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      Factors Associated with Hepatitis C Knowledge Before and After an Educational Intervention among Vietnamese Americans

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          Abstract

          BACKGROUND

          Hepatitis C virus (HCV) is a major cause of chronic liver disease and cancer. Vietnamese Americans are at high risk of HCV infection, with men having the highest US incidence of liver cancer. This study examines an intervention to improve HCV knowledge among Vietnamese Americans.

          STUDY

          Seven Vietnamese community-based organizations in Pennsylvania and New Jersey recruited a total of 306 Vietnamese participants from 2010 to 2011.

          RESULTS

          Average knowledge scores for pretest and posttest were 3.32 and 5.88, respectively (maximum 10). After adjusting for confounding variables, age and higher education were positively associated with higher pretest scores and having a physician who spoke English or Vietnamese was negatively associated with higher pretest scores. Additionally, after adjusting for confounding variables, household income, education, and having an HCV-infected family member significantly increased knowledge scores.

          CONCLUSIONS

          Promotion and development of HCV educational programs can increase HCV knowledge among race and ethnic groups, such as Vietnamese Americans. Giving timely information to at-risk groups provides the opportunity to correct misconceptions, decrease HCV risk behaviors, and encourage testing that might improve timely HCV diagnosis and treatment.

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          Most cited references47

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          The prevalence of hepatitis C virus infection in the United States, 1988 through 1994.

          Miriam J Alter, Deanna Kruszon-Moran, Omana Nainan … (1999)
          Because many persons with chronic hepatitis C virus (HCV) infection are asymptomatic, population-based serologic studies are needed to estimate the prevalence of the infection and to develop and evaluate prevention efforts. We performed tests for antibody to HCV (anti-HCV) on serum samples from 21,241 persons six years old or older who participated in the third National Health and Nutrition Examination Survey, conducted during 1988 through 1994. We determined the prevalence of HCV RNA by means of nucleic acid amplification and the genotype by means of sequencing. The overall prevalence of anti-HCV was 1.8 percent, corresponding to an estimated 3.9 million persons nationwide (95 percent confidence interval, 3.1 million to 4.8 million) with HCV infection. Sixty-five percent of the persons with HCV infection were 30 to 49 years old. Seventy-four percent were positive for HCV RNA, indicating that an estimated 2.7 million persons in the United States (95 percent confidence interval, 2.4 million to 3.0 million) were chronically infected, of whom 73.7 percent were infected with genotype 1 (56.7 percent with genotype 1a, and 17.0 percent with genotype 1b). Among subjects 17 to 59 years of age, the strongest factors independently associated with HCV infection were illegal drug use and high-risk sexual behavior. Other factors independently associated with infection included poverty, having had 12 or fewer years of education, and having been divorced or separated. Neither sex nor racial-ethnic group was independently associated with HCV infection. In the United States, about 2.7 million persons are chronically infected with HCV. People who use illegal drugs or engage in high-risk sexual behavior account for most persons with HCV infection.
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            A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt.

            William Sievert, Ibrahim Altraif, Homie A Razavi … (2011)
            The hepatitis C pandemic has been systematically studied and characterized in North America and Europe, but this important public health problem has not received equivalent attention in other regions. The objective of this systematic review was to characterize hepatitis C virus (HCV) epidemiology in selected countries of Asia, Australia and Egypt, i.e. in a geographical area inhabited by over 40% of the global population. Data references were identified through indexed journals and non-indexed sources. In this work, 7770 articles were reviewed and 690 were selected based on their relevance. We estimated that 49.3-64.0 million adults in Asia, Australia and Egypt are anti-HCV positive. China alone has more HCV infections than all of Europe or the Americas. While most countries had prevalence rates from 1 to 2% we documented several with relatively high prevalence rates, including Egypt (15%), Pakistan (4.7%) and Taiwan (4.4%). Nosocomial infection, blood transfusion (before screening) and injection drug use were identified as common risk factors in the region. Genotype 1 was common in Australia, China, Taiwan and other countries in North Asia, while genotype 6 was found in Vietnam and other Southeast Asian countries. In India and Pakistan genotype 3 was predominant, while genotype 4 was found in Middle Eastern countries such as Egypt, Saudi Arabia and Syria. We recommend implementation of surveillance systems to guide effective public health policy that may lead to the eventual curtailment of the spread of this pandemic infection. © 2011 John Wiley & Sons A/S.
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              Effects of limited English proficiency and physician language on health care comprehension.

              Elisabeth Wilson, Frances Wang, Alicia Fernández … (2005)
              To determine the effect of limited English proficiency on medical comprehension in the presence and absence of language-concordant physicians. A telephone survey of 1,200 Californians was conducted in 11 languages. The survey included 4 items on medical comprehension: problems understanding a medical situation, confusion about medication use, trouble understanding labels on medication, and bad reactions to medications. Respondents were also asked about English proficiency and whether their physicians spoke their native language. We analyzed the relationship between English proficiency and medical comprehension using multivariate logistic regression. We also performed a stratified analysis to explore the effect of physician language concordance on comprehension. Forty-nine percent of the 1,200 respondents were defined as limited English proficient (LEP). Limited English-proficient respondents were more likely than English-proficient respondents to report problems understanding a medical situation (adjusted odds ratio [AOR] 3.2/confidence interval [CI] 2.1, 4.8), trouble understanding labels (AOR 1.5/CI 1.0, 2.3), and bad reactions (AOR 2.3/CI 1.3, 4.4). Among respondents with language-concordant physicians, LEP respondents were more likely to have problems understanding a medical situation (AOR 2.2/CI 1.2, 3.9). Among those with language-discordant physicians, LEP respondents were more likely to report problems understanding a medical situation (AOR 9.4/CI 3.7, 23.8), trouble understanding labels (AOR 4.2/CI 1.7, 10.3), and bad medication reactions (AOR 4.1/CI 1.2, 14.7). Limited English proficiency is a barrier to medical comprehension and increases the risk of adverse medication reactions. Access to language-concordant physicians substantially mitigates but does not eliminate language barriers.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Med Insights Gastroenterol
                Journal ID (iso-abbrev): Clin Med Insights Gastroenterol
                Journal ID (publisher-id): Clinical Medicine Insights: Gastroenterology
                Title: Clinical Medicine Insights. Gastroenterology
                Publisher: Libertas Academica
                ISSN (Electronic): 1179-5522
                Publication date Collection: 2015
                Publication date (Electronic): 29 October 2015
                Volume: 8
                Pages: 45-53
                Affiliations
                [1 ]Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, USA.
                [2 ]Center for Asian Health, College of Public Health, Temple University, Philadelphia, PA, USA.
                [3 ]Greater Philadelphia Health Action, Inc., Philadelphia, PA, USA.
                [4 ]Chinatown Medical Services, Philadelphia, PA, USA.
                [5 ]Department of Public Health, Center for Asian Health, College of Public Health, Temple University, Philadelphia, PA, USA.
                Author notes
                Article
                Publisher ID: cgast-8-2015-045
                DOI: 10.4137/CGast.S24737
                PMC ID: 4629630
                SO-VID: 3c3dbff9-e2b3-4582-8ce7-d256122e6bce
                Copyright © © 2015 the author(s), publisher and licensee Libertas Academica Ltd.
                License:

                This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.

                History
                Date received : 12 February 2015
                Date revision received : 01 June 2015
                Date accepted : 03 June 2015
                Categories
                Subject: Original Research

                Keywords: hepatitis c,liver cancer,vietnamese
                Data availability:
                Keywords: hepatitis c, liver cancer, vietnamese

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