patient-centered care and asian americans

Conditions: Hepatitis B; Hepatitis C; Liver Disease

Summary: liver cancer and hepatitis b are health disparities for asian americans, and hepatitis c is a rising problem. little is known about how to improve the quality of health care asian americans receive for viral hepatitis. technology, specifically mobile applications, can provide a flexible and efficient way to address these challenges. this project seeks to develop, implement, and test an intervention to increase hepatitis b and c screening for asian americans in 2 healthcare systems in san francisco. the research team will develop, implement, and evaluate the efficacy of an interactive, patient- centered mobile app for use on a tablet computer to increase hepatitis b and c screening among unscreened asian americans age 18 and older. the team will use their experience in health promotion to develop the intervention by working with patients, community leaders and advocates, clinical staff, healthcare providers, and healthcare system administrators from a county safety net system and an academic primary care practice in the san francisco bay area. the mobile application will include video clips with a physician (video doctor) addressing patient concerns regarding hepatitis b and c screening in the patient's preferred language, english, chinese, or vietnamese. a patient who has not been screened for hepatitis b will answer questions about his or her characteristics and preferences using the mobile application. the mobile application will then show 30-60 seconds video clips with messages that address the patient's responses related to hepatitis b screening and that are delivered by an actor playing a physician. those who are born between 1945 and 1965 also receive messages about hepatitis c screening. at the end, the tablet computer will generate a provider alert to let the treating provider know what the patient's preferences are regarding testing for viral hepatitis. once developed, the intervention will then be used in combination with a physician panel notification and tested against physician panel notification only in a randomized controlled trial to see which approach is better in increasing the rate of hepatitis b and c screening. the team will also work with the 2 healthcare system to ensure that the interventions will be practical and easily adopted once the study is over. the findings of this project will greatly expand understanding about how to use technology- based interventions to improve quality of healthcare in diverse patient populations.


Eligibility criteria:
inclusion criteria: * ages 18+ years * identifies as asian * asian american, chinese, or vietnamese * speaks english, chinese (cantonese), or vietnamese * does not have an electronic health record (ehr)-documented hbv screening test (defined as a hepatitis b surface antigen \[hbsag\] test). * we select chinese and vietnamese because those are the 2 most common languages spoken by limited english-proficient asian americans exclusion criteria: * dementia or any conditions precluding understanding informed consent or using a touch screen with audio

Keywords: hepatitis b hepatitis c screening asian americans mobile technology