Cheng Shanna, Li Elton, Lok Anna S
College of Human Medicine, Michigan State University, 2019 965 Fee Rd. A110, East Lansing, MI, 48824, USA.
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.
J Community Health. 2017 Jun;42(3):533-543. doi: 10.1007/s10900-016-0285-4.
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.
尽管有指南建议在亚洲人群中进行乙肝病毒（HBV）筛查，但并非所有亚洲人都接受了筛查。我们评估了密歇根州HBV筛查的障碍和预测因素。在亚洲杂货店、餐馆、教堂和社区活动中，对居住在密歇根州东南部且自我认定为亚洲人的成年人进行了调查。404人参与了调查，其中54%为女性，年龄中位数为51岁，63%为中国人，93.8%出生在美国境外。181人（44.8%）未曾或不记得接受过HBV筛查。其中，89%表示他们的初级保健医生（PCP）从未提及过筛查。未接受筛查的参与者比接受过筛查的参与者更有可能认为HBV是遗传的且无法治疗。他们也更有可能认为，如果被发现感染了HBV，他们应该避免与他人密切接触，会给家人带来耻辱，并且会失去工作。在223名（55.2%）接受过筛查的人中，48%表示他们的PCP对他们进行筛查的决定影响最大，70.9%表示他们是在看医生时接受筛查的。接受筛查的参与者更有可能认识患有HBV的人、有PCP并且有健康保险。逻辑回归分析表明，认识患有HBV的人是筛查的唯一预测因素。尽管有HBV筛查指南，但接受调查的亚裔美国人中只有一半接受了筛查。需要提高初级保健医生的认识，以增加该人群的HBV筛查。
