Abstract ED04-06: Reducing cancer health disparities through a targeted media campaign to promote hepatitis B screening among Vietnamese Americans

This presentation will focus on the use of targeted media campaigns to address cancer disparities in Asian American populations. Mass media campaigns to change health behaviors are generally effective, particularly when they are targeted or tailored. Campaigns that were successful in changing behaviors employed multiple modalities and repetition over long time periods. Some effective media campaigns employed a strong theoretical foundation to inform message production and campaign strategy. For ethnic minority populations, particularly those who live in large ethnic enclaves with available ethnic media sources, mass media campaigns may be effective in reaching large audiences at a relatively low cost. We present here as an example the effect of media campaigns to promote healthy behaviors among Vietnamese Americans, with a focus on a media campaign to promote hepatitis B screening as a way to reduce liver cancer disparities.

Liver cancer is the most drastic example of the cancer health disparities affecting Asian Americans. The liver cancer incidence rate among Vietnamese American men and women from 1998–2002 was 55.5/100,000 and 16.8/100,000, respectively. These rates are 7–8 times higher than those for non-Hispanic White men (6.7/100,000) and women (2.6/100,000). Liver cancer incidence among Asians and Asian Americans is highly associated with chronic hepatitis B, and the rate of chronic hepatitis B among Vietnamese Americans is 10–14%. However, less than 2/3 of all Vietnamese Americans have been tested for hepatitis B.

Nearly half of all Vietnamese Americans are linguistically isolated. Most live in major urban centers with large communities, which have Vietnamese-language media including print, radio, and television. As a result, culturally tailored mass media in the Vietnamese language is a viable method of health promotion. Prior controlled studies have shown that culturally targeted media campaigns for Vietnamese Americans have been successful in increasing knowledge about breast and cervical cancer screening, intention to obtain breast or cervical cancer screening, and knowledge about hepatitis B and its prevention. Media campaigns targeting Vietnamese Americans have also led to increased Pap test receipt, lower rates of cigarette smoking among men, and increased receipt of hepatitis B vaccination among children.

The media campaign to promote hepatitis B screening among Vietnamese Americans is part of a Program Project to study and address liver cancer disparities among Asian Americans. The campaign targets Vietnamese Americans age 18 to 64 years in Northern California and will last 36 months. Media channel include Vietnamese ethnic television programs and Vietnamese-language radio stations and newspapers. The campaign also includes a bilingual (English and Vietnamese) website, bilingual print materials such as a booklet, brochure, and information cards, and promotional items. Materials have been and will be developed by bilingual bicultural health educators with input from leaders and focus group participants from the targeted community. The effect of the media campaign will be assessed through a pre- and post-intervention telephone survey of the intervention community and a comparable control community.

The theoretical framework to evaluate the factors related to hepatitis B screening behavior and to guide the intervention is the Health Behavior Framework. The act of obtaining hepatitis B testing represents the culmination of a complex chain of decision-making on the part of each person. The media education campaign proposed here addresses potential barriers within the framework to hepatitis B serological testing and incorporates them into the design of the campaign. The results of the pre-intervention survey, which will be presented, also guide the development of the campaign materials. Examples of the media campaign materials will be shown, with emphasis on how the materials address a construct from the Health Behavior Framework such as beliefs, knowledge, perceived susceptibility, perceived severity, perceived efficacy, self-efficacy, norms, social support, and physician factors. Health care access factors are also important, and we will show how the media campaign collaborates with local agencies to ensure that there is adequate access to hepatitis B testing.