Knowledge, Attitudes, and Behaviors of Viral Hepatitis Among Recent African Immigrants in the United States: A Community Based Participatory Research Qualitative Study.

Essa A Mohamed,Abdul M Oseini,Christi A Patten,Loretta K Allotey,Henry Kerandi,Ju Dong Yang,Nasra H Giama,Lewis R Roberts,Hassan M Shaleh,Hawa M Ali,Lily L Tamire,Awol Windissa,Hager Ahmed Mohammed,Joyce E Balls-Berry,Hamdi A Ali,Wudneh O Gaga,Ibrahim A Waaeys,Linda Kerandi,Safra A Mohamed

doi:10.3389/fpubh.2020.00025

Abstract

Background: In the United States, hepatocellular carcinoma is the ninth leading cause of cancer mortality. Hepatocellular carcinoma disproportionately affects individuals of African ancestry with the rates being higher amongst individuals of foreign-born African ancestry. This study explored knowledge, attitudes, and behaviors toward viral hepatitis transmission, screening, and vaccination among recent African immigrants in Minnesota and identify ways to improve early detection and screening methods.Methods: A community based participatory research (CBPR) team with minority researchers and community members sought to gain insight on persons of African Ancestry knowledge, attitudes, and behaviors related to viral hepatitis by conducting a qualitative research study. The CBPR team developed a focus group moderator's guide with semi-structured questions related to transmission, screening, and vaccination of viral hepatitis. We conducted seven focus groups using bilingual, bicultural moderators with participants from local Ethiopian, Liberian and Kenyan communities from August 10th, 2014 to October 11th, 2014. Focus groups were audio recorded and transcribed. The CBPR team categorized the data into themes and subthemes with consensus using traditional content analysis.Results: Community partners recruited 63 participants with a majority identifying as male (51%). Participants lacked knowledge of viral hepatitis screening, vaccination, and treatment. Participants were aware of some behaviors that increased risk of acquisition of hepatitis. Participants endorsed a strategy of developing and delivering educational materials for African immigrants. Moreover, access to care and cultural awareness were mentioned as pivotal for prevention and treatment of viral hepatitis.Conclusions: Findings from this pilot study provide insight on areas of research focus. Having a research team consisting of members from the community helped to increase trust and foster an understanding of shared community values. Information from this study provides evidence to support the development culturally appropriate strategies to address disparities in viral hepatitis in these communities.

Highlights

In the United States, hepatocellular carcinoma is the ninth leading cause of cancer mortality
The incidence of Hepatocellular carcinoma (HCC) in the African continent is increasing due to rising numbers of viral hepatitis infections [12,13,14,15,16,17]. These findings suggest that immigrant African populations from regions endemic for viral hepatitis are at substantial risk of developing HCC
The findings illustrate that general knowledge of viral hepatitis transmission, prevention, and liver disease progression is poor among the three African immigrants (AI) Minnesotan communities

Summary

Introduction

In the United States, hepatocellular carcinoma is the ninth leading cause of cancer mortality. Hepatocellular carcinoma disproportionately affects individuals of African ancestry with the rates being higher amongst individuals of foreign-born African ancestry. This study explored knowledge, attitudes, and behaviors toward viral hepatitis transmission, screening, and vaccination among recent African immigrants in Minnesota and identify ways to improve early detection and screening methods. Hepatocellular carcinoma (HCC) is the most common primary cancer of the liver [1] and has the sixth highest cancer incidence worldwide [2]. The 2012 Cancer Report by the Minnesota Department of Health reported the incidence and mortality rates due to liver cancer among the Black population were higher than their White counterparts [10]. African immigration to Minnesota is the third highest by percentage of state population [11]

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