Factors associated with hepatitis B serologic screening in a population-based survey of Korean Americans from Washington state Adeena Khan, MD 1 Genji S. Terasaki, MD 2 , Joon-Ho Yu 2,3 , MPH, PhD, John Choe, MD, MPH 2 University of Washington School of Medicine: 1 Internal Medicine Residency Training Program, 2 Departments of Medicine and 3 Pediatrics
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Adeena Khan, MD 1 Genji S. Terasaki, MD 2 , Joon-Ho Yu 2,3 , MPH, PhD, John Choe, MD, MPH 2
Factors associated with hepatitis B serologic screening in a population-based survey of Korean Americans from Washington state. Adeena Khan, MD 1 Genji S. Terasaki, MD 2 , Joon-Ho Yu 2,3 , MPH, PhD, John Choe, MD, MPH 2 - PowerPoint PPT Presentation
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Factors associated with hepatitis B serologic screening in a population-based survey of Korean Americans from Washington state
Adeena Khan, MD1
Genji S. Terasaki, MD2, Joon-Ho Yu2,3, MPH, PhD,
John Choe, MD, MPH2
University of Washington School of Medicine: 1 Internal Medicine Residency
Training Program, 2 Departments of Medicine and 3 Pediatrics
Background: Impact on Asian Patients
• 1.3 million Americans with chronic hepatitis B virus (HBV)
• Health disparity among Asian Americans– ≥50% of all chronic HBV infection are Asian Americans
• Perinatal transmission major risk factor for Asian Americans
• Cirrhosis and hepatocellular carcinoma are late sequelae
Endemic Areas of Infection
Current Testing
Why Test for Hepatitis B?– Prevent transmission, encourage vaccination– Behavior modification– Treat with antivirals– Screen for sequelae
Study Question
• Korean Americans and Hepatitis B testing
• Predictors of Hepatitis B testing– Asian American subgroups
• Hypothesis– We hypothesized that factors related to communication
and access to medical care would serve as barriers of facilitators of having had prior HBV testing
Methods: Questionnaire
Methods: Study Design• Population Based Questionnaire of Korean Americans
between 18-64 years of age• Questions:
– Demographics– Communication– Access to Care– Hep B knowledge– Hep B testing
• Bilingual and bicultural field interviewers conducted in-person surveys in homes
Results: Demographics N = 466
Age <35 35-49 >49
100 (22%)223 (48%) 142 (31%)
Marital Status Married Previously married Never married
385 (83%)25 (5%)
55 (12%)Birth Country S. Korea N. Korea US
448 (98%)3 (1%)4 (1%)
Education <12 12-16 >16
131 (12%)255 (55%)79 (17%)
Results: communication
Proportion Life in U.S.
<1/31/3-2/3>2/3
Need Interpreter
YesNo
Results: Access
One Doctor
YesNo
Medical Insurance
YesNo
Results: Analysis
• Bivariate association– Access factors not associated with HBV testing– Communication factors also not associated– Trend toward association with one site of medical care (p = 0.07)
Results: Multivariate Regression
Factors Association with Hep B testing OR (95% CI)
One doctor 0.89 (0.41, 1.92)
Interpreter needed 1.35 (0.68, 2.67)
One healthcare location 1.50 (0.39, 6.02)
Age 0.97 (0.50, 1.90)
English proficiency 0.78 (0.56, 1.10)
Percentage of life in U.S. (quintiles) <22% 22-36% 36-45% 45-55% >55%