The objective was to learn about the hepatitis prevention behavior of relatively unacculturated North American Chinese adults, along with their knowledge, beliefs, and perceptions with regard to hepatitis, screening, and vaccination. Forty Chinese men and women, aged 18–64, were recruited from immigrant communities in Seattle, Washington, and Vancouver, British Columbia. Semi-structured interviews (Cantonese or Mandarin) were audiotaped, translated, transcribed verbatim, and coded. Open coding, axial coding, constant comparison methods, and QSR NUD*IST 5 software was used for analysis. Findings were validated using eight focus groups. Findings indicated that many interviewees lack accurate knowledge with regard to hepatitis, often confusing the different types. Perceived causes of hepatitis included potentially harmful food (e.g., fried foods or potentially contaminated foods), alcohol, contact with infected individuals, stress, and inadequate rest. Preventive strategies associated with Chinese health beliefs included the use of Chinese herbal medicine, maintaining a stress-free mind, strengthening the body’s natural defenses, and getting enough sleep. Other preventive strategies were the practice of good hygiene, vaccination, and the avoidance of contact with infected persons. Vaccination was not seen as primary, as 65% of those who had heard of hepatitis vaccination did not cite it as a means for hepatitis prevention until asked. Also, participants lacked information about the types and purposes of hepatitis vaccination and were worried about side effects. In conclusion, any attempt to promote hepatitis testing and vaccination among the North American Chinese should take traditional beliefs and practices into consideration.
Similar content being viewed by others
REFERENCES
World Health Organization. Fact sheet N204. Hepatitis B. 2000. Available at: http://www.who.int/mediacentre/factsheets/fs204/en/print.html. Accessed March 9, 2005.
Wong F. Hepatitis B and C in the Chinese community is a very common problem. HepNet. 1998. Available at: http://www.hepnet.com/hepb/wong1198.html. Accessed March 9, 2005.
Aggarwal R, Ranjan P (2004) Preventing and treating hepatitis B infection. BMJ 329: 1080–1086
Custer B, Sullivan SD, Hazlet TK, Iloeje U, Veenstra DL, Kowdley KV (2004) Global epidemiology of hepatitis B virus. J Clin Gastroenterol 38(10 Suppl): S158–S168
Lavanchy D (2004) Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat 11: 97–107
Vryheid RE, Yu ES, Mehta KM, McGhee J (2001) The declining prevalence of hepatitis B virus infection among Asian and Pacific Islander children. Asian Am Pac Isl J Health 9: 162–178
Do S (2001) The natural history of hepatitis B in Asian Americans. Asian Am Pac Isl J Health 9: 141–153
Nguyen MH, Keeffe EB (2003) Chronic hepatitis B and hepatitis C in Asian Americans. Rev Gastroenterol Disord 3: 125–134
Reeve TJ, Bennett CE. We the People: Asians in the United States. United States Census 2000 Special Reports 2004. Available at: http://www.census.gov/prod/2004pubs/censr-17.pdf. Accessed May 19, 2005.
Public Health Agency of Canada. Hepatitis B Fact Sheet, 2003. Last updated: 2004-02-16. Available at: http://www.phac-aspc.gc.ca/hcai-iamss/bbp-pts/hepatitis/hep_b_e.html. Accessed March 9, 2005.
Public Health Agency of Canada. Preventing the transmission of bloodborne pathogens in health care and public health settings. Canada Communicable Disease Report (CCDR) 1997; 23S3. Last updated: 2002-11-08. Available at: http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/97vol23/23s3/index.html. Accessed April 16, 2005.
Lin HH, Wang LY, Hu CT et al. (2003) Decline of hepatitis B carrier rate in vaccinated and unvaccinated subjects: sixteen years after newborn vaccination program in Taiwan. J Med Virol 69: 471–474
Safary A, Beck J (2000) Vaccination against hepatitis B: current challenges for Asian countries and future directions. J Gastroenterol Hepatol 15: 396–401
Euler GL (2001) The epidemiology of hepatitis B vaccination catch-up among AAPI children in the United States. Asian Am Pac Isl J Health 9: 154–161
Hong Z, Zou S, Giulivi A. Hepatitis B and its control in Southeast Asia and China. Canada Communicable Disease Report 2001; 27S3. Last updated: 2001-10-12. Available at: http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/01vol27/27s3/27s3k_e.html. Accessed April 26, 2005.
Alter MJ (2003) Epidemiology and prevention of hepatitis B. Semin Liver Dis 23: 39–46
Hurley JL, Turner HS, Butler KM (2001) Planning and execution of a successful hepatitis B immunization program. J Am Coll Health 49: 189–191
Taplin S (2004) Foreword: Promoting cancer screening: Lessons learned and future directions for research and practice. CANCER Suppl (Published online: http://www.interscience.wiley.com) 101: 1105–1106
Hwu YJ, Coates VE, Boore JR (2001) The health behaviours of Chinese people with chronic illness. Int J Nurs Stud 38: 629–641
Yeo SS, Meiser B, Barlow-Stewart K, Goldstein D, Tucker K, Eisenbruch M (2005) Understanding community beliefs of Chinese-Australians about cancer: initial insights using an ethnographic approach. Psychooncology 14: 174–186
Wong-Kim E, Sun A, DeMattos MC (2003) Assessing cancer beliefs in a Chinese immigrant community. Cancer Control 10(5 Suppl): 22–28
Holroyd E, Twinn S, Adab P (2004) Socio-cultural influences on Chinese women’s attendance for cervical screening. J Adv Nurs 46: 42–52
Liang W, Yuan E, Mandelblatt JS, Pasick RJ (2004) How do older Chinese women view health and cancer screening? Results from focus groups and implications for interventions. Ethn Health 9: 283–304
Lai WA, Lew-Ting CY, Chie WC (2005) How diabetic patients think about and manage their illness in Taiwan. Diabet Med 22: 286–292
Zhang J, Verhoef MJ (2002) Illness management strategies among Chinese immigrants living with arthritis. Soc Sci Med 55: 1795–1802
Daly J, Davidson P, Chang E, Hancock K, Rees D, Thompson DR (2002) Cultural aspects of adjustment to coronary heart disease in Chinese-Australians: a review of the literature. J Adv Nurs 39: 391–399
Statistics Canada. Canada’s ethnocultural portrait: the changing mosaic. 2001 Census: Analysis Series. 2003-01-21. Available at: http://www.12.statcan.ca/english/census01/Products/Analytic/companion/abor/pdf/96F0030XIE2001007.pdf. Accessed May 19, 2005.
U.S. Census Bureau. Ancestry profile 3: place of birth for the foreign-born population. Census 2000 Summary File 3. 2002-09-17. Available at: http://www.census.gov. Accessed March 9, 2005.
Hislop TG, Deschamps M, Teh C et al. (2003) Facilitators and barriers to cervical cancer screening among Chinese Canadian women. Can J Public Health 94: 68–73
Ralston JD, Taylor VM, Yasui Y, Kuniyuki A, Jackson JC, Tu SP (2003) Knowledge of cervical cancer risk factors among Chinese immigrants in Seattle. J Community Health 28: 41–57
Tu SP, Yasui Y, Kuniyuki AA et al. (2003) Mammography screening among Chinese-American women. Cancer 97: 1293–1302
NUD*IST [computer program]. Version 5. Bundoora Victoria Australia: QSR International Pty Ltd, 2000.
Strauss A, Corbin J (eds) (1990) Basics of Qualitative Research: Grounded Theory, Procedures and Techniques. Sage Publications, Newbury Park, CA
Lincoln YS, Guba EG (1985) Naturalistic Inquiry. Sage Publications, Beverly Hills CA, pp 314–316
Chen TS, Chen PS (1998) The liver in traditional Chinese medicine. J Gastroenterol Hepatol 13: 437–442
Burke NJ, Jackson JC, Thai HC et al. (2004) ‘Honoring tradition, accepting new ways’: development of a hepatitis B control intervention for Vietnamese immigrants. Ethn Health 9: 153–169
Thompson MJ, Taylor VM, Jackson JC et al. (2002) Hepatitis B knowledge and practices among Chinese American women in Seattle, Washington. J Cancer Educ 17: 222–226
Thompson MJ, Taylor VM, Yasui Y et al. (2003) Hepatitis B knowledge and practices among Chinese Canadian women in Vancouver, British Columbia. Can J Public Health 94: 281–286
Tan A (2004) Health and illness in the Asian population. In: Spector RE (eds) Cultural Diversity in Health and Illness. 6th ed. Pearson Education Inc, Upper Saddle River NJ, pp. 209–229
Lu AP, Jia HW, Xiao C, Lu QP (2004) Theory of traditional Chinese medicine and therapeutic method of diseases. World J Gastroenterol 10: 1854–1856
Paisley JA, Haines J, Greenberg M, Makarchuk MJ, Vogelzang S, Lewicki K (2002) An examination of cancer risk beliefs among adults from Toronto’s Somali, Chinese, Russian and Spanish-speaking communities. Can J Public Health 93: 138–141
Theisen C (2004) In different cultures, cancer screening presents challenges. J Natl Cancer Inst 96: 10–12
Jackson JC, Do H, Chitnarong K et al. (2002) Development of Cervical Cancer Control Interventions for Chinese Immigrants. J Immigrant Health 4: 147–157
Taylor VM, Hislop TG, Jackson JC et al. (2002) A randomized controlled trial of interventions to promote cervical cancer screening among Chinese women in North America. J Natl Cancer Inst 94: 670–677
Lasky EM, Martz CH (1993) The Asian/Pacific Islander population in the United States: Cultural perspectives and their relationship to cancer prevention and early detection. In: Frank-Stromborg M, Olsen SJ (eds) Cancer Prevention in Minority Populations: Cultural Implications for Health Care Professionals. Mosby, St. Louis, MO, pp. 80–112
Acknowledgments
Supported by Grant #CA097199 and cooperative agreement #1 U01 CA114640-01 from the National Cancer Institute. We would like to thank the study participants for taking the time to complete interviews and share their insight and experience. This work would not have been possible without the dedication of the interviewers Irene Chan, Titania Chan, Nelson Ha, Lina Hsu, Hugo Lau, Angeline Low, Serena Suen, Lucia Tseng, and Ben Tseng.
Author information
Authors and Affiliations
Corresponding author
Additional information
Hueifang Chen is Research Analyst, Shin-Ping Tu, Associate Professor, Mei-Po Yip, Research Coordinator, John H. Choe, Acting Instructor, all in the Division of General Internal Medicine, University of Washington, Seattle, WA, USA; Chong Z. Teh is Research Coordinator, T. Gregory Hislop, Research Scientist, in the Division of Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Victoria M. Taylor and Beti Thompson are Full Members in the Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Rights and permissions
About this article
Cite this article
Chen, H., Tu, SP., Teh, C.Z. et al. LAY BELIEFS ABOUT HEPATITIS AMONG NORTH AMERICAN CHINESE: IMPLICATIONS FOR HEPATITIS PREVENTION. J Community Health 31, 94–112 (2006). https://doi.org/10.1007/s10900-005-9000-6
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10900-005-9000-6