Theoretically informed correlates of hepatitis B knowledge among four Asian groups: The health behavior framework

Background: Few studies have examined theoretically informed constructs related to hepatitis B (HBV) testing, and comparisons across studies are challenging due to lack of uniformity in constructs assessed. The present analysis examined relationships among Health Behavior Framework factors across four Asian American groups to advance the development of theory-based interventions for HBV testing in at-risk populations. Methods: Data were collected from 2007-2010 as part of baseline surveys during four intervention trials promoting HBV testing among Vietnamese-, Hmong-, Korean- and Cambodian-Americans (n = 1,735). Health Behavior Framework constructs assessed included: awareness of HBV, knowledge of transmission routes, perceived susceptibility, perceived severity, doctor recommendation, stigma of HBV infection, and perceived efficacy of testing. Within each group we assessed associations between our intermediate outcome of knowledge of HBV transmission and other constructs, to assess the concurrent validity of our model and instruments. Results: While the absolute levels for Health Behavior Framework factors varied across groups, relationships between knowledge and other factors were generally consistent. This suggests similarities rather than differences with respect to posited drivers of HBV-related behavior. Discussion: Our findings indicate that Health Behavior Framework constructs are applicable to diverse ethnic groups and provide preliminary evidence for the construct validity of the Health Behavior Framework.