Hepatitis B screening among Chinese Americans: a structural equation modeling analysis

BMC Infectious Diseases

Research Article

Shumenghui Zhai¹  Yin Tan¹  Guo Yolanda Zhang¹  Xiang Ma¹  Steven E Shive²  Grace X Ma³  Min Qi Wang⁴ 

[1] Center for Asian Health and College of Public Health, Temple University, 19122, Philadelphia, PA, USA;Department of Health, Research Associate, Center for Asian Health, Temple University; and East Stroudsburg University, DeNike Hall, 200 Prospect St., East Stroudsburg University, 18301-2999, East Stroudsburg, PA, USA;Department of Public Health, Director of Center for Asian Health, College of Public Health, 1301 Cecil B Moore Ave. Ritter Annex, Rm 913, 19122, Philadelphia, PA, USA;Department of Public and Community Health, University of Maryland, College Park, Maryland, USA;

关键词: HBV;    Hepatitis B;    HBV screening;    Chinese;    Health care access;   

DOI  :  10.1186/s12879-015-0854-7

 received in 2014-09-05, accepted in 2015-02-19,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundHepatitis B Virus (HBV) disproportionately affects new immigrants from endemic regions such as China. Untreated infections increase health risks for liver diseases including cancer. Yet most of those infected are unaware of their disease limiting prevention and early treatment options. The purpose of this community based study was to evaluate a heuristic model identifying factors contributing to Hepatitis B (HBV) screening among Chinese Americans.MethodsA cross-sectional design included a sample of 924 Chinese men and women 18 years of age and older of which 718 had complete data for final analysis. Confirmatory factor analysis verified conceptual indicators including access/satisfaction with health care and enabling, predisposing, cultural, and health belief factors. Structural equation modeling was used to identify direct and indirect predictors of Hepatitis B screening.ResultsBivariate analysis revealed that Chinese respondents who were never screened for HBV were significantly more likely to be below age 40 (69.8%), male (69.2%), had less than a high school education (76.4%), with less than 6 years living in the US (72.8%) and had no health insurance (79.2%). The final model identified enabling factors (having health insurance, a primary health care provider to go to when sick and more frequent visits to a doctor in the last year) as the strongest predictor of HBV screening (coefficient = 0.470, t = 7.618, p < .001). Predisposing factors (education variables) were also significantly related to HBV screening. Cultural factors and Satisfaction with Health care were associated with HBV screening only through their significant relationships with enabling factors.ConclusionsThe tested theoretical model shows promise in predicting HBV testing among Chinese Americans. Increasing access to health care by expanding insurance options and improving culturally sensitivity in health systems are critical to reach new immigrants like Chinese for HBV screening. Yet such strategies are consistent with DHHS Action plan for the Prevention and Treatment of Viral Hepatitis. Implementing community-based strategies like partnering with relevant Community-Based Organizations are important for meeting HBV policy targets.

【 授权许可】

CC BY   
© Ma et al.; licensee BioMed Central. 2015