Community outreach workers may help increase HBV vaccination rates to cut risk of liver cancer

Liver cancer is more common among Asian Americans in part because they are at high risk of HBV infection. One out of 12 Asian Americans carries the virus, accounting for more than half of the cases in the US. Although the HBV vaccine is now given at birth in many countries throughout the world, a large portion of Asian American adults remain unprotected and at risk for developing cancer, because the virus, which can cause liver cancer, is endemic in many Asian and Sub-Saharan African countries. A new Thomas Jefferson University study of Asian Americans living in the Baltimore Washington metropolitan area shows that community outreach workers, or so-called lay health workers (LHW), may help bridge that gap by ensuring the medical information is understood.

The study aimed to identify effective approaches to increase HBV vaccinations. Most LHW studies conducted in Asian American communities have focused on increasing self-reported hepatitis B screening and knowledge, but very few went on to study whether the full course of hepatitis B vaccinations was completed.

In their study, Hee-Soon Juon Ph.D., a Professor of Medical Oncology and researcher at the Sidney Kimmel Cancer Center at Jefferson and colleagues developed a training program for lay health workers who may not have had backgrounds in healthcare, but who were members of the Asian American communities. The researchers also evaluated the program's ability to increase the number of completed vaccinations in a randomized controlled trial. Their research was published in the journal PLOS ONE.

Between April 2013 and March 2014, Dr. Juon and colleagues recruited 645 Chinese, Korean, and Vietnamese participants to complete a survey and be screened for HBV. Of those, 232 were identified as being at-risk for contracting HBV and were randomized into either a group that either received educational pamphlets about the HBV vaccine by mail or one that received pamphlets plus a three reminder calls that gave participants a chance to discuss any hesitations with a member of the community who spoke their language.

The results showed that those who received phone-call follow ups were more likely to have one or more vaccinations than those who only received educational pamphlets, they were also more likely to have the full course of HBV vaccine plus booster shots. When asked what motivated them, 70 percent of those vaccinated said that the personal calls were the main motivating factor.

The researchers are now planning new methods of outreach that employ social media tools and video.