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A Health Belief Model Examination of Factors Related to Hepatitis B Screening Among African Immigrants in Philadelphia

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Abstract

Chronic hepatitis B infection is a leading cause of liver cancer worldwide. In the USA, African immigrants (AI) have high hepatitis B virus (HBV) infection rates but low HBV knowledge and screening rates. Research about HBV among AI living in Philadelphia is particularly limited. This study aims to assess barriers to and factors influencing HBV screening in the Philadelphia AI population. African and Caribbean-born adults in Greater Philadelphia were recruited for phone interviews at community health fairs hosted by the African Cultural Alliance of North America (ACANA) and the African Family Health Organization (AFAHO) in partnership with the Hepatitis B Foundation. Seventeen interviews were recorded, transcribed, and coded independently by two members of the research team using NVivo software. Themes and subthemes were created by analysis of the codes and arranged under Health Belief Model (HBM) concepts. Major perceived barriers included lack of HBV knowledge and awareness and cultural challenges related to health care access, preventive care, fear, and stigma. Participants recommended using community organizations and programs to spread awareness about HBV and serve as cues to action. In-person education was emphasized due to lack of access to and knowledge of technology such as Zoom. While HBV educational sessions have been implemented in this population, they have not been consistent or far-reaching. The results of this study can contribute to the implementation of a comprehensive AI-specific HBV education and screening program through partnerships with community organizations to ensure that all high-risk individuals in the Philadelphia area are screened.

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Data Availability

De-identified qualitative transcripts can be made available by contacting the corresponding author with a reasonable request.

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Acknowledgements

We would like to thank the staff and volunteers at the African Cultural Alliance of North America, African Family Health Organization, and Hepatitis B Foundation for their services provided at the community health fairs. We would also like to thank the study participants and French phone interpreters. Finally, we would like to thank Anshel Kenkare and Lauren Posego from the Jefferson Refugee Health Partners Research Committee for assisting with the creation of this study.

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Authors and Affiliations

  1. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Makala Wang

  2. Hepatitis B Foundation, Doylestown, PA, USA

    Anousha Qureshi & Catherine Freeland

  3. African Cultural Alliance of North America, Philadelphia, PA, USA

    Nettie Johnson, Abu Mansalay & Ava Muhr

  4. Thomas Jefferson University, Philadelphia, PA, USA

    Diane J. Abatemarco & Catherine Freeland

Authors
  1. Makala Wang
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  2. Anousha Qureshi
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  4. Abu Mansalay
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  5. Ava Muhr
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  6. Diane J. Abatemarco
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  7. Catherine Freeland
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Contributions

Conceptualization: M.W., N.J., A. Mansalay, A. Muhr, C.F.; methodology: M.W., N.J., A. Mansalay, A. Muhr, C.F.; formal analysis and investigation: M.W., A.Q., C.F.; writing—original draft preparation: M.W.; writing—review and editing: M.W., A.Q., N.J., A. Mansalay, A. Muhr, D.A, C.F.; supervision: C.F., D.A. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Catherine Freeland.

Ethics declarations

The authors have no relevant financial or non-financial conflicts of interest to disclose.

Ethics Approval

All study participants provided verbal consent before being interviewed in accordance with federal regulations that allow waiver of signed consent. This study was determined to be exempt from IRB review by the Jefferson Institutional Review Board

Competing Interests

All authors have no competing interests to disclose.

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Wang, M., Qureshi, A., Johnson, N. et al. A Health Belief Model Examination of Factors Related to Hepatitis B Screening Among African Immigrants in Philadelphia. J. Racial and Ethnic Health Disparities (2023). https://doi.org/10.1007/s40615-023-01841-w

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