Chandrasekar Edwin, Kaur Ravneet, Song Sharon, Kim Karen E
Asian Health Coalition, Chicago, IL, USA.
Division of the Biological Sciences and Office of Community Engagement and Cancer Disparities, University of Chicago, Chicago, IL, USA.
J Multidiscip Healthc. 2015 Jan 6;8:1-9. doi: 10.2147/JMDH.S75239. eCollection 2015.
Hepatitis B (HBV) is an urgent, unmet public health issue that affects Asian Americans disproportionately. Of the estimated 1.2 million living with chronic hepatitis B in USA, more than 50% are of Asian ethnicity, despite the fact that Asian Americans constitute less than 6% of the total US population. The Centers for Disease Control and Prevention recommends HBV screening of persons who are at high risk for the disease. Yet, large numbers of Asian Americans have not been diagnosed or tested, in large part because of perceived cultural and linguistic barriers. Primary care physicians are at the front line of the US health care system, and are in a position to identify individuals and families at risk. Clinical settings integrated into Asian American communities, where physicians are on staff and wellness care is emphasized, can provide testing for HBV. In this study, the Asian Health Coalition and its community partners conducted HBV screenings and follow-up linkage to care in both clinical and nonclinical settings. The nonclinic settings included health fair events organized by churches and social services agencies, and were able to reach large numbers of individuals. Twice as many Asian Americans were screened in nonclinical settings than in health clinics. Chi-square and independent samples t-test showed that participants from the two settings did not differ in test positivity, sex, insurance status, years of residence in USA, or education. Additionally, the same proportion of individuals found to be infected in the two groups underwent successful linkage to care. Nonclinical settings were as effective as clinical settings in screening for HBV, as well as in making treatment options available to those who tested positive; demographic factors did not confound the similarities. Further research is needed to evaluate if linkage to care can be accomplished equally efficiently on a larger scale.
乙型肝炎（HBV）是一个紧迫且未得到解决的公共卫生问题，对亚裔美国人的影响尤为严重。在美国，估计有120万慢性乙型肝炎患者，其中超过50%为亚裔，尽管亚裔美国人在美国总人口中所占比例不到6%。疾病控制与预防中心建议对该疾病高危人群进行HBV筛查。然而，大量亚裔美国人尚未被诊断或检测，很大程度上是因为存在文化和语言障碍。初级保健医生处于美国医疗保健系统的前沿，有能力识别有风险的个人和家庭。融入亚裔美国人社区的临床机构，有医生在职且强调健康护理，可以提供HBV检测。在本研究中，亚洲健康联盟及其社区合作伙伴在临床和非临床环境中进行了HBV筛查以及后续的护理联系。非临床环境包括由教会和社会服务机构组织的健康博览会活动，能够接触到大量人群。在非临床环境中接受筛查的亚裔美国人数量是健康诊所的两倍。卡方检验和独立样本t检验表明，来自这两种环境的参与者在检测阳性率、性别、保险状况、在美国居住年限或教育程度方面没有差异。此外，两组中被发现感染的个体接受成功护理联系的比例相同。非临床环境在HBV筛查以及为检测呈阳性者提供治疗选择方面与临床环境同样有效；人口统计学因素并未混淆这些相似之处。需要进一步研究以评估在更大规模上是否能同样高效地实现护理联系。
