Ma Grace X, Zhu Lin, Lu Wenyue, Handorf Elizabeth, Tan Yin, Yeh Ming-Chin, Johnson Cicely, Guerrier Guercie, Nguyen Minhhuyen T
Center for Asian Health, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.
Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA.
Healthcare (Basel). 2022 Oct 5;10(10):1944. doi: 10.3390/healthcare10101944.
Although Asian Americans make up 6% of the U.S. population, they account for 58% of Americans with chronic hepatitis B (CHB). Yet, adherence to monitoring and antiviral treatment guidelines among Asian American CHB patients remains suboptimal.
The purpose of this study was to evaluate the efficacy of a multicomponent intervention on adherence to CHB monitoring among Asian Americans with CHB. The intervention components included virtual patient education, patient navigation, and mobile health reminders delivered by bilingual community health educators. Chi-square test and -test were used to compare demographic characteristics and two CHB measures: CHB clinical follow-up and CHB laboratory monitoring by the time of the 12-month follow-up assessment. A generalized linear mixed-effects model (GLMM) was fitted to assess the effectiveness of the intervention.
The study sample consisted of 358 Chinese and Vietnamese Americans living with CHB, including 181 in the intervention group and 177 in the control group. The intervention group had a significantly higher rate of CHB clinical follow-up (86.2%) and CHB laboratory monitoring (79.0%) than did the control group (54.2% and 45.2%, respectively). Results of the GLMM showed significant intervention effects on CHB clinical follow-up (odds ratio = 7.35, 95% confidence interval = 4.06-13.33) and CHB laboratory monitoring (odds ratio = 6.60, 95% confidence interval = 3.77-11.56) at the 12-month follow-up assessment.
The multicomponent intervention was effective in improving adherence to CHB monitoring among Asian Americans. Additional implementation research is needed to better understand and apply effective interventions to other underserved populations.
尽管亚裔美国人占美国人口的6%，但他们却占美国慢性乙型肝炎（CHB）患者的58%。然而，亚裔美国CHB患者对监测和抗病毒治疗指南的依从性仍然欠佳。
本研究旨在评估多组分干预措施对亚裔美国CHB患者CHB监测依从性的效果。干预组分包括由双语社区健康教育工作者提供的虚拟患者教育、患者导航和移动健康提醒。采用卡方检验和t检验比较人口统计学特征以及两项CHB指标：12个月随访评估时的CHB临床随访和CHB实验室监测。采用广义线性混合效应模型（GLMM）评估干预效果。
研究样本包括358名患有CHB的华裔和越南裔美国人，其中干预组181人，对照组177人。干预组的CHB临床随访率（86.2%）和CHB实验室监测率（79.0%）显著高于对照组（分别为54.2%和45.2%）。GLMM结果显示，在12个月随访评估时，干预对CHB临床随访（优势比=7.35，95%置信区间=4.06-13.33）和CHB实验室监测（优势比=6.60，95%置信区间=3.77-11.56）有显著效果。
多组分干预措施在提高亚裔美国人对CHB监测的依从性方面有效。需要进一步开展实施研究，以更好地理解有效干预措施并将其应用于其他服务不足的人群。
