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Hepatitis B and liver cancer among Hmong : knowledge, perceptions of risk, and barriers to hepatitis B screening and vaccination

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dc.contributor.advisor Thorburn, Sheryl
dc.creator Kue, Jennifer
dc.date.accessioned 2011-05-09T18:20:54Z
dc.date.available 2011-05-09T18:20:54Z
dc.date.copyright 2011-05-02
dc.date.issued 2011-05-09
dc.identifier.uri http://hdl.handle.net/1957/21176
dc.description Graduation date: 2011 en_US
dc.description.abstract Chronic hepatitis B disproportionately affects Asian Americans. Although Asians make up only 4.2% of the total United States (U.S.) population, they account for more than half of those infected with hepatitis B. If left untreated, chronic hepatitis B could lead to cirrhosis, liver damage, and liver cancer. Studies show that the Hmong population in the U.S., who emigrated from Southeast Asia where hepatitis B is endemic, have a high prevalence of hepatitis B, yet knowledge about the disease, as well as, screening and vaccination rates, are low. Guided by the ecological perspective, the Health Belief Model (HBM), and the Explanatory Models Approach, the purpose of this exploratory study was to examine 1) knowledge and beliefs about hepatitis B infection and transmission; 2) perceptions of risk to hepatitis B; 3) barriers to hepatitis B screening and vaccination; and 4) knowledge of liver cancer among Hmong living in Oregon. This study used a mixed methods approach (i.e., quantitative and qualitative) to collect data from Hmong women and men living in Oregon. Data from 17 key informant and 83 in-depth interviews were analyzed using content analysis techniques. Results indicated that most in-depth interview participants had heard of the hepatitis B virus (96%) and slightly over half had been screened (53%) and vaccinated (51%). Bivariate analyses showed that education, health insurance, preventive care, doctor’s recommendation, and English proficiency were significantly associated with having been screened for hepatitis B. Only English proficiency was significantly associated with hepatitis B vaccination. In general, more than half of the in-depth interview participants were able to correctly identify most of the routes of hepatitis B transmission; however, there were still large gaps in knowledge. Nearly 40% were unaware that sexual intercourse was a route of transmission, 41% did not know that sharing a toothbrush could spread the virus, and 57% did not know that the virus is not transmitted through coughing. Multivariate logistic regression analyses indicated that the relationship between most HBM components (e.g., perceived susceptibility, perceived benefits) was not associated with screening or vaccination. Qualitative results provided insight into screening and vaccination experiences and Hmong beliefs about liver cancer. In general, in-depth interview participants reported not facing many barriers in getting screened or vaccinated for hepatitis B. Some participants cited that not knowing the testing process or the importance of testing made it difficult to get screened. Participants tended to have fatalistic beliefs about liver cancer and remarked that liver cancer signified death or a disease that was incurable. The findings suggest that Hmong in Oregon have low levels of knowledge about hepatitis B and liver cancer and indicate a need for culturally tailored educational interventions. en_US
dc.language.iso en_US en_US
dc.subject Hepatitis B en_US
dc.subject Liver Cancer en_US
dc.subject Asians en_US
dc.subject Hmong en_US
dc.subject Screening en_US
dc.subject Vaccination en_US
dc.subject.lcsh Hmong Americans -- Health and hygiene -- Oregon en_US
dc.subject.lcsh Hmong Americans -- Oregon -- Attitudes en_US
dc.subject.lcsh Hepatitis B -- Diagnosis -- Oregon en_US
dc.subject.lcsh Hepatitis B -- Vaccination -- Oregon en_US
dc.title Hepatitis B and liver cancer among Hmong : knowledge, perceptions of risk, and barriers to hepatitis B screening and vaccination en_US
dc.type Thesis/Dissertation en_US
dc.degree.name Doctor of Philosophy (Ph. D.) in Public Health en_US
dc.degree.level Doctoral en_US
dc.degree.discipline Health and Human Sciences en_US
dc.degree.grantor Oregon State University en_US
dc.contributor.committeemember Champeau, Donna
dc.contributor.committeemember Khanna, Sunil
dc.contributor.committeemember Zukoski, Ann
dc.contributor.committeemember Pavol, Mike

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