A Patient-Centered Intervention to Increase Screening of Hepatitis B and C among Asian Americans

Investigator: Tung Nguyen, MD
Sponsor: Patient-Centered Outcomes Research Institute

Location(s): United States


Liver cancer and hepatitis B are major health disparities for Asian-Americans, while hepatitis C is a rising problem. Little is known about how to improve the quality of health care Asian-Americans receive in general and for viral hepatitis in particular. Technology, specifically mobile applications, potentially can provide a flexible and efficient way to address these challenges. This proposed project seeks to develop, implement, and test an intervention to increase hepatitis B and C screening for Asian-Americans in two healthcare systems in the San Francisco Bay Area.

The research team will develop, implement, and evaluate the efficacy of an interactive, patient-centered mobile application for use on a tablet computer to increase the rate of hepatitis B and C screening among unscreened Asian-Americans age 18 and older. The team members will use their experience from a successful track record 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 video clips lasting 30 to 60 seconds 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 two healthcare systems to ensure that the interventions will be practical and easily adopted after the study is over. The findings of this project will greatly expand understanding about how to use technology-based interventions to improve quality of health care in diverse patient populations.