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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 3/2010

01-03-2010 | Original Article

Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

Authors: Jessica P. Hwang, MD, MPH, Aimee K. Roundtree, PhD, Joan C. Engebretson, PhD, Maria E. Suarez-Almazor, MD, PhD

Published in: Journal of General Internal Medicine | Issue 3/2010

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Abstract

BACKGROUND

Physicians can play a significant role in helping to decrease the hepatitis B virus (HBV) burden among Asian Americans. Few studies have described knowledge and practice patterns in the medical community among different provider types regarding HBV and liver cancer.

OBJECTIVE

Our study explores the HBV beliefs, attitudes and practice patterns of medical providers serving Asian American communities.

DESIGN

We conducted three focus groups with primary care providers, liver specialists, and other providers predominantly serving Asian American community. We asked about practices and barriers to appropriate medical care and outreach.

PARTICIPANTS

We moderated three focus groups with 23 participants, 18 of whom completed and returned demographic surveys. Twelve were of Asian ethnicity and 13 spoke English as a second language. Only eight screened at least half of their patients, most (72%) using the hepatitis B surface antigen test.

APPROACH

We used grounded theory methods to analyze focus group transcripts.

RESULTS

Participants frequently discussed cultural and financial barriers to hepatitis care. They admitted reluctance to screen for HBV because patients might be unwilling or unable to afford treatment. Cultural differences were discussed most by primary care providers; best methods of outreach were discussed most by liver specialists; and alternative medicine was discussed most by acupuncturists and other providers.

CONCLUSIONS

More resources are needed to lower financial barriers complicating HBV care and encourage providing guideline-recommended screenings. Other providers can help promote HBV screening and increase community and cultural awareness.
Literature
1.
U.S. Department of Health and Human Services. Public Health Service. National Toxicology Program. Report on Carcinogens, Eleventh Edition. 2005.
2.
3.
Chao SD, Chang ET, So SK. Eliminating the threat of chronic hepatitis B in the Asian and Pacific Islander community: a call to action. Asian Pac J Cancer Prev. 2009;10(3):507–12.PubMed
4.
Hwang J, Hassan MM. Survival and hepatitis status among Asian Americans with hepatocellular carcinoma treated without liver transplantation. BMC Cancer. 2009;9:46.CrossRefPubMed
5.
6.
Sorrell MF, Belongia EA, Costa J, et al. National institutes of health consensus development conference statement: management of hepatitis B. Ann Intern Med. 2009;150(2):104–10.PubMed
7.
Taylor VM, Jackson JC, Pineda M, Pham P, Fischer M, Yasui Y. Hepatitis B knowledge among Vietnamese immigrants: implications for prevention of hepatocellular carcinoma. J Cancer Educ. 2000;15(1):51–5.PubMed
8.
Taylor VM, Jackson JC, Chan N, et al. Hepatitis B knowledge and practices among Cambodian American women in Seattle, Washington. J Community Health. 2002;27(3):151–63.CrossRefPubMed
9.
Thompson MJ, Taylor VM, Jackson JC, et al. Hepatitis B knowledge and practices among Chinese American women in Seattle, Washington. J Cancer Educ. 2002;17(4):222–6.PubMed
10.
Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 2004;11(2):97–107.CrossRefPubMed
11.
Tsai N. Management of chronic hepatitis B in Asian Americans and pacific islanders. Gastroenterol Hepatol. 2005;1(3):188–94.
12.
Friedman DS, Hahn SR, Gelb L, et al. Doctor-patient communication, health-related beliefs, and adherence in glaucoma results from the Glaucoma Adherence and Persistency Study. Ophthalmology. 2008;115(8):1320–7.CrossRefPubMed
13.
14.
Jayasinghe J. Non-adherence in the hypertensive patient: can nursing play a role in assessing and improving compliance? Can J Cardiovasc Nurs. 2009;19(1):7–12.PubMed
15.
Spink KS, Reeder B, Chad K, Wilson K, Nickel D. Examining physician counselling to promote the adoption of physical activity. Can J Public Health. 2008;99(1):26–30.PubMed
16.
Lee YY, Lin JL. The effects of trust in physician on self-efficacy, adherence and diabetes outcomes. Soc Sci Med. 2009;68(6):1060–8.CrossRefPubMed
17.
Ong LM, de Haes JC, Hoos AM, Lammes FB. Doctor-patient communication: a review of the literature. Soc Sci Med. 1995;40(7):903–18.CrossRefPubMed
18.
Kerse N, Buetow S, Mainous AG 3rd, et al. Physician-patient relationship and medication compliance: a primary care investigation. Ann Fam Med. 2004;2(5):455–61.CrossRefPubMed
19.
Kaplan SH, Greenfield S, Ware JE Jr. Assessing the effects of physician-patient interactions on the outcomes of chronic disease. Med Care. 1989;27(3 Suppl):S110–27. Erratum in: Med Care. 1989;27(7):679.CrossRefPubMed
20.
Wee CC, McCarthy EP, Phillips RS, Wee CC, McCarthy EP, Phillips RS. Factors associated with colon cancer screening: the role of patient factors and physician counseling. Prev Med. 2005;41(1):23–9.CrossRefPubMed
21.
Simpson M, Buckman R, Stewart M, et al. Doctor-patient communication: the Toronto consensus statement. BMJ. 1991;303(6814):1385–7.CrossRefPubMed
22.
Lai CJ, Nguyen TT, Hwang J, et al. Provider knowledge and practice regarding hepatitis B screening in Chinese-speaking patients. J Cancer Educ. 2007;22(1):37–41.CrossRefPubMed
23.
Morgan DM, ed. Successful Focus Groups: Advancing the state of the art. Vol 156. Newbury Park, CA: SAGE Publications: 1993.
24.
Krueger R. Focus Groups: a practical guide for applied research. Thousand Oaks: Sage Publications; 1994.
25.
Burke NJ, Jackson JC, Thai HC, et al. Honoring tradition, accepting new ways: development of a hepatitis B control intervention for Vietnamese immigrants. Ethn Health. 2004;9(2):153–69.CrossRefPubMed
26.
Choe JH, Chan N, Do HH, Woodall E, Lim E, Taylor VM. Hepatitis B and liver cancer beliefs among Korean immigrants in Western Washington. Cancer. 2005;104(12 Suppl):2955–8.CrossRefPubMed
27.
Strauss AC, Corbin J, eds. Grounded theory in practice. Thousand Oaks: Sage Publications; 1997.
28.
Corbin J, Strauss AC. Basics of qualitative research: techniques and procedures for developing grounded theory. Thousand Oaks: Sage Publications; 1998.
29.
30.
31.
Mast EE, Weinbaum CM, Fiore AE, et al. A comprehensive immunization strategy to eliminate transmission of hepatitis B virus infection in the United States: recommendations of the Advisory Committee on Immunization Practices (ACIP) Part II: immunization of adults. MMWR Recomm Rep. 2006;55(RR-16):1–33. quiz CE31-34. Erratum in: MMWR Morb Mortal Wkly Rep. 2007;56(42):1114.PubMed
32.
33.
Hampton T. Officials recommend expanded testing for chronic hepatitis B virus infection. JAMA. 2008;300(18):2108.CrossRefPubMed
34.
Lin SY, Chang ET, So SK. Why we should routinely screen Asian American adults for hepatitis B: a cross-sectional study of Asians in California. Hepatology. 2007;46(4):1034–40.CrossRefPubMed
35.
Weinbaum CM, Williams I, Mast EE, et al. Recommendations for identification and public health management of persons with chronic hepatitis B virus infection. MMWR Recomm Rep. 2008;57(RR-8):1–20.PubMed
36.
Gaglio PJ, Sterling R, Daniels E, et al. Hepatitis B virus and HIV coinfection: results of a survey on treatment practices and recommendations for therapy.[see comment]. Clin Infect Dis. 2007;45(5):618–23.CrossRefPubMed
37.
Freed GL, Bordley WC, Clark SJ, Konrad TR. Universal hepatitis B immunization of infants: reactions of pediatricians and family physicians over time. Pediatrics. 1994;93(5):747–51.PubMed
38.
Freed GL, Bordley WC, Clark SJ, Konrad TR. Reactions of pediatricians to a new Centers for Disease Control recommendation for universal immunization of infants with hepatitis B vaccine.[see comment]. Pediatrics. 1993;91(4):699–702.PubMed
39.
Winnock M, Neau D, Castera L, et al. Hepatitis B vaccination in HIV-infected patients: a survey of physicians and patients participating in the Aquitaine cohort.[see comment]. Gastroenterol Clin Biol. 2006;30(2):189–95.PubMedCrossRef
40.
Zickmund SL, Brown KE, Bielefeldt K, Zickmund SL, Brown KE, Bielefeldt K. A systematic review of provider knowledge of hepatitis C: is it enough for a complex disease? Dig Dis Sci. 2007;52(10):2550–6.CrossRefPubMed
41.
Hwang JP, Huang CH, Yi JK. Knowledge about hepatitis B and predictors of hepatitis B vaccination among Vietnamese American college students. J Am Coll Health. 2008;56(4):377–82.CrossRefPubMed
42.
Ma GX, Shive SE, Fang CY, et al. Knowledge, attitudes, and behaviors of hepatitis B screening and vaccination and liver cancer risks among Vietnamese Americans. J Health Care Poor Underserved. 2007;18(1):62–73.CrossRefPubMed
43.
Ma GX, Shive SE, Toubbeh JI, Tan Y, Wu D. Knowledge, attitudes, and behaviors of Chinese hepatitis B screening and vaccination. Am J Health Behav. 2008;32(2):178–87.PubMed
44.
Nguyen TT, Taylor V, Chen MS Jr, Bastani R, Maxwell AE, McPhee SJ. Hepatitis B awareness, knowledge, and screening among Asian Americans. J Cancer Educ. 2007;22(4):266–72.CrossRefPubMed
45.
Barrett B, Shadick K, Schilling R, et al. Hmong/medicine interactions: improving cross-cultural health care. Fam Med. 1998;30(3):179–84.PubMed
46.
Ramsay DB, Friedman M, Borum ML, Ramsay DB, Friedman M, Borum ML. Does the race or gender of hepatitis C infected patients influence physicians' assessment of hepatitis A and hepatitis B serologic status? South Med J. 2007;100(7):683–5.PubMed
47.
Flaskerud JH, Liu PY. Effects of an Asian client-therapist language, ethnicity and gender match on utilization and outcome of therapy. Community Ment Health J. 1991;27(1):31–42.CrossRefPubMed
48.
LaVeist TA, Nuru-Jeter A, Jones KE. The association of doctor-patient race concordance with health services utilization.[see comment]. J Public Health Policy. 2003;24(3–4):312–23.CrossRefPubMed
49.
Beach MC, Roter DL, Wang NY, Duggan PS, Cooper LA. Are physicians' attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? Patient Educ Couns. 2006;62(3):347–54.CrossRefPubMed
50.
Meghani SH, Brooks JM, Gipson-Jones T, Waite R, Whitfield-Harris L, Deatrick JA. Patient-provider race-concordance: does it matter in improving minority patients' health outcomes? Ethn Health. 2009;14(1):107–30.CrossRefPubMed
51.
Wahner-Roedler DL, Vincent A, Elkin PL, Loehrer LL, Cha SS, Bauer BA. Physicians' attitudes toward complementary and alternative medicine and their knowledge of specific therapies: a survey at an academic medical center. Evid Based Complement Alternat Med. 2006;3(4):495–501.CrossRefPubMed
52.
Furlow ML, Patel DA, Sen A, Liu JR. Physician and patient attitudes towards complementary and alternative medicine in obstetrics and gynecology. BMC Complement Altern Med. 2008;8:35.CrossRefPubMed
53.
Lee RT, Hlubocky FJ, Hu J-J, Stafford RS, Daugherty CK. An international pilot study of oncology physicians' opinions and practices on Complementary and Alternative Medicine (CAM). Integrative Cancer Therapies. 2008;7(2):70–5.CrossRefPubMed
54.
Kurtz ME, Nolan RB, Rittinger WJ. Primary care physicians' attitudes and practices regarding complementary and alternative medicine. J Am Osteopath Assoc. 2003;103(12):597–602.PubMed
55.
Bourgeault IL. Physicians' attitudes toward patients' use of alternative cancer therapies. CMAJ Can Med Assoc J. 1996;155(12):1679–85.
56.
Chang ET, Lin SY, Sue E, Bergin M, Su J, So SKS. Building partnerships with traditional chinese medicine practitioners to increase hepatitis B awareness and prevention. J Altern Complement Med. 2007;13(10):1125–7.CrossRefPubMed
57.
Ben-Arye E, Scharf M, Frenkel M. How should complementary practitioners and physicians communicate? A cross-sectional study from Israel. J Am Board Fam Med: JABFM. 2007;20(6):565–71.CrossRefPubMed
58.
Greenfield SM, Brown R, Dawlatly SL, Reynolds JA, Roberts S, Dawlatly RJ. Gender differences among medical students in attitudes to learning about complementary and alternative medicine. Complement Ther Med. 2006;14(3):207–12.CrossRefPubMed
59.
Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142(4):260–73.PubMed
60.
Roter DL, Hall JA. Physician gender and patient-centered communication: a critical review of empirical research. Annu Rev Public Health. 2004;25:497–519.CrossRefPubMed
61.
Todres M, Stephenson A, Jones R. Medical education research remains the poor relation. BMJ. 2007;335(7615):333–5.CrossRefPubMed
62.
Asch DA, Epstein A, Nicholson S. Evaluating medical training programs by the quality of care delivered by their alumni. JAMA. 2007;298(9):1049–51.CrossRefPubMed
63.
Saha S, Beach MC, Cooper LA. Patient centeredness, cultural competence and healthcare quality. J Natl Med Assoc. 2008;100(11):1275–85.PubMed
Metadata
Title
Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups
Authors
Jessica P. Hwang, MD, MPH
Aimee K. Roundtree, PhD
Joan C. Engebretson, PhD
Maria E. Suarez-Almazor, MD, PhD
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 3/2010
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-009-1204-5

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