TY - JOUR
T1 - A mixed-methods approach to understanding perceptions of hepatitis B and hepatocellular carcinoma among ethnically diverse Black communities in South Florida
AU - Jones, Patricia
AU - Soler, Joselin
AU - Solle, Natasha Schaefer
AU - Martin, Paul
AU - Kobetz, Erin
N1 - Funding Information:
The salary of the corresponding author is partially supported by a Diversity Supplement awarded by the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities (U01MD010614-01S1). The NIH was not involved in study design or in the collection, analysis or interpretation of data. Further, the NIH did not contribute to the writing of this manuscript or decision to submit for publication. Study procedures and patient incentives were made possible by the Sylvester Catchment Center Grant awarded to the corresponding author in 2016. Acknowledgments
Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Purpose: Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC), disproportionately affects minorities. Compared to other races, Blacks more often present with advanced HCC and have decreased survival. We observed higher HBV-associated HCC rates among Blacks than reported nationally. In our center, Haitian Blacks had the highest rates of HBV-associated HCC and shorter survival compared to other Blacks. We investigated knowledge and perceptions regarding HBV and HCC among Blacks born in the United States or Haiti. Methods: Using community partnerships, participants were recruited via word of mouth, email, social media or from Hepatology clinic. Focus groups were conducted in Haitian Creole or English and stratified by birthplace, gender and infection status. Discussions were audio-recorded and transcribed verbatim. A constant comparative method was used for data analysis; themes are based on conversational details. Results: There were 55 participants; 49% were male and 27% had chronic HBV. Only 42% of Haitian Blacks knew about HBV prior to participation vs. 78% of African Americans, p 0.03. Both groups expressed that fear, mistrust of the medical establishment, denial and stigma might compel persons to avoid seeking care. Both groups attributed higher rates of late stage HCC diagnosis in Blacks to inadequate financial resources and education. Those with HBV reported confusion regarding their infection and suboptimal communication with healthcare providers. Conclusions: In two communities disproportionately affected by HBV, misconceptions about disease transmission, stigma, low health literacy and decreased access to care may limit detection for HBV. Culturally relevant community-based interventions are needed to increase HBV detection.
AB - Purpose: Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC), disproportionately affects minorities. Compared to other races, Blacks more often present with advanced HCC and have decreased survival. We observed higher HBV-associated HCC rates among Blacks than reported nationally. In our center, Haitian Blacks had the highest rates of HBV-associated HCC and shorter survival compared to other Blacks. We investigated knowledge and perceptions regarding HBV and HCC among Blacks born in the United States or Haiti. Methods: Using community partnerships, participants were recruited via word of mouth, email, social media or from Hepatology clinic. Focus groups were conducted in Haitian Creole or English and stratified by birthplace, gender and infection status. Discussions were audio-recorded and transcribed verbatim. A constant comparative method was used for data analysis; themes are based on conversational details. Results: There were 55 participants; 49% were male and 27% had chronic HBV. Only 42% of Haitian Blacks knew about HBV prior to participation vs. 78% of African Americans, p 0.03. Both groups expressed that fear, mistrust of the medical establishment, denial and stigma might compel persons to avoid seeking care. Both groups attributed higher rates of late stage HCC diagnosis in Blacks to inadequate financial resources and education. Those with HBV reported confusion regarding their infection and suboptimal communication with healthcare providers. Conclusions: In two communities disproportionately affected by HBV, misconceptions about disease transmission, stigma, low health literacy and decreased access to care may limit detection for HBV. Culturally relevant community-based interventions are needed to increase HBV detection.
KW - Chronic liver disease
KW - Community-based participatory research
KW - Disparities
KW - Focus groups
KW - Patient knowledge
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U2 - 10.1007/s10552-020-01345-6
DO - 10.1007/s10552-020-01345-6
M3 - Article
C2 - 32964364
AN - SCOPUS:85091277217
VL - 31
SP - 1079
EP - 1091
JO - Cancer Causes and Control
JF - Cancer Causes and Control
SN - 0957-5243
IS - 12
ER -