Lay Health Worker Model to Reduce Liver Cancer Disparities in Asian Americans

非专业卫生工作者模型可减少亚裔美国人的肝癌差异

• 批准号: 8929379
• 负责人: HEE-SOON JUON
• 金额: $ 44.01万
• 依托单位: THOMAS JEFFERSON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-04-15 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8929379
• 关键词: 18 year old; Accounting; Address; Adherence; Adult; Affect; American; Antiviral Therapy; Area; Asian Americans; Baltimore; Birth; Blood Tests; Cancer Etiology; Case-Control Studies; Centers for Disease Control and Prevention (U.S.); Cessation of life; Child; Chinese People; Chronic Hepatitis B; Cirrhosis; Cohort Studies; Collaborations; Communities; Databases; Diagnosis; Diagnostic Neoplasm Staging; Disease; Early Diagnosis; Education; Education and Outreach; Effectiveness; Ethnic group; Event; Future; Generations; Goals; HBV Vaccination; Health; Hepatitis B; Hepatitis B Prevalence; Hepatitis B Virus; Immigrant; Institution; Intervention; Knowledge; Koreans; Life; Linguistics; Liver; Liver Failure; Liver diseases; Mails; Malignant Neoplasms; Malignant neoplasm of liver; Maryland; Medical; Modeling; Monitor; Mothers; Pacific Island Americans; Participant; Patients; Population; Prevention; Prevention program; Protocols documentation; Public Health Schools; Questionnaires; Randomized; Randomized Controlled Trials; Recruitment Activity; Research; Research Infrastructure; Research Training; Risk; Screening Result; Self-Administered; Series; Services; Signs and Symptoms; Solid; Survival Rate; Telephone; Telephone Interviews; Test Result; Testing; Training; Universities; Vaccinated; Vaccination; Virus; Virus Diseases; Washington; base; cancer education; cancer health disparity; cancer prevention; community based participatory research; cost; design; economic cost; eligible participant; follow-up; health disparity; high risk; improved; insight; intervention program; liver cancer prevention; metropolitan; minority health; mortality; neglect; outreach; premature; prevent; programs; racial and ethnic; racial and ethnic disparities; response; screening

DESCRIPTION (provided by applicant): Hepatitis B virus (HBV) infection is globally most common and serious viral infection of the liver. It can cause premature death from liver diseases or liver cancer. Chronic HBV infection and liver cancer caused by HBV among Asian Americans and Pacific Islanders (AAPIs) is one of the most serious - but frequently neglected-health disparity issues in the U.S. AAPIs account for over half of the 1.3 million chronic hepatitis B cases and deaths from HBV infection. This excess risk can be attributed to high rates of HBV infection (particularly among first-generation immigrants) in combination with low rates of HBV screening and vaccination due to cultural, linguistic, and financial barriers. HBV infection affect Asian Americans disproportionately, and thus it leads to a huge liver cancer disparity among Asian Americans compared to other racial/ethnic groups. In response to these cancer disparities, the objective of this project is to build a sustainable, community-based, participator program of lay health workers (LHWs) who can promote liver cancer prevention programs among high-risk groups of Asian Americans. This proposed study attempts to implement culturally integrated liver cancer prevention programs for Chinese, Korean, and Vietnamese Americans through outreach, screening, education, research, and training in the Baltimore-Washington Metropolitan Area. The specific aims are: (1) To develop a training protocol and certificate program for LHWs; (2) To assess the prevalence of HBV infection; (3) To implement intervention programs, based on screening test results; and (4) To evaluate the effectiveness of LHW intervention on adherence to HBV vaccinations among those unprotected. A total of 600 Asian American adults (200 Chinese, Koreans, and Vietnamese in each group), 18 years of age and older will be recruited from the community. Trained and certified LHWs will recruit participants at community-based organizations and hep B free screening events. All the eligible participants will complete a self-administered questionnaire and receive liver cancer education. Then, they will receive hepatitis B test. Every participant will receive the results of screening tests by mail or phone. We will provide referral services for treatment to those infected. For those unprotected, we will implement intervention programs to increase a series of vaccinations within 6 months using a randomized controlled design. Seven months after mailing the results, we will conduct telephone interviews among those unprotected. Upon completing follow-up, those in the control will receive the delayed LHW intervention. The insights gained from this proposed LHW intervention will be valuable in implementing liver cancer prevention programs for other high-risk non-English speaking populations and will address health disparities among immigrant populations.

描述（由申请人提供）：丙型肝炎病毒（HBV）感染是全球最常见和严重的肝脏病毒感染。它可能导致肝病或肝癌过早死亡。亚裔美国人和太平洋岛民（AAPIS）引起的HBV引起的慢性HBV感染和肝癌是美国AAPIS中最严重但经常被忽视的健康差异问题之一，占HBV感染的130万例慢性乙型肝炎病例中的一半以上。由于文化，语言和财务障碍，这种过多的风险可以归因于高HBV感染率（尤其是在第一代移民中）以及HBV筛查和疫苗接种率低的情况。与其他种族/族裔相比，HBV感染对亚裔美国人的影响不成比例，因此，亚裔美国人的肝癌差异很大。 为了应对这些癌症差异，该项目的目的是建立一个可持续的基于社区的外行健康工作者（LHWS）的参与者计划，他们可以在亚裔美国人的高风险群体中促进预防肝癌预防计划。这项拟议的研究试图通过在巴尔的摩 - 华盛顿大都会地区的外展，筛查，教育，研究和培训来为中国，韩国和越南美国人实施文化综合的肝癌预防计划。具体目的是：（1）为LHWS制定培训方案和证书计划； （2）评估HBV感染的患病率； （3）基于筛查测试结果实施干预计划； （4）评估LHW干预对未受保护的人遵守HBV疫苗接种的有效性。 总共有600名亚裔美国人（每组中有200名中国人，韩国人和越南人），将从社区招募18岁及以上的年龄。经过培训和认证的LHWS将招募社区组织和HEP B免费筛查活动的参与者。所有合格的参与者将完成一份自我管理的问卷，并接受肝癌教育。然后，他们将接受丙型肝炎测试。每个参与者将通过邮件或电话收到筛选测试的结果。我们将为受感染者提供推荐服务以治疗。对于那些无保护的人，我们将使用随机控制的设计在6个月内实施干预计划，以增加一系列疫苗接种。邮寄结果七个月后，我们将在不受保护的人中进行电话采访。完成后续行动后，控制中的人将接受延迟的LHW干预。从这项拟议的LHW干预中获得的见解对于针对其他高风险非英语人群实施肝癌预防计划将是有价值的，并将解决移民人口中的健康差异。