Ethnic Differences in Prevalence and Barriers of HBV Screening and Vaccination Among Asian Americans

Abstract

Our study identifies the prevalence of HBV virus (HBV) screening and vaccination among Asian Americans, and ethnic differences for factors associated with screening and vaccination behaviors. In 2009–2010 we recruited 877 Korean, Chinese, and Vietnamese Americans 18 years of age and above through several community organizations, churches and local ethnic businesses in Maryland for a health education intervention and a self-administered survey. Prevalence of HBV screening, screening result and vaccinations were compared by each ethnic group. We used logistic regression analysis to understand how sociodemographics, familial factors, patient-, provider-, and resource-related barriers are associated with screening and vaccination behaviors, using the total sample and separate analysis for each ethnic group. Forty-seven percent of participants reported that they had received HBV screening and 38% had received vaccinations. Among the three groups, the Chinese participants had the highest screening prevalence, but lowest self-reported infection rate; Vietnamese has the lowest screening and vaccination prevalence. In multivariate analysis, having better knowledge of HBV, and family and physician recommendations was significantly associated with screening and vaccination behaviors. Immigrants who had lived in the US for more than a quarter of their lifetime were less likely to report ever having been screened (OR = 0.39, 95% CI: 0.28–0.55) or vaccinated (OR = 0.62, 95% CI: 0.44–0.88). In ethnic-specific analysis, having a regular physician (OR = 4.46, 95% CI: 1.62–12.25) and doctor's recommendation (OR = 2.11, 95% CI: 1.05–4.22) are significantly associated with Korean's vaccination behaviors. Health insurance was associated with vaccination behaviors only among Vietnamese (OR = 2.66, 95% CI: 1.21–5.83), but not among others.

Hepatitis B Virus Infection and Exposure Among Foreign-Born Asian Americans in the U.S.

“…Few other Asian American studies have examined level of education as a factor associated with the prevalence of anti-HBc. Consistent with previous studies (14,27), our study significantly correlated level of education with chronic HBV infection among Asian Americans. The inadequate apparatus of disease control and screening and vaccination policy in the origin countries resulted in hepatitis B infection-related health disparity among individuals with different educational levels.…”

Hepatitis B Screening Practice among Older Chinese in the Greater Washington, DC, Area

“…The first basic model included demographic variables: age, sex, US residency, educational attainment, self-reported English-speaking ability, and health insurance coverage, which were significantly associated with HBV screening in previous studies. 8,14,25 The second regression model added the variable of physician's recommendation for cancer. The third model added the HBV knowledge variable.…”

Vietnamese American women’s beliefs and perceptions on cervical cancer, cervical cancer screening, and cancer prevention vaccines: A community-based participatory study

“…Researchers found that VA immigrant women with limited English literacy skills, lower educational levels, and financial barriers were less likely to have cancer vaccine acceptance and believe in being susceptible to developing CC (Strong, Lee, Tanaka, & Juon, 2012;Yi et al, 2013). VA immigrant women who reported respect for their health care provider (HCP)s' opinions were more likely to accept medical recommendations for cancer prevention vaccinations (Strong et al, 2012;Yi et al, 2013).…”