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Telephone outreach may increase HBV vaccination rates among Asians
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Implementing a lay health worker telephone intervention program increased the likelihood of Asian-American minorities receiving the hepatitis B virus infection vaccination, according to published findings.
“This study suggests that this culturally integrated intervention program may be useful for reducing liver cancer disparities from chronic HBV infection in high-risk Asian Americans,” Hee-Soon Juon, PhD, professor in the department of oncology, Thomas Jefferson University, Philadelphia, and colleagues wrote.
Between April 2013 and March 2014, Juon and colleagues recruited 645 adult Asian Americans in the Baltimore-Washington Metropolitan area involved in community-based organizations to undergo HBV screening. Of these, 600 (201 were Chinese, 198 were Korean and 201 were Vietnamese) completed a pretest survey and received an HBV screening. A total of 33 participants had chronic HBV infection and 335 showed evidence of resolved HBV infection, which the researchers deemed protected. Approximately 39% of patients were unprotected and therefore more susceptible to contracting HBV infection.
From the screenings, the researchers randomly assigned participants either to an intervention group (n = 124) or control group (n = 108) led by lay health workers (LHW) recruited from the various ethnic communities from the same area. Participants in the intervention group received a list of resources via mail, such as where to get free vaccinations, and also received phone calls from trained LHWs reminding them to obtain vaccination. The control group received only a list of resources by mail.
“[We] aimed to evaluate the effect of a lay health worker telephone intervention on completing a series of hepatitis B virus vaccinations among foreign-born Asian Americans,” the researchers wrote.
Seven months after the participants received their HBV screening results, the trained LHWs followed up with all participants via phone and asked how many of the recommended series of vaccinations they had received (none, one, two or all three).
After 7 months, participants in the intervention group were more likely to have received one or more recommended vaccinations compared with the control group (OR = 3.04; 95% CI, 1.16-8). Participants in the intervention group were also more likely to have completed all three dose vaccinations compared with the control group (OR = 7.29; 95% CI, 3.39-15.67).
The researchers noted the participants’ biggest barrier that prevented them from seeking the vaccinations was their lack of time.
The biggest influences for getting vaccinated among the 89 participants who received one were the intervention program (70.8%) and self-motivation (49.4%). A majority of participants in the intervention group received the phone calls from LHWs (93%) and almost all of them got the reminder to get vaccinated (98%), according to the research.
“With this program implementation, we saw more Asian Americans becoming educated about HBV and taking appropriate actions to seek prevention,” the researchers wrote.
The researchers mentioned it was difficult to know whether participants were motivated by the program.
“We learned that our education program (e.g., reading photo novels) was one of the most important promotors to motivate them to do so. … The other promoter is self-awareness after receiving the letter along with screening results. This result suggests that photo novels are effective teaching tools, especially for low literacy foreign-born Asian Americans.”
The researchers recommended health care workers also use social media outlets, mass emailing lists and establish mobile health interventions for additional ways of reaching out and/or following up with patients to educate them on vaccinations.
The researchers concluded: “The LHW telephone intervention program yielded a substantial increase in the likelihood of vaccination in underserved, high-risk, Asian minority populations. … With the availability if LHW training material and resources in various Asian languages on the internet for free download, such as photo novel brochures and role-playing videos, this LHW intervention program should be easily implemented.” – by Melinda Stevens
Disclosure: The researchers report no relevant financial disclosures.