Author information

¹Center for Asian Health, Lewis Katz School of Medicine, Temple University, Kresge Hall, Suite 320, 3440 N Broad St., Philadelphia, PA, 19140, USA. grace.ma@temple.edu.

²Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA. grace.ma@temple.edu.

³Center for Asian Health, Lewis Katz School of Medicine, Temple University, Kresge Hall, Suite 320, 3440 N Broad St., Philadelphia, PA, 19140, USA.

⁴Department of Urban Health and Population Science, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.

⁵School of Nursing, University of Washington, Seattle, WA, USA.

⁶Hepatology Clinic, Philadelphia, PA, USA.

⁷Department of Biological Sciences, Hunter College, City University of New York, New York, NY, USA.

⁸Faith Hope Love Chinese Church, Philadelphia, PA, USA.

⁹Korean Community Services of Metropolitan New York, New York, NY, USA.

¹⁰Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA.

Abstract

Background: Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC). Asian Americans have the highest incidence and mortality rates of HCC among all US racial/ethnic groups. Inadequate monitoring and treatment of chronic hepatitis B contribute to poor health outcomes and increased healthcare costs among Asian Americans.

Aims: The goal of this study is to assess the effect of a patient-led strategy on chronic hepatitis B monitoring and treatment adherence specifically among Asian Americans with culturally tailored Patient Navigator-led Intervention.

Methods: From 2015 to 2018, 532 eligible participants living with chronic hepatitis B in the greater Philadelphia and New York city metropolitan areas were randomly assigned to either the intervention group or the control group. Generalized linear mixed-effects models were used to estimate the odds ratio (OR) for rates of doctor visits for chronic hepatitis B and rates of alanine aminotransferase testing for evidence of liver damage.

Results: Intervention group had higher rates of doctor visits than the control group at both 6-month (77.22% vs. 45.75%) and 12-month assessments (90.73% vs. 60.61%). Significantly more intervention group participants received ALT testing than control group participants at 6-month (52.90% vs. 25.10%) and 12-month (75.40% vs. 46.75%) follow-up.

Conclusions: Culturally and linguistically appropriate intervention has strong effects on adherence to follow-up care among Asian American hepatitis B patients experiencing challenges to medication adherence and follow up care. These findings further identify opportunities for practical implementation of evidence-based intervention that could lead to reductions in disparities in chronic liver disease and liver cancer among high-risk, underserved populations.

Trial registration: ClinicalTrials.gov NCT02421666