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亚特兰大都会区越南人群乙型肝炎检测:医疗保健相关和文化适应相关因素的作用。

Hepatitis B Testing Among Vietnamese in Metropolitan Atlanta: The Role of Healthcare-Related and Acculturation-Related Factors.

机构信息

Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.

Emory College of Arts & Sciences, Emory University, Atlanta, GA, USA.

出版信息

J Community Health. 2021 Aug;46(4):767-776. doi: 10.1007/s10900-020-00947-0. Epub 2020 Nov 12.

Abstract

BACKGROUND

Compared to other racial/ethnic groups, U.S. Vietnamese have higher Hepatitis B infection prevalence, which is a major liver cancer risk factor. Increased testing could reduce this disparity. It is critical to understand subgroups of U.S. Vietnamese least likely to have been tested for Hepatitis B and design appropriate interventions. We examined healthcare- and acculturation-related factors influencing Hepatitis B testing among U.S. Vietnamese.

METHODS

Survey data of 100 U.S. Vietnamese attending health fairs/programs hosted by community-based organizations (2017-2018) were analyzed. Healthcare-related predictors included insurance and past 2-year checkup. Acculturation-related predictors included Vancouver Acculturation Index, percentage of lifetime in the U.S., and Vietnamese and English fluency. We conducted a multiple logistic regression controlling for age, sex, education, and household income.

RESULTS

The sample was an average 37.5 years old and 61.6% female. Insurance coverage was reported by 83.0%. Average percentage of lifetime in the U.S. was 56.8%. Seventy percent reported having received Hepatitis B testing. Hepatitis B testing was associated with health insurance (aOR = 2.61, 95% CI = [1.05-6.47], p = .04) but not any acculturation-related predictors CONCLUSION: Improving insurance coverage and options can be a strategy to increase Hepatitis B testing among U.S. Vietnamese. More education regarding Hepatitis B (e.g., via community-based, culturally-appropriate, lay health worker-led programs) is needed to ensure that individuals are aware of their testing status and pursue appropriate healthcare decisions.

摘要

背景

与其他种族/族裔群体相比,美国越南裔的乙型肝炎感染率更高,而乙型肝炎是肝癌的一个主要危险因素。增加检测可以减少这种差异。了解最不可能接受乙型肝炎检测的美国越南裔亚群并设计适当的干预措施至关重要。我们研究了影响美国越南裔乙型肝炎检测的与医疗保健和文化适应相关的因素。

方法

对参加社区组织举办的健康博览会/计划的 100 名美国越南裔的调查数据(2017-2018 年)进行了分析。与医疗保健相关的预测因素包括保险和过去 2 年的体检。与文化适应相关的预测因素包括温哥华文化适应指数、一生中留美时间的百分比,以及越南语和英语的流利程度。我们进行了多次逻辑回归,控制了年龄、性别、教育程度和家庭收入。

结果

样本的平均年龄为 37.5 岁,女性占 61.6%。83.0%的人报告有保险。一生中留美时间的平均百分比为 56.8%。70%的人报告接受过乙型肝炎检测。乙型肝炎检测与医疗保险相关(优势比 = 2.61,95%置信区间 = [1.05-6.47],p = .04),但与任何文化适应相关的预测因素无关。

结论

提高医疗保险的覆盖范围和选择范围可能是增加美国越南裔乙型肝炎检测的策略。需要提供更多关于乙型肝炎的教育(例如,通过社区为基础、文化上适当、由非专业卫生工作者主导的项目),以确保个人了解自己的检测状况并做出适当的医疗保健决策。

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