Attitudes toward Hepatitis B and Liver Cancer Prevention among Chinese Americans in the San Francisco Bay Area, California

Background: Chronic hepatitis B and associated liver cancer constitute important health threats with disparityamong Asian/Pacific Islander Americans (APIs). However, many APIs are unaware of and unprotected againstthese diseases.
Methods: To inform the development of community-based programs to increase hepatitis B andliver cancer awareness and prevention among APIs, we conducted a series of qualitative focus groups in 2007 toidentify motivations and deterrents related to hepatitis B education, testing, and vaccination among San FranciscoBay Area Chinese Americans. Six focus groups were held in Cantonese, English, or Mandarin for women ormen, respectively. Recorded transcripts were transcribed, translated, and then coded by consensus.
Results:Factors that motivated individuals to be tested for hepatitis B included peace of mind, prevention of transmissionto others, informed decision-making ability, convenience, and pre-vaccination screening. Primary motivationsfor hepatitis B vaccination were protection of future health and avoidance of hepatitis B. However, factors thatdiscouraged people from testing or vaccination included costs, lack of health insurance, fear of side effects,worries about reliability or efficacy, poor patient-doctor communication, reliance on professional opinion,apparent good health, inconvenience, and personal preference. Individuals were generally in favor of informingrelatives and friends about hepatitis B testing and vaccination, and offered several reasons for and againsteducating others about these activities.
Conclusions: In summary, our study identifies common attitudes andinfluences regarding the decision to take preventive action against hepatitis B and liver cancer. These findingscan be applied toward the design of more effective educational and outreach materials and programs for ChineseAmericans and possibly other APIs.