.67). The most important barrier preventing them from seeking hepatitis B vaccinations was lack of time to get the vaccination. The most important promoters to getting vaccinations, among those who had vaccinations (n = 89), were our intervention program (70.8%) and self-motivation (49.4%). The majority of participants in the intervention group received the phone calls from LHWs (93%) and almost all of them got the reminder to receive vaccines (98%).ConclusionThe LHW intervention was successful at increasing HBV vaccinations rates among foreign-born Asian Americans. This study suggests that this culturally integrated intervention program may be useful for reducing liver cancer disparities from chronic HBV infection in high risk Asian Americans.Trial RegistrationClinicalTrials.gov NCT02760537

Flipped or inverted classroom (IC) models are promising for foreign language instruction in that they appear to promote well-regarded practices that bridge both sociocultural and cognitive theoretical frameworks, such as allowing for higher degrees of learner agency and facilitating deeper levels of processing. To date, the majority of work on IC models for language learning has been instructional rather than empirical in nature. By contrast, this study examined the impact of IC lessons on 14 intact third-semester Spanish classes (N = 213). Instructors were randomly assigned to either an IC or an in-class presentational (CP) condition for lessons and accompanying assignments on 2 uses of the Spanish pronoun se. An attitudinal inventory indicated that learners in the IC condition rated their assignments significantly higher in terms of perceived comfort, enjoyment, and subsequent confidence in the material. However, regression analysis showed that ratings were stratified based upon several predictor variables. For measures of L2 knowledge, learners in the IC condition performed significantly better than those in the CP when identifying grammatical uses of the target structure on a grammaticality judgment test. No significant differences were found between the groups' performance on a rule description task or a chapter test. Implications for implementing IC models are discussed.

Few studies have investigated the prevalence of hepatitis B virus (HBV) and C virus (HCV) infection among Vietnamese Americans (VAs). The purpose of this paper is to assess the prevalence of HBV and HCV infection, identify the sociodemographic characteristics of the HBV infected population and the level of HBV knowledge among VAs in the Baltimore-Washington-Metropolitan-Areas with data from a health fair in 2011. A total of 617 VAs received serological testing for HBV and HCV, and 329 completed a survey of HBV knowledge assessment. About 9% were infected with HBV and 5% with HCV. VAs younger than 30 years had the highest HBV prevalence (13.1%) followed by those age 41–50 years (12.1%). The prevalence of HCV infection was particularly higher among those older than 70 years old (13.9%). Misunderstanding HBV as a food-borne disease is prevalent among VAs. Efforts to develop public health screening and education programs targeting this population are warranted.

IntroductionMongolia has the highest liver cancer incidence in the world. Hepatocellular carcinoma is the most prevalent primary liver cancer, and the most common risk factors are hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. Although viral hepatitis occurs mostly in the developing world, migration of people from high prevalence countries contributes to the health outcomes of the United States. Data on Mongolian Americans is limited. The objective of this study was to estimate HBV and HCV infection prevalence among Mongolia-born immigrants living in the Washington, District of Columbia, metropolitan area.MethodsWe tested Mongolia-born immigrants for chronic hepatitis at community-based screening events from 2016 to 2017. Descriptive statistics were generated to describe the screening results. Bivariate analysis was conducted to examine the relationship between hepatitis prevalence and sociodemographic characteristics.ResultsOf 634 participants, most did not speak English primarily, were uninsured, and did not have a regular primary care provider. Eighty-two participants (12.9%) had chronic HBV or HCV infection after accounting for HBV and HCV co-infection. Thirty-nine (6.2%) were chronically infected with HBV, and 233 (36.8%) were susceptible to HBV. Sixty-three (9.9%) participants were positive for HCV exposure, and 45 (7.1%) had confirmed chronic HCV infection. While no sociodemographic characteristics were associated with HBV infection, age and primary spoken language (Mongolian) were significantly associated with HCV exposure.ConclusionForeign-born immigrants such as Mongolian Americans have a high prevalence of chronic viral hepatitis infection. Targeted screening, vaccination, and treatment programs can help decrease immigrant risk for developing hepatocellular carcinoma.

Introduction: While the majority of viral hepatitis is experienced in the developing world, migration of people from high prevalence countries contributes to health outcomes in the United States. The purpose of this study was to estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in foreign-born immigrants living in the Baltimore-Washington metropolitan area.Methods: This study used cross-sectional data from 5,982 individuals screened at community events held from 2009 to 2015. Descriptive statistics were generated to describe the screening results. Positive results for HBV infection (HBsAg+) and HCV infection (HCVAb+) were analyzed according to age, gender, and country of birth.