Assessing Physicians' Recommendations for Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Testing Among Minority Populations in Greater Philadelphia and New York City

Deaths from liver cancer are on the rise and disproportionately affect minority racial/ethnic groups. In this study, we examined associations between physicians' recommendations for hepatitis B virus (HBV) and hepatitis C virus (HCV) screening and sociodemographic and lifestyle factors among minority populations in the areas of Greater Philadelphia and New York City. Using Poisson regression with robust variance estimation, we evaluated potential associations for 576 Hispanic American (HA), African American (AA), and Asian Pacific American (APA) adults, using blood tests as an outcome measure, with adjustment for sociodemographic factors We found that APAs (34.2%) were most likely to have a physician recommend HBV and HCV screening tests (34.2% and 27.1%, respectively), while HAs were least likely to receive an HBV recommendation (15.0%) and AAs were least likely to receive an HCV recommendation (15.3%). HAs were significantly likely to have never received a blood test for either HBV or HCV (RR = 1.25, 95% CI: 1.05, 1.49). APAs were significantly more likely to receive a screening recommendation for HBV (RR = 1.10, 95%CI: 1.01, 1.20) and to have a blood test (RR = 1.57, 95% CI: 1.06, 2.33). Our findings show that, among HAs, AAs, and APAs, physician recommendations are strongly associated with patients undergoing blood tests for HBV and HCV and that minority populations should increasingly be recommended to screen for HBV and HCV, especially given their elevated risk.

Different Types of Intimate Partner Violence Among Latinx Women: A Call for Expanded Measurement, Screening, and Safety Planning

Despite increased attention on intimate partner violence (IPV) among Latinx women in the United States, measurement often overlooks economic abuse, reproductive coercion, institution-related threats, and technology-facilitated abuse. Using a broad range of measures, this paper examines prevalence and correlations between different types of IPV among a sample of 38 Latinx women enrolled into a pilot study. Results indicate consistently high prevalence of IPV types and significant correlations between several types of abuse (including sexual abuse, technology-facilitated abuse, and institution-related threats). Findings emphasize the need for comprehensive IPV measurement, screening, expanded safety planning, and research on the impact of these types of abuse.

Reducing Liver Cancer Risk through Dietary Change: Positive Results from a Community-Based Educational Initiative in Three Racial/Ethnic Groups

Dietary behaviors and alcohol consumption have been linked to liver disease and liver cancer. So far, most of the liver cancer awareness campaigns and behavioral interventions have focused on preventive behaviors such as screening and vaccination uptake, while few incorporated dietary aspects of liver cancer prevention. We implemented a community-based education initiative for liver cancer prevention among the African, Asian, and Hispanic populations within the Greater Philadelphia and metropolitan New York City areas. Data from the baseline and the 6-month follow-up surveys were used for the assessment of changes in dietary behaviors and alcohol consumption among participants. In total, we recruited 578 participants through community-/faith-based organizations to participate in the educational workshops. The study sample included 344 participants who completed both baseline and follow-up survey. The Hispanic subgroup was the only one that saw an overall significant change in dietary behaviors, with the Mediterranean dietary score increasing significantly from 30.000 at baseline survey to 31.187 at 6-month follow-up assessment (p < 0.05), indicating a trend towards healthier dietary habit. In the African Americans participants, the consumption scores of fruits and poultry increased significantly, while vegetables and red meats decreased. In Asian Americans, the consumption of non-refined cereals, red meats, and dairy products decreased. Alcohol consumption decreased significantly among Hispanics while it did not change significantly among the other two communities. This community-based educational initiative generated different impacts in the three populations, further highlighting the needs for more targeted, culturally tailored efforts in health promotion among these underprivileged communities.

Abstract PO-058: Increasing liver cancer prevention knowledge through a community-based education initiative to improve liver cancer prevention for underserved African, Asian, and Hispanic communities

Background: Though a largely preventable disease, liver cancer is now the fastest-increasing cause of cancer death in the US, and it is highly fatal. Hepatocellular carcinoma (HCC) is the most common type of liver cancer, and it disproportionally affect racial/ethnic minorities, especially the medically underserved. Most HCC cases are associated with hepatitis B virus (HBV) and hepatitis C virus (HCV). Methods: To increase awareness of liver cancer prevention and screening, we partnered with community-based organizations through NCI funded U54 TUFCCC/HC Cancer Partnership Community Outreach Core, in the greater Philadelphia metropolitan and New York City to design and conduct a liver cancer prevention project. Pre- and post- survey data was collected from underserved Asian, African, and Hispanic American community members who participated in educational workshops. This abstract will report the 473 eligible participants' knowledge on HBV, HCV, and liver cancer both before and after the education. We conducted wilcoxon Signed-rank, Kruskal-Wallis, and Wilcoxon sum-rank tests. Results: Knowledge of risk factors increased significantly in all three communities from the pre-survey to the post-intervention survey (2.15 vs. 3.69, p&lt;0.0001). Knowledge of risk factors also significantly increased within the African (1.11, p&lt;0.0001), Asian (1.88, p&lt;0.0001) and Hispanic (3.21, p&lt;0.0001) American Communities. There were no significant differences in increased knowledge by gender (male= 2.18 vs female=2.25, p=0.72). Conclusions: The findings of our study show the importance and effectiveness educational interventions have on promoting liver cancer prevention knowledge among the minority groups who are most affected in the U.S. by liver cancer disparity.

Citation Format: Wenyue Lu, Lin Zhu, Safa Ibrahim, Kerry Traub, Ellen Kim, Ada Wong, Nathaly Rubio-Torio, Evelyn Gonzalez, Marilyn A. Fraser, Ming-Chin Yeh, Grace X. Ma, Olorunseun O. Ogunwobi, Yin Tan. Increasing liver cancer prevention knowledge through a community-based education initiative to improve liver cancer prevention for underserved African, Asian, and Hispanic communities [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-058.

Abstract PO-161: A community-based liver cancer education initiative led to healthier dietary and alcohol use behaviors among racial/ethnic minority community members

Background: There is an increasing body of literature that suggests a relationship between modifiable dietary behaviors and alcohol use and liver cancer. We designed and implemented a culturally tailored community-based education program to promote liver cancer prevention. Methods: Through NCI funded U54 TUFCCC/HC Cancer Partnership Community Outreach Core program, using CBPR approach, we engaged community-based organizations and community stakeholders serving underserved African, Asian, and Hispanic American communities in the Philadelphia metropolitan area and New York City. The community-based education incorporated in-person and virtual hybrid education workshops to address COVID-19 pandemic barriers. We conducted pre-education surveys and follow-up assessments at 6 months post-education. Participants' dietary behaviors, alcohol use, and sociodemographic characteristics were examined at both time points. Results: 526 participants were recruited including 92 African Americans, 247 Asian Americans, and 187 Hispanic Americans, with an average age of 59. We found that at 6-month follow-up assessment, participants had average decreased intake of red meat (3.148/6 vs. 2.685/6, p &lt; 0.001), and average increased intake of vegetables (4.484/6 vs. 5.044/6, p &lt; 0.001) and fruits (4.327/6 vs. 4.877/6, p &lt; 0.001), compared to their intake at pre-education assessment. Additionally, average change in beer (-0.252) and spirit (-0.905) consumption substantively decreased from pre-intervention to 6-month follow-up assessment. Conclusion: This community-based education showed significant effects in improving healthy dietary behaviors and reducing alcohol intake among community members through CBPR community engagement from the two metropolitan areas. Future efforts are needed to sustain the positive changes in modifiable lifestyle behaviors and liver cancer prevention in these medically underserved communities.

Citation Format: Tiffany Li, Wenyue Lu, Lin Zhu, Ellen Kim, Kerry Traub, Steven Zhu, Nathaly Rubio-Torio, Evelyn Gonzalez, Marilyn A. Fraser, Ming-Chin Yeh, Grace X. Ma, Olorunseun O. Ogunwobi, Yin Tan. A community-based liver cancer education initiative led to healthier dietary and alcohol use behaviors among racial/ethnic minority community members [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-161.

Abstract PO-243: A community-engaged hepatitis B and C screening intervention in medically underserved African, Asian and Hispanic American communities

Background Liver cancer incidence and death rate are on the rise in the US. racial/ethnic populations are disproportionally affected by liver cancer; from 1994 to 2014, liver cancer death rate rose by 57% in black/African Americans and 69% in Hispanic Americans, and Asian Americans’ liver cancer mortality rate is 60% higher than that of non-Hispanic White. About 65% to 70% of liver cancer cases are caused by hepatitis B and C virus (HBV and HCV). Limited studies or programs have focused on addressing liver cancer in multiple disparity racial/ethnic populations. Methods The Community Outreach Core team of NCI funded U54 TUFCCC/HC Partnership engaged ten community-based organizations (CBOs) and jointly initiated a community-based HBV/HCV liver cancer prevention initiative, aimed to increase HBV and HCV screening in African, Asian and Hispanic American Communities using training community peer educators to co-implement the education. 503 community participants living in New York City and Greater Philadelphia areas participated in this initiative, and completed pre-, and post-education tests. Paired t test was used to measure the knowledge change from pre- to post-education, and Chi square test was conducted to detect the HBV/HCV testing among different racial/ethnic groups. A p value lower than 0.05 is considered statistically significant. All data analysis was conducted in Stata 15. Results All participants were from liver cancer disparity populations, including Asian (54.94%), African American (15.10%), and Hispanic (29.95%) Americans. Overall, significantly improved knowledge on HBV/HCV and liver cancer prevention were observed after the education. Participants’ average knowledge score on HBV/HCV increased significantly from pre- to post-education (7.14/10 vs.9.02/10, p&lt;0.001), implying that they overall had better understandings on HBV/HCV transmission, prevention, and treatment (detailed information on HBV/HCV knowledge measurement will be presented in the poster). Moreover, participants were able to identify significantly more liver cancer risk factors after the intervention (1.5/5 vs. 3.1/5, p&lt;0.001). Importantly, findings of the study revealed alarming results on low screening with HBV and HCV among participants; majority of the participants never had HBV (75.66%) or HCV testing (90.62%). Hispanics (82.05%) reported the highest rate of never had HBV test, followed by Asians (73.91%) and African Americans (73.21%). Asians (95.65%) were most likely to never had HCV test, followed by Hispanics (88.46%) and African Americans (75%). Furthermore, more than two thirds of the participants had never been recommended by their doctors to do HBV (68.77%) or HCV (73.31%) tests. Conclusions Our findings indicated that engage community to promote liver cancer prevention among disparity populations is an effective approach. HBV/HCV screening and liver cancer prevention should involve physicians’ effort.

Citation Format: Wenyue Lu, Kerry Traub, Safe Ibrahim, Lin Zhu, Evelyn Gonzalez, Ada Wong, Nathaly Rubio-Torio, Grace Ma, Olorunseun Ogunwobi, Marilyn Fraser, Ming-Chin Yeh, Yin Tan. A community-engaged hepatitis B and C screening intervention in medically underserved African, Asian and Hispanic American communities [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-243.