title: Sociocultural factors that potentially affect the institution of prevention and treatment strategies for prevention of hepatitis B in Chinese Canadians.
abstract: BACKGROUND
  Despite the availability of screening for chronic hepatitis B (CHB) infection and effective treatments now available, many at-risk individuals fail to seek appropriate medical attention.
  
  
  OBJECTIVE
  To identify the barriers to care for CHB infection in a Chinese Canadian community.
  
  
  METHODS
  A survey conducted in English or Chinese collected information from individuals with CHB infection that evaluated the level of understanding and identified the barriers that may prevent Chinese patients from undergoing monitoring, screening and/or treatment for CHB infection.
  
  
  RESULTS
  Among the 204 patients enrolled, common misconceptions were that sharing food transmits hepatitis B and that patients with severe disease are always symptomatic. Patients with a better understanding of hepatitis B were better educated, younger and were being followed at a tertiary care centre (P<0.01 for all). Prominent barriers to health care were time, inconvenience and language difficulties. Patients under the care of family physicians who had extended office hours were less likely to cite time (P=0.06) and distance (P=0.05) as barriers.
  
  
  CONCLUSIONS
  Patient misconceptions that severe liver disease due to hepatitis B infection is symptomatic may factor into the unwillingness to spare the time and undergo the inconvenience associated with regular medical follow-up. Implementation of programs that increase awareness of the silent progression of CHB infection and provide culturally responsive clinics, better able to work within patients' time constraints may improve Chinese patients' access to health care.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada.
authors.forename: Harry
authors.initials: H
authors.lastname: Wu
authors.forename: Colina
authors.initials: C
authors.lastname: Yim
authors.forename: Alex
authors.initials: A
authors.lastname: Chan
authors.forename: Michael
authors.initials: M
authors.lastname: Ho
authors.forename: Jenny
authors.initials: J
authors.lastname: Heathcote
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D002170:Canada; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006306:Health Surveys; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D055815:Young Adult