title: Cluster-Randomized Trial to Increase Hepatitis B Testing among Koreans in Los Angeles.
abstract: BACKGROUND
  In the United States, Korean immigrants experience a disproportionately high burden of chronic hepatitis B (HBV) viral infection and associated liver cancer compared with the general population. However, despite clear clinical guidelines, HBV serologic testing among Koreans remains persistently suboptimal.
  
  
  METHODS
  We conducted a cluster-randomized trial to evaluate a church-based small group intervention to improve HBV testing among Koreans in Los Angeles. Fifty-two Korean churches, stratified by size (small, medium, large) and location (Koreatown versus other), were randomized to intervention or control conditions. Intervention church participants attended a single-session small-group discussion on liver cancer and HBV testing, and control church participants attended a similar session on physical activity and nutrition. Outcome data consisted of self-reported HBV testing obtained via 6-month telephone follow-up interviews.
  
  
  RESULTS
  We recruited 1,123 individuals, 18 to 64 years of age, across the 52 churches. Ninety-two percent of the sample attended the assigned intervention session and 86% completed the 6-month follow-up. Sample characteristics included were as follows: mean age 46 years, 65% female, 97% born in Korea, 69% completed some college, and 43% insured. In an intent-to-treat analysis, the intervention produced a statistically significant effect (OR = 4.9, P < 0.001), with 19% of intervention and 6% of control group participants reporting a HBV test.
  
  
  CONCLUSIONS
  Our intervention was successful in achieving a large and robust effect in a population at high risk of HBV infection and sequelae.
  
  
  CONCLUSIONS
  The intervention was fairly resource efficient and thus has high potential for replication in other high-risk Asian groups.
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California. bastani@ucla.edu.
authors.forename: Roshan
authors.initials: R
authors.lastname: Bastani
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Glenn
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California.
authors.forename: Annette E
authors.initials: AE
authors.lastname: Maxwell
authors.affiliation: Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Jo
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Herrmann
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crespi
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California.
authors.forename: Weng K
authors.initials: WK
authors.lastname: Wong
authors.affiliation: Fielding School of Public Health, Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California, Los Angeles, California.
authors.forename: L Cindy
authors.initials: LC
authors.lastname: Chang
authors.affiliation: Division of Biostatistics, Department of Public Health Sciences, University of California Davis, Davis, California.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Stewart
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California San Francisco, San Francisco, California.
authors.forename: Tung T
authors.initials: TT
authors.lastname: Nguyen
authors.affiliation: Division of Hematology and Oncology, Department of Internal Medicine, University of California Davis, Davis, California.
authors.forename: Moon S
authors.initials: MS
authors.lastname: Chen
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Taylor
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education; D019694:Hepatitis B, Chronic / Q000175:diagnosis*; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D057194:Intention to Treat Analysis; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D015397:Program Evaluation; D012068:Religion and Medicine; D056910:Republic of Korea / Q000208:ethnology; D012698:Serologic Tests / Q000706:statistics & numerical data; D055815:Young Adult