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

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.

Keywords: African; community based research; immigrant health; liver cancer disparities; viral hepatitis.

Copyright © 2020 Mohamed, Giama, Shaleh, Kerandi, Oseini, Ahmed Mohammed, Kerandi, Allotey, Waaeys, Ali, Ali, Mohamed, Yang, Gaga, Tamire, Windissa, Patten, Balls-Berry and Roberts.

References

    1. Ferlay JI, Ervik M, Forman D, Bray F. GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012. (2013). Available online at: (accessed April 29, 2016).
    1. Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden: Globocan 2000. Int J Cancer. (2001) 94:153–6. 10.1002/ijc.1440
    1. Parkin DM. The global health burden of infection-associated cancers in the year 2002. Int J Cancer. (2006) 118:3030–44. 10.1002/ijc.21731
    1. Seeff LB. Introduction: the burden of hepatocellular carcinoma. Gastroenterology. (2004) 127(5 Suppl. 1):S1–4. 10.1053/j.gastro.2004.09.010
    1. Bosch FX, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology. (2004) 127:S5–16. 10.1053/j.gastro.2004.09.011
    1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. (2005) 55:74–108. 10.3322/canjclin.55.2.74
    1. El-Serag HB, Marrero JA, Rudolph L, Reddy KR. Diagnosis and treatment of hepatocellular carcinoma. Gastroenterology. (2008) 134:1752–63. 10.1053/j.gastro.2008.02.090
    1. Chang MH. Prevention of hepatitis B virus infection and liver cancer. Recent Results Cancer Res. (2014) 193:75–95. 10.1007/978-3-642-38965-8_5
    1. Andriamandimby SF, Olive MM, Shimakawa Y, Rakotomanana F, Razanajatovo IM, Andrianinarivomanana TM, et al. . Prevalence of chronic hepatitis B virus infection and infrastructure for its diagnosis in Madagascar: implication for the WHO's elimination strategy. BMC Public Health. (2017) 17:636. 10.1186/s12889-017-4630-z
    1. Minnesota Department of Health Cancer in Minnesota 1988–2009. Saint Paul, MN: Minnesota Department of Health; (2012).
    1. Gambino C, Trevelyan E, Fitzwater J. The Foreign-Born Population From Africa: 2008–2012. American Community Survey Briefs. U.S. Census Bureau; (2014). Available online at: (accessed December 21, 2017).
    1. Ott JJ, Stevens GA, Groeger J, Wiersma ST. Global epidemiology of hepatitis B virus infection: new estimates of age-specific HBsAg seroprevalence and endemicity. Vaccine. (2012) 30:2212–9. 10.1016/j.vaccine.2011.12.116
    1. Karuru JW, Lule GN, Joshi M, Anzala O. Prevalence of HCV and HCV/HIV co-infection among in-patients at the Kenyatta National Hospital. East Afr Med J. (2005) 82:170–2. 10.4314/eamj.v82i4.9276
    1. Karuru JW, Lule GN, Joshi M, Anzala O. Prevalence of HCV and HIV/HCV co-infection among volunteer blood donors and VCT clients. East Afr Med J. (2005) 82:166–9. 10.4314/eamj.v82i4.9275
    1. Tramuto F, Maida CM, Colomba GM, Di Carlo P, Mazzola G, Li Vecchi V, et al. . Occult hepatitis B infection in the immigrant population of Sicily, Italy. J Immigr Minor Health. (2013) 15:725–31. 10.1007/s10903-012-9699-y
    1. Yang JD, Gyedu A, Afihene MY, Duduyemi BM, Micah E, Kingham TP, et al. . Hepatocellular carcinoma occurs at an earlier age in africans, particularly in association with chronic hepatitis B. Am J Gastroenterol. (2015) 110:1629–31. 10.1038/ajg.2015.289
    1. Yang JD, Mohamed EA, Aziz AO, Shousha HI, Hashem MB, Nabeel MM, et al. . Characteristics, management, and outcomes of patients with hepatocellular carcinoma in Africa: a multicountry observational study from the Africa Liver Cancer Consortium. Lancet Gastroenterol Hepatol. (2017) 2:103–11. 10.1016/S2468-1253(16)30161-3
    1. Goldstein ST, Zhou F, Hadler SC, Bell BP, Mast EE, Margolis HS. A mathematical model to estimate global hepatitis B disease burden and vaccination impact. Int J Epidemiol. (2005) 34:1329–39. 10.1093/ije/dyi206
    1. Yang JD, Roberts LR. Hepatocellular carcinoma: a global view. Nat Rev Gastroenterol Hepatol. (2010) 7:448–58. 10.1038/nrgastro.2010.100
    1. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al. . Global burden of cancers attributable to infections in 2008: a review and synthetic analysis. Lancet Oncol. (2012) 13:607–15. 10.1016/S1470-2045(12)70137-7
    1. Stanaway JD, Flaxman AD, Naghavi M, Fitzmaurice C, Vos T, Abubakar I, et al. . The global burden of viral hepatitis from 1990 to 2013: findings from the Global Burden of Disease Study 2013. Lancet. (2016) 388:1081–8. 10.1016/S0140-6736(16)30579-7
    1. Hassan MA, Kim WR, Li R, Smith CI, Fried MW, Sterling RK, et al. . Characteristics of US-born versus foreign-born Americans of African descent with chronic hepatitis B. Am J Epidemiol. (2017) 186:356–66. 10.1093/aje/kwx064
    1. Shire AM, Sandhu DS, Kaiya JK, Oseini AM, Yang JD, Chaiteerakij R, et al. . Viral hepatitis among Somali immigrants in Minnesota: association of hepatitis C with hepatocellular carcinoma. Mayo Clinic Proc. (2012) 87:17–24. 10.1016/j.mayocp.2011.08.001
    1. Heary CM, Hennessy E. The use of focus group interviews in pediatric health care research. J Pediatr Psychol. (2002) 27:47–57. 10.1093/jpepsy/27.1.47
    1. Krueger R. Focus Groups: A Practical Guide for Applied Research. Thousand Oaks, CA: Sage; (1994).
    1. Krueger R, Casey M. Focus Groups: A Practical Guide for Applied Research. 4th ed Thousand Oaks, CA: Sage; (2009).
    1. ul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Aljadhey H. A cross sectional assessment of knowledge, attitude and practice towards Hepatitis B among healthy population of Quetta, Pakistan. BMC Public Health. (2012) 12:692. 10.1186/1471-2458-12-692
    1. Choe JH, Chan N, Do HH, Woodall E, Lim E, Taylor VM. Hepatitis B and liver cancer beliefs among Korean immigrants in Western Washington. Cancer. (2005) 104(12 Suppl):2955–8. 10.1002/cncr.21518
    1. Choe JH, Taylor VM, Yasui Y, Burke N, Nguyen T, Acorda E, et al. . Health care access and sociodemographic factors associated with hepatitis B testing in Vietnamese American men. J Immigr Minor Health. (2006) 8:193–201. 10.1007/s10903-006-9322-1
    1. Thompson MJ, Taylor VM, Yasui Y, Hislop TG, Jackson JC, Kuniyuki A, et al. . Hepatitis B knowledge and practices among Chinese Canadian women in Vancouver, British Columbia. Can J Public Health. (2003) 94:281–6. 10.1007/BF03403606
    1. Cheung J, Lee TK, Teh CZ, Wang CY, Kwan WC, Yoshida EM. Cross-sectional study of hepatitis B awareness among Chinese and Southeast Asian Canadians in the Vancouver-Richmond community. Can J Gastroenterol. (2005) 19:245–9. 10.1155/2005/583406
    1. Blanas DA, Nichols K, Bekele M, Shankar H, Bekele S, Jandorf L, et al. . Adapting the Andersen model to a francophone West African immigrant population: hepatitis B screening and linkage to care in New York City. J Community Health. (2015) 40:175–84. 10.1007/s10900-014-9916-9
    1. Jorgensen CM, Carnes CA. Lessons learned from exploratory research about viral hepatitis. Health Promot Pract. (2013) 14:364–9. 10.1177/1524839912455643
    1. Burke NJ, Do HH, Talbot J, Sos C, Svy D, Taylor VM. Chumnguh thleum: understanding liver illness and hepatitis B among Cambodian immigrants. J Community Health. (2011) 36:27–34. 10.1007/s10900-010-9277-y
    1. Wallace J, McNally S, Richmond J, Hajarizadeh B, Pitts M. Managing chronic hepatitis B: a qualitative study exploring the perspectives of people living with chronic hepatitis B in Australia. BMC Res Notes. (2011) 4:45. 10.1186/1756-0500-4-45
    1. van der Veen YJ, Voeten HA, de Zwart O, Richardus JH. Awareness, knowledge and self-reported test rates regarding Hepatitis B in Turkish-Dutch: a survey. BMC Public Health. (2010) 10:512. 10.1186/1471-2458-10-512
    1. Kue J, Thorburn S. Hepatitis B knowledge, screening, and vaccination among Hmong Americans. J Health Care Poor Underserved. (2013) 24:566–78. 10.1353/hpu.2013.0081
    1. Palmer CK, Thomas MC, von Wagner C, Raine R. Reasons for non-uptake and subsequent participation in the NHS Bowel Cancer Screening Programme: a qualitative study. Br J Cancer. (2014) 110:1705–11. 10.1038/bjc.2014.125
    1. Chen H, Tu SP, Teh CZ, Yip MP, Choe JH, Hislop TG, et al. . Lay beliefs about hepatitis among North American Chinese: implications for hepatitis prevention. J Community Health. (2006) 31:94–112. 10.1007/s10900-005-9000-6
    1. Bolutayo K, van Manh AL, Cohen N, Ndiaye D, Jandorf L, Perumalswami PV. Reducing liver cancer risk in African-born immigrants through culturally targeted hepatitis B group education programs. J Cancer Educ. (2018) 33:1201–5. 10.1007/s13187-017-1231-6
    1. The Africa Migration Insider US Hosting 30,000 Illegal Kenyan Immgrants. (2015). Available online at: (accessed December 29, 2015).
    1. Maldonado CZ, Rodriguez RM, Torres JR, Flores YS, Lovato LM. Fear of discovery among Latino immigrants presenting to the emergency department. Acad Emerg Med. (2013) 20:155–61. 10.1111/acem.12079
    1. Chavez LR. Undocumented immigrants and their use of medical services in Orange County, California. Soc Sci Med. (2012) 74:887–93. 10.1016/j.socscimed.2011.05.023
    1. Hacker K, Chu J, Leung C, Marra R, Pirie A, Brahimi M, et al. . The impact of Immigration and Customs Enforcement on immigrant health: Perceptions of immigrants in Everett, Massachusetts, USA. Soc Sci Med. (2011) 73:586–94. 10.1016/j.socscimed.2011.06.007
    1. Amuedo-Dorantes C, Puttitanun T, Martinez-Donate AP. How do tougher immigration measures affect unauthorized immigrants? Demography. (2013) 50:1067–91. 10.1007/s13524-013-0200-x
    1. Hutton DW, Tan D, So SK, Brandeau ML. Cost-effectiveness of screening and vaccinating Asian and Pacific Islander adults for hepatitis B. Ann Intern Med. (2007) 147:460–9. 10.7326/0003-4819-147-7-200710020-00004
    1. Veldhuijzen IK, Toy M, Hahne SJ, De Wit GA, Schalm SW, de Man RA, et al. . Screening and early treatment of migrants for chronic hepatitis B virus infection is cost-effective. Gastroenterology. (2010) 138:522–30. 10.1053/j.gastro.2009.10.039
    1. Poureslami I, Rootman I, Doyle-Waters MM, Nimmon L, Fitzgerald JM. Health literacy, language, and ethnicity-related factors in newcomer asthma patients to Canada: a qualitative study. J Immigr Minor Health. (2011) 13:315–22. 10.1007/s10903-010-9405-x
    1. Deville W, Greacen T, Bogic M, Dauvrin M, Dias S, Gaddini A, et al. . Health care for immigrants in Europe: is there still consensus among country experts about principles of good practice? A Delphi study BMC Public Health. (2011) 11:699. 10.1186/1471-2458-11-699
    1. Priebe S, Sandhu S, Dias S, Gaddini A, Greacen T, Ioannidis E, et al. . Good practice in health care for migrants: views and experiences of care professionals in 16 European countries. BMC Public Health. (2011) 11:187. 10.1186/1471-2458-11-187
    1. Shaw SJ, Huebner C, Armin J, Orzech K, Vivian J. The role of culture in health literacy and chronic disease screening and management. J Immigr Minor Health. (2009) 11:460–7. 10.1007/s10903-008-9135-5
    1. Balls-Berry J, Watson C, Kadimpati S, Crockett A, Mohamed EA, Brown I, et al. . Black men's perceptions and knowledge of diabetes: a church-affiliated barbershop focus group study. J Racial Ethn Health Disparities. (2015) 2:465–72. 10.1007/s40615-015-0094-y
    1. Ogunwobi OO, Dibba O, Zhu L, Ilboudo A, Tan Y, Fraser MA, et al. . Hepatitis B virus screening and vaccination in first-generation African immigrants: a pilot study. J Community Health. (2019) 44:1037–43. 10.1007/s10900-019-00668-z
    1. Sriphanlop P, Jandorf L, Kairouz C, Thelemaque L, Shankar H, Perumalswami P. Factors related to hepatitis B screening among Africans in New York City. Am J Health Behav. (2014) 38:745–54. 10.5993/AJHB.38.5.12

Source: PubMed

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구독하다