Hepatitis B virus outreach to immigrant population in Greater Boston Area: Key to improving hepatitis B knowledge

Table 1 Demographics of the study population

Characteristics	n (%) or mean ± SD
Age (yr)	47 (18)
19-30	20 (22)
31-40	16 (18)
41-50	17 (19)
51-60	15 (17)
> 60	22 (24)
Gender
F	62 (70)
M	26 (30)
Years in the United States	13 (12)
0-5	24 (28)
6-10	14 (16)
11-15	12 (14)
16-20	21 (24)
> 20	16 (18)
Country of origin
Somalia	44 (44)
Morocco	10 (10)
Cameroon	8 (8)
Others1	39 (39)

¹See Figure S1. Study population demographics provided by participants as number (No) and percent (%) or mean and standard deviation values (for age and years in the United States).

Table 2 Perceived hepatitis b risk before and after teaching session n (%)

Perceived at least some risk of being HBV infected	Pre session(n = 101)	Post session(n = 56)	P value
Mean	1.34	3.26	< 0.001
At least some risk	11 (11)	35 (70)
Gender
Female	7 (12)	24 (71)
Male	3 (12)	5 (63)
Age (yr)
< 45	2 (5)	23 (70)
> 45	8 (18)	9 (75)
Years in the United States
< 5	2 (9)	11 (79)
> 5	9 (13)	19 (63)
Continent of Origin1
Africa	11 (16)	19 (73)
Asia	0	6 (67)
Europe	0	4 (57)
America	0	1 (50)
Reasons why your risk is high
Country of origin	30 (40)	22 (44)
Needle exposure	15 (20)	9 (18)
Sexual exposure	14 (19)	9 (18)
I don’t know	11 (15)	9 (18)
I am not at risk	15 (20)	6 (12)
Other reasons2	8 (10)	9 (18)
Mother to child transmission	0	1 (0.02)

¹Africa (Cameroon, Gambia, Kenya, Libya, Morocco, Senegal, Somalia, Togo, Uganda), Asia (Cambodia, South Korea, Uzbekistan), Europe (France, Greece, Turkey), America (Brazil, Canada, Colombia, Costa Rica, Mexico, United States);

²Other reasons: Pre (genetic, food, public transportation, wound, job, utensils, contact with blood, sharing blade), Post (lack of information); Participant answers to perceived HBV risk were categorized as either Low risk, if answered 1, or Some risk, for answers of more than 1 in a Likert Scale (1= low; 5 = high risk); HBV: Hepatitis B virus.

Table 3 Responses to additional open ended questions n (%)

Variable	Pre	Post
Why is it important to test those at risk for HBV?
Prevent the spread of infection	21 (24)	8 (16)
Initiate the treatment early	14 (16)	10 (20)
To be aware of our status	12 (14)	8 (16)
Prevent long term complications	9 (10)	8 (16)
Because no symptoms are present until late stage	2 (2)
I don’t know	27 (31)	11 (22)
To vaccinate those unaffected		2 (4)
2 of the above	2 (2)	2 (4)
Why you do not think it is important to test
It is important	36 (73)	22 (81)
It is not important	3 (6)	1 (3)
I don’t know	6 (12)	2 (7)
Because it is not very common	1 (2)
I don’t have enough information to recommend the test	2 (4)
Patient has the right to decide if he wants it	1 (2)	1 (3)
Because everybody has Hepatitis B		1 (3)
Barriers of access to medical care
Insurance coverage	18 (31)	17 (40)
It is easy for me	28 (48)	16 (38)
I don't know	3 (5)	2 (5)
Absence of good doctors	1 (2)
Lack of available doctors	2 (3)	1 (2)
Lack of time	2 (3)
Language barrier	1 (2)	1 (2)
Others reasons	2 (3)	3 (7)
2 factors above	1 (2)	2 (5)
Uncomfortable asking for Hepatitis B testing
I don’t find it uncomfortable	45 (90)	26 (76)
I am afraid of the result/consequences of the infection	2 (4)	2 (6)
Shyness/fear of what he might think	2 (4)	2 (6)
Because it is sexually transmitted	1 (2)
Because I feel well		1 (3)
Because it is taboo		3 (9)
Why it will be difficult to get tested for HBV
It would not be difficult for me	38 (64)	24 (61)
Insurance coverage	6 (10)	5 (13)
Fear of the results	4 (7)	5 (13)
I don't know	5 (8)	1 (2.5)
Cost of the test	4 (7)	1 (2.5)
Concerns about confidentiality	2 (3)	1 (2.5)
Lack of time		1 (2.5)
2 or 3 factors above	2 (3)	1 (2.5)
Why it could be difficult to get treated for HBV
It would not be difficult for me	37 (65)	19 (59)
Insurance coverage	7 (12)	2 (7)
Cost of treatment	4 (7)	3 (9)
Treatment side effects	2 (3.5)
I don't know	3 ( (5))
Lifelong treatment		2 (7)
Lack of treatment providers	1 (2)
Other reasons	1 (2)
2 0r 3 factors above	2 (3.5)	6 (19)

Pre and Post indicate answers provided prior to and following teaching session, respectively; HBV: hepatitis B virus.

Table 4 True or false questions prior to (Pre) and following (Post) the teaching session n (%)

Variable	Pre Correct	Post correct	P value1
Mean of total correct answers (Std.dev) (mean ± SD)	5.5 ± 3.3	7.6 ± 2.9	< 0.001
1 Hepatitis B is an infection that affects the kidneys	43(43)	35 (63)	0.02
2 Hepatitis A turns into Hepatitis B, which then turns into Hepatitis C	60 (59)	49 (88)	< 0.0001
3 Hepatitis B is the most common liver infection in the world	58 (57)	50 (89)	< 0.0001
4 You can get hepatitis B from touching, sharing food utensils, or drinking too much alcohol	56 (55)	47 (84)	< 0.0001
5 The only way to get hepatitis B is through sexual contact	44 (45)	34 (61)	0.04
6 The test for hepatitis B involves taking a small sample of blood	67 (66)	47 (84)	0.02
7 If you have Hep B but no symptoms, no need to worry about your liver	54 (53)	43 (77)	0.006
8 Hepatitis B infection can cause scarring of the liver and liver cancer	59 (58)	44 (79)	0.01
9 There is no treatment for hepatitis B	50 (50)	37 (66)	0.06
10 If you do not have hepatitis B, there is a vaccine that can prevent it	65 (64)	42 (75)	0.20

¹Indicates P value calculated using Fisher’s exact test. Non-significant P values are indicated in bold.