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Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups

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Abstract

BACKGROUND

Physicians can play a significant role in helping to decrease the hepatitis B virus (HBV) burden among Asian Americans. Few studies have described knowledge and practice patterns in the medical community among different provider types regarding HBV and liver cancer.

OBJECTIVE

Our study explores the HBV beliefs, attitudes and practice patterns of medical providers serving Asian American communities.

DESIGN

We conducted three focus groups with primary care providers, liver specialists, and other providers predominantly serving Asian American community. We asked about practices and barriers to appropriate medical care and outreach.

PARTICIPANTS

We moderated three focus groups with 23 participants, 18 of whom completed and returned demographic surveys. Twelve were of Asian ethnicity and 13 spoke English as a second language. Only eight screened at least half of their patients, most (72%) using the hepatitis B surface antigen test.

APPROACH

We used grounded theory methods to analyze focus group transcripts.

RESULTS

Participants frequently discussed cultural and financial barriers to hepatitis care. They admitted reluctance to screen for HBV because patients might be unwilling or unable to afford treatment. Cultural differences were discussed most by primary care providers; best methods of outreach were discussed most by liver specialists; and alternative medicine was discussed most by acupuncturists and other providers.

CONCLUSIONS

More resources are needed to lower financial barriers complicating HBV care and encourage providing guideline-recommended screenings. Other providers can help promote HBV screening and increase community and cultural awareness.

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Acknowledgements

The authors acknowledge Jing Peng for coordinating the focus groups and data entry; Mahfam Mohseni, Cheryl Rogers and Roz Bryant for assisting in coding transcripts; and Stephanie Deming for providing editorial assistance. Drs. Roundtree and Suarez-Almazor are investigators at the Houston Centers for Education and Research on Therapeutics, which receives core support from the Agency for Healthcare Research and Quality (5 U18 HS016093). The research reported in this manuscript was supported by a grant from Gilead, Inc.

Conflict of Interest

None disclosed.

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Authors and Affiliations

  1. Department General Internal Medicine, Ambulatory Treatment & Emergency Care, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 1465, Houston, TX, 77030, USA

    Jessica P. Hwang MD, MPH, Aimee K. Roundtree PhD & Maria E. Suarez-Almazor MD, PhD

  2. University of Houston-Downtown, Houston, TX, USA

    Aimee K. Roundtree PhD

  3. The University of Texas School of Nursing, Houston, TX, USA

    Joan C. Engebretson PhD

Authors
  1. Jessica P. Hwang MD, MPH
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  2. Aimee K. Roundtree PhD
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  3. Joan C. Engebretson PhD
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  4. Maria E. Suarez-Almazor MD, PhD
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Corresponding author

Correspondence to Jessica P. Hwang MD, MPH.

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Hwang, J.P., Roundtree, A.K., Engebretson, J.C. et al. Medical Care of Hepatitis B among Asian American Populations: Perspectives from Three Provider Groups. J GEN INTERN MED 25, 220–227 (2010). https://doi.org/10.1007/s11606-009-1204-5

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