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Predictors and Barriers to Hepatitis B Screening in a Midwest Suburban Asian Population

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Abstract

Despite guidelines recommending hepatitis B virus (HBV) screening among the Asian population, not all Asians are screened. We assessed barriers to and factors predicting HBV screening in Michigan. Adults residing in Southeast Michigan self-identifying as Asian were surveyed at Asian grocery stores, restaurants, churches, and community events. 404 persons participated in the survey, 54 % were women, median age was 51 years, 63 % were Chinese, and 93.8 % were born outside the U.S. 181 (44.8 %) had not or could not recall having been screened for HBV. Of these, 89 % said their primary care physicians (PCP) had never brought up screening. Unscreened participants were more likely to think HBV is genetically inherited and cannot be treated than those who had been screened. They were also more likely to think they should avoid close contact with others, would bring shame to their families, and lose their job, if found to be infected with HBV. Among 223 (55.2 %) who had been screened, 48 % said their PCP had the greatest influence in their decision to be screened and 70.9 % said they were screened at a doctor’s visit. Screened participants were more likely to know someone with HBV, have a PCP, and have health insurance. Logistic regression analysis showed knowing someone with HBV was the only predictor for screening. Despite guidelines for HBV screening, only half of the Asian Americans surveyed had been screened. Increasing awareness among PCPs is needed to increase HBV screening in this population.

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Acknowledgments

No financial support was received for this project. Shanna Cheng and Elton Li would like to acknowledge and show gratitude to Dr. Anna Lok for her support and mentorship throughout the course of this project. We would also like to acknowledge and show gratitude to the communities, participants, and translators for partaking in our project; and to Ms. Elizabeth Wu for her critical review of the manuscript.

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Authors and Affiliations

  1. College of Human Medicine, Michigan State University, 2019 965 Fee Rd. A110, East Lansing, MI, 48824, USA

    Shanna Cheng & Elton Li

  2. Division of Gastroenterology and Hepatology, University of Michigan Health System, 1500 E Medical Center Drive, 3912 Taubman Center, SPC 5362, Ann Arbor, MI, 48109, USA

    Anna S. Lok

Authors
  1. Shanna Cheng
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  2. Elton Li
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  3. Anna S. Lok
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Correspondence to Anna S. Lok.

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Conflict of interest

ASL has received research grants from Bristol-Myers Squibb and Gilead. SC and EL have no conflicts of interest to declare.

Human Participants

All human participants verbally and voluntarily consented to be a part of this study. This study was approved by the University of Michigan Institutional Review Board and was granted exemption.

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Cheng, S., Li, E. & Lok, A.S. Predictors and Barriers to Hepatitis B Screening in a Midwest Suburban Asian Population. J Community Health 42, 533–543 (2017). https://doi.org/10.1007/s10900-016-0285-4

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