Background: Asian Americans have the highest rates of chronic hepatitis B virus (HBV) infection (CHB) in the United States. They suffer from liver diseases such as cirrhosis and liver cancer. Those with CHB often report that they feel well even though they are at high risk for complications. Because of the high incidence and prevalence of CHB, patients at high risk need to be tested every 6 to 12 months for early signs of liver problems.
Objectives: This study will answer critical questions for Asian Americans with CHB about improving timely testing. The primary aim is to compare patients who have a Patient Navigator plus Mobile Phone Text Messaging Intervention (PNMI) to those who receive standard care. The secondary aim is to compare PNMI and standard-care patients on knowledge about CHB, coping skills, social support, finding benefits, quality of life, and anxiety. The exploratory aim will compare PNMI and standard-care patients’ satisfaction with PNMI. We plan to answer the question, “For those infected with HBV, will patient-centered PNMI intervention be more effective in increasing patient adherence to monitoring tests than the standard care?”
Methods: Asian Americans in Philadelphia and New York who have HBV and are age 18 or older will participate. Using a randomization process, 500 of these patients will receive either the PMNI or standard care. At patients’ entry into the study, 6 months, and 12 months, information will be collected about:
- following HBV testing and monitoring guidelines,
- knowing about HBV care and management,
- quality of life,
- social support,
- coping skills,
- anxiety level, and
- patient satisfaction.
Patient navigators representing Asian cultures will receive a thorough, two-day HBV training. PNMI patients will receive three education sessions and text messages over mobile phone. Patients, patient advocates, physicians, and Center for Asian Health (CAH) staff will be active study partners.
Patient Outcomes: We expect to find better health outcomes and lower HBV health gaps, as measured by the number of patients:
- getting doctor-recommended tests and care every 6 or 12 months;
- getting doctor-recommended HBV care;
- having more HBV knowledge, a better quality of life, social support, and coping skills; and
- having fewer barriers and less anxiety.
With regular testing, cancer can be found earlier and treated more successfully, leading to longer life.
Patient and Stakeholder Engagement: Fourteen years of community-based participatory research makes CAH staff, patients, patient advocates, and doctors good partners to create and test the PNMI intervention. Partners will tell the community, doctors, and other scientists about the study findings.
Anticipated Impact: Asian American’s high rate of HBV and liver cancer is their largest health gap compared with white Americans. This study may reduce this gap. If patients who are part of the PNMI intervention do better than those in standard care, then the PNMI may become widely used by CHB patients in the United States and all over the world.
Other Health Services Interventions
Training and Education Interventions