Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Department of Clinical Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Cancer. 2018 Mar 1;124(5):973-982. doi: 10.1002/cncr.31134. Epub 2017 Nov 13.
The primary objective of the current study was to evaluate the efficacy of a community-based participatory intervention program in improving hepatitis B virus (HBV) screening and vaccination among Korean Americans who were not previously screened.
A cluster randomized trial involving 32 Korean church-based community organizations (1834 participants) was conducted. Sixteen churches were randomly assigned to an HBV screening and vaccination multicomponent intervention condition (972 participants) and 16 were assigned to a general cancer education control condition (862 participants). The main components of the intervention program included interactive group education; patient navigation; and the engagement of health care providers, church leadership, and church members in the medical field. The application of community-based participatory research principles was monitored and evaluated. HBV screening and vaccination rates (self-reported and medical record verification) were assessed at 6-month and 12-month follow-ups, respectively.
The results of the current study demonstrated significant efficacy in the HBV screening rate (92.5% in the intervention group vs 5.5% in the control group), 3-series HBV vaccination completion rate (84% in the intervention group vs 17.6% in the control group), and overall screening and vaccination compliance rate (87% in the intervention group vs 3.8% in the control group). Participants in the intervention group were significantly more likely to receive HBV screening (92.5%) compared with those in the control group (5.5%). In multivariate mixed-effect logistic regression analysis, the odds ratio for an intervention effect on HBV screening was 512.3 after adjusting for cluster effect and other demographic variables. With regard to vaccination rates, of the 332 participants who were screened with no immunity in the intervention group, 308 (92.8%) received at least 1 HBV vaccination, 300 (90.4%) received at least 2 shots, and 279 participants (84%) received all 3 shots.
A combination of community-based participatory research and a multilevel approach may produce the most optimal results and be essential in producing a considerable effect for enhancing HBV screening and vaccination, particularly for Korean American populations with limited language proficiency and insurance coverage. Cancer 2018;124:973-82. © 2017 American Cancer Society.
本研究的主要目的是评估一种基于社区的参与式干预方案在提高既往未筛查的美籍韩裔人群乙型肝炎病毒（HBV）筛查和疫苗接种率方面的效果。
采用整群随机试验，纳入 32 个韩国教会社区组织（1834 名参与者）。16 个教会被随机分配到 HBV 筛查和疫苗接种多组分干预组（972 名参与者），16 个教会被分配到一般癌症教育对照组（862 名参与者）。干预方案的主要内容包括互动式小组教育、患者导航以及医疗保健提供者、教会领导和教会成员参与医疗领域。社区参与式研究原则的应用受到监测和评估。分别在 6 个月和 12 个月的随访中评估 HBV 筛查和疫苗接种率（自我报告和病历核实）。
本研究结果显示 HBV 筛查率（干预组为 92.5%，对照组为 5.5%）、3 剂 HBV 疫苗全程接种率（干预组为 84%，对照组为 17.6%）和总体筛查及接种依从率（干预组为 87%，对照组为 3.8%）均具有显著效果。与对照组（5.5%）相比，干预组参与者接受 HBV 筛查的比例明显更高（92.5%）。在调整聚类效应和其他人口统计学变量后，多变量混合效应逻辑回归分析显示，HBV 筛查的干预效果比值比为 512.3。在疫苗接种率方面，在干预组中，332 名筛查无免疫的参与者中，有 308 名（92.8%）至少接种了 1 剂 HBV 疫苗，300 名（90.4%）至少接种了 2 剂，279 名（84%）接种了全部 3 剂。
结合社区参与式研究和多层次方法可能产生最佳效果，对于语言能力有限和保险覆盖范围有限的美籍韩裔人群，增强 HBV 筛查和疫苗接种效果至关重要。癌症 2018;124:973-82。©2017 美国癌症协会。
