Hepatitis B (HBV) infection plays a primary role in the development of liver cancer, contributing to nearly 80% of liver cancer cases. Vietnamese males have the highest incidence of liver cancer of any ethnic group, and HBV infection is a serious and prevalent health problem among Vietnamese immigrants. Guided by the Health Belief Model framework, the purpose of the present study was to assess levels of perceived risk, severity, barriers and benefits, and cues to action in HBV screening and vaccination in relation to actual screening and vaccination behavior in a sample of Vietnamese adults. The study consisted of 359 Vietnamese adults residing in Pennsylvania and New Jersey. The majority of participants were immigrants (98.1%) and had low socio-economic and educational status. Only 8.8% of participants reported being screened and 7.3% vaccinated for HBV. Participants who had been screened reported feeling at higher risk and perceived HBV infection to be more likely to lead to liver cancer and death than those who had not been screened. In addition, participants who had been screened reported fewer perceived barriers and more cues to action than unscreened participants. Compared to participants who had been vaccinated, unvaccinated participants were more likely to report feeling healthy and a lack of knowledge about where to obtain HBV testing as barriers. Multivariate logistic regression analyses indicated that perceived barriers were negatively associated with screening behavior as well as vaccination behavior. These results suggest that community-based, culturally appropriate interventions for Vietnamese Americans should directly address barriers to screening and vaccination in order to enhance screening and vaccination rates in this underserved population.

Less acculturated Chinese Americans experience cultural and language barriers. The present study assessed the relationship between linguistic aspects of acculturation and cigarette smoking among Chinese Americans. A cross-sectional, self-administered survey was administered to a consecutive sample of 541 Chinese American adults (aged 18 years or older) attending four pediatric, medical, or dental practices located in Philadelphia's Chinatown from November 2000 to February 2001. Linguistic acculturation was measured by adapting a reliable and valid acculturation scale developed for Southeast Asians. English and Chinese language proficiency subscales were utilized to analyze the association between language proficiency and current smoking. Whereas 25% of Chinese American men reported current smoking, only 3% of Chinese American women reported current smoking. Chinese American men with lower English proficiency reported significantly higher rates of current smoking compared with Chinese American men with a higher level of English proficiency (33% vs. 18%, p<.01). Less English-proficient Chinese American male smokers were less likely to have received advice from a physician to quit smoking (50% vs. 85%, p=.01). In multivariate analysis, increased English proficiency was associated with decreased odds of current smoking (OR=0.38, 95% CI=0.16-0.89) among Chinese American men after controlling for confounding variables. In conclusion, higher English proficiency was associated with decreased current smoking among Chinese American men. Chinese American men with limited English proficiency should especially be targeted for tobacco control interventions. Further research is needed to assess whether acculturation is associated with smoking among Chinese American women and with use of smoking cessation treatments and services by Chinese American smokers.

A community-based, culturally appropriate, multilevel HBV screening intervention effectively increases screening rates in a high-risk, hard-to-reach Vietnamese American population.

Objectives: Successful human papilloma virus (HPV) vaccine delivery depends heavily on parents’ attitudes, perceptions, and willingness to have their children vaccinated. In this study, we assessed parental knowledge, attitudes, and beliefs about the HPV vaccine, and examine factors associated with willingness to have eligible children receive HPV vaccination. Methods: From a community health center serving Chinese members in the Greater Philadelphia area, 110 Chinese-American parents with at least one child aged 11 to 18 who had not received HPV vaccine were recruited. Data were collected in face-to-face interviews. Results: Chinese-American parents generally lacked knowledge on HPV and the HPV vaccine, yet had a moderately high level of intention to vaccinate their children against HPV. Ordinal logistic regression results indicated that knowledge, whether or not to involve children, doctor influence, and time lived in the United States were significantly and independently related to parental intention to have their children vaccinated against HPV. Conclusion: Interventions should make efforts to raise awareness of HPV and promote vaccination in doctors’ offices. The lower level of parental intention among relatively recent immigrants indicated the necessity to target this population in public health campaigns and intervention efforts.