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Open Access Publications from the University of California

Cluster-Randomized Trial to Increase Hepatitis B Testing among Koreans in Los Angeles.

  • Author(s): Bastani, Roshan
  • Glenn, Beth A
  • Maxwell, Annette E
  • Jo, Angela M
  • Herrmann, Alison K
  • Crespi, Catherine M
  • Wong, Weng K
  • Chang, L Cindy
  • Stewart, Susan L
  • Nguyen, Tung T
  • Chen, Moon S
  • Taylor, Victoria M
  • et al.

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In the United States, Korean immigrants experience a disproportionately high burden of chronic hepatitis B (HBV) viral infection and associated liver cancer compared with the general population. However, despite clear clinical guidelines, HBV serologic testing among Koreans remains persistently suboptimal.We conducted a cluster-randomized trial to evaluate a church-based small group intervention to improve HBV testing among Koreans in Los Angeles. Fifty-two Korean churches, stratified by size (small, medium, large) and location (Koreatown versus other), were randomized to intervention or control conditions. Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing, and control church participants attended a similar session on physical activity and nutrition. Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews.We recruited 1,123 individuals, 18 to 64 years of age, across the 52 churches. Ninety-two percent of the sample attended the assigned intervention session and 86% completed the 6-month follow-up. Sample characteristics included were as follows: mean age 46 years, 65% female, 97% born in Korea, 69% completed some college, and 43% insured. In an intent-to-treat analysis, the intervention produced a statistically significant effect (OR = 4.9, P < 0.001), with 19% of intervention and 6% of control group participants reporting a HBV test.Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae.The intervention was fairly resource efficient and thus has high potential for replication in other high-risk Asian groups.

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