Abstract
BackgroundChronic hepatitis B (CHB) is a major global health issue disproportionately affecting Asian Americans and other immigrant populations in the United States. Despite the high risk of morbid complications from CHB, the majority of individuals with CHB do not access healthcare due to a complex of barriers. These barriers influence health literacy which may affect behaviors linked to hepatitis B care. We aimed to identify and evaluate various sociocultural factors and how they interact with health literacy to impact CHB care and health seeking in a Korean American population.MethodsA total of 28 Korean American individuals with CHB were divided into 5 different focus discussion groups. This study investigated the participants’ sociocultural backgrounds as well as their awareness and utilization of the healthcare system that could influence their health literacy and behaviors in accessing care.ResultsOur analysis identified and concentrated on three themes that emerged from these discussions: low risk perception and knowledge of CHB and its complications; language, immigrant status, and stigma; and financial and institutional barriers. The participants’ overall awareness of the disease and prevention methods demonstrated poor understanding of important characteristics and potential outcomes of the disease. Additionally, differences in cultural expectations and a lack of understanding and utilization of healthcare systems affected health literacy in further limiting participants’ motivation to seek care.ConclusionsThe present study suggests that there are culture-specific barriers to health literacy governing individuals’ health behavior in accessing hepatitis B care. These findings may inform strategies for developing culturally tailored resources and programs and for facilitating the implementation of community-wide hepatitis B education and screening initiatives in immigrant communities.
Highlights
Chronic hepatitis B (CHB) is a major global health issue disproportionately affecting Asian Americans and other immigrant populations in the United States
Since CHB burden in the Korean American population is heavy with a significant disparity in health access, we investigated sociocultural barriers to hepatitis B literacy and their influence on access to care
Participants Participants were Korean American adults who were found to be hepatitis B surface antigen (HBsAg) seropositive (i.e., hepatitis B virus (HBV)-infected) from community-based hepatitis B awareness campaigns conducted in Flushing, New York, between January 2016 and June 2017
Summary
Chronic hepatitis B (CHB) is a major global health issue disproportionately affecting Asian Americans and other immigrant populations in the United States. Despite the high risk of morbid complications from CHB, the majority of individuals with CHB do not access healthcare due to a complex of barriers. These barriers influence health literacy which may affect behaviors linked to hepatitis B care. Given that approximately 50,000 people legally enter the U.S every year from intermediate to highly endemic (i.e. HBV prevalence > 2%) countries and a majority of these individuals are not screened, CHB remains a serious public health issue in the U.S [8, 9]
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