A mixed-methods approach to understanding perceptions of hepatitis B and hepatocellular carcinoma among ethnically diver
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ORIGINAL PAPER
A mixed‑methods approach to understanding perceptions of hepatitis B and hepatocellular carcinoma among ethnically diverse Black communities in South Florida Patricia Jones1,2 · Joselin Soler1 · Natasha Schaefer Solle2,3 · Paul Martin1,2 · Erin Kobetz2,3,4 Received: 21 August 2019 / Accepted: 11 September 2020 / Published online: 22 September 2020 © Springer Nature Switzerland AG 2020
Abstract Purpose Hepatitis B (HBV), the leading cause of hepatocellular carcinoma (HCC), disproportionately affects minorities. Compared to other races, Blacks more often present with advanced HCC and have decreased survival. We observed higher HBV-associated HCC rates among Blacks than reported nationally. In our center, Haitian Blacks had the highest rates of HBV-associated HCC and shorter survival compared to other Blacks. We investigated knowledge and perceptions regarding HBV and HCC among Blacks born in the United States or Haiti. Methods Using community partnerships, participants were recruited via word of mouth, email, social media or from Hepatology clinic. Focus groups were conducted in Haitian Creole or English and stratified by birthplace, gender and infection status. Discussions were audio-recorded and transcribed verbatim. A constant comparative method was used for data analysis; themes are based on conversational details. Results There were 55 participants; 49% were male and 27% had chronic HBV. Only 42% of Haitian Blacks knew about HBV prior to participation vs. 78% of African Americans, p 0.03. Both groups expressed that fear, mistrust of the medical establishment, denial and stigma might compel persons to avoid seeking care. Both groups attributed higher rates of late stage HCC diagnosis in Blacks to inadequate financial resources and education. Those with HBV reported confusion regarding their infection and suboptimal communication with healthcare providers. Conclusions In two communities disproportionately affected by HBV, misconceptions about disease transmission, stigma, low health literacy and decreased access to care may limit detection for HBV. Culturally relevant community-based interventions are needed to increase HBV detection. Keywords Disparities · Focus groups · Chronic liver disease · Patient knowledge · Community-based participatory research
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10552-020-01345-6) contains supplementary material, which is available to authorized users.
Abbreviations AA African American AIDS Acquired immunodeficiency syndrome BCSR Behavioral Community Shared Resource Core CDC Centers for Disease Control and Prevention HBV Hepatitis B virus 1
Joselin Soler [email protected]
Department of Medicine, Division of Digestive Health and Liver Diseases, University of Miami Miller School of Medicine, Miami, USA
2
Natasha Schaefer Solle [email protected]
Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, USA
3
Department of Medicine, Div
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