Hepatitis B screening among Chinese Americans: a structural equation modeling analysis.

Area of Science:

• Public Health
• Hepatology
• Health Disparities

Background:

• Hepatitis B Virus (HBV) disproportionately impacts immigrants from endemic regions, increasing liver disease and cancer risks.
• Many infected individuals remain unaware, hindering prevention and early treatment.
• A community-based study evaluated factors influencing HBV screening among Chinese Americans.

Purpose of the Study:

• To identify key factors contributing to Hepatitis B (HBV) screening uptake in the Chinese American population.
• To test a heuristic model predicting HBV screening behavior.

Main Methods:

• Cross-sectional study with 718 Chinese Americans (18+ years) with complete data.
• Confirmatory factor analysis to validate indicators: healthcare access/satisfaction, enabling, predisposing, cultural, and health belief factors.
• Structural equation modeling to determine direct and indirect predictors of HBV screening.

Main Results:

• Individuals never screened for HBV were younger, male, less educated, recent immigrants, and uninsured.
• Enabling factors (insurance, primary provider, frequent visits) were the strongest predictors of HBV screening (coefficient=0.470, p<.001).
• Predisposing factors (education) also predicted screening; cultural factors and satisfaction influenced screening indirectly via enabling factors.

Conclusions:

• A theoretical model effectively predicts HBV testing among Chinese Americans.
• Expanding insurance and enhancing cultural sensitivity in healthcare are vital for immigrant HBV screening.
• Community-based strategies and partnerships are essential for meeting HBV policy targets.