Cluster-randomized trial to increase hepatitis B testing among Koreans in Los Angeles

Roshan Bastani, Beth A. Glenn, Annette E. Maxwell, Angela M. Jo, Alison K. Herrmann, Catherine M. Crespi, Weng K. Wong, L. Cindy Chang, Susan L Stewart, Tung T. Nguyen, Moon S Chen, Victoria M. Taylor

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19 Scopus citations


Background: In the United States, Korean immigrants experience a disproportionately high burden of chronic hepatitis B (HBV) viral infection and associated liver cancer compared with the general population.However, despite clear clinical guidelines,HBV serologic testing among Koreans remains persistently suboptimal. Methods: We conducted a cluster-randomized trial to evaluate a church-based small group intervention to improve HBV testing among Koreans in Los Angeles. Fifty-two Korean churches, stratified by size (small, medium, large) and location (Koreatown versus other), were randomized to intervention or control conditions. Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing, and control church participants attended a similar session on physical activity and nutrition. Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews. Results: We recruited 1,123 individuals, 18 to 64 years of age, across the 52 churches. Ninety-two percent of the sample attended the assigned intervention session and 86% completed the 6-month follow-up. Sample characteristics included were as follows: mean age 46 years, 65% female, 97% born in Korea, 69% completed some college, and 43% insured. In an intent-to-treat analysis, the intervention produced a statistically significant effect (OR = 4.9, P < 0.001), with 19% of intervention and 6% of control group participants reporting a HBV test. Conclusion: Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae. Impact: The intervention was fairly resource efficient and thus has high potential for replication in other high-risk Asian groups.

Original languageEnglish (US)
Pages (from-to)1341-1349
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Issue number9
StatePublished - Sep 1 2015

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

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    Bastani, R., Glenn, B. A., Maxwell, A. E., Jo, A. M., Herrmann, A. K., Crespi, C. M., Wong, W. K., Chang, L. C., Stewart, S. L., Nguyen, T. T., Chen, M. S., & Taylor, V. M. (2015). Cluster-randomized trial to increase hepatitis B testing among Koreans in Los Angeles. Cancer Epidemiology Biomarkers and Prevention, 24(9), 1341-1349.