hep b presentation
TRANSCRIPT
Culturally appropriate health promotion Perceptions of liver cancer and hepatitis B in the
Victorian Chinese Community
Eliisa Fok, BSc, MPH
Emily Adamson
Primary liver cancer and hepatitis B
• Mortality due to liver cancer is increasing faster than any
other internal cancer
• Liver cancer has the fastest increasing incidence
• Late diagnosis is a problem
Cancer NSW IMR2012; AIHW 2012 ; Amin et al 2006
HEPATITIS B CIRRHOSIS
LIVER CANCER
Hepatitis B in the Chinese Community
• 1 in 12 Chinese- Australians (~8.1%)
• Less than half know they have it
• High liver cancer incidence has a
direct correlation with high CHB
prevalence (Medicare Local Report, 2013).
Turnour, Cretikos, Conaty (2011)
MacLachlan, Allard, Cowie (2013)
Research Objectives
• To identify perceptions of liver cancer and its link to
hepatitis B in the Chinese community
• To identify barriers and enablers to testing for CHB
• To determine perceptions of hepatitis B messages and
how the link between CHB and liver cancer would
motivate or deter people from being tested
Participant Selection
• Chinese people who were born in
mainland China
• Were aged between 35-55 years of
age
• Were not living here on a student
visas
• 28 people participated in the focus
groups
Hepatitis B perceptions
“No point of fear…in China so many people are infected
and you cannot prevent it, just carry on your life
without worry”
“Not much you can do about it”
“There is no treatment so what can be done if you do
end up having it”
Liver cancer perceptions
“Chinese treat the liver a very important organ”
“Hep B became liver cirrhosis…liver cirrhosis
become liver cancer”
“Smoking bad for liver…many Chinese smoke, drink
alcohol”
Liver cancer perceptions
“If you have cervical cancer or breast cancer, if you
discover early, you could live. But liver cancer, death”.
Health service perceptions
“Too troublesome here, waiting too long”
“Little health problems…if very sick, then go…same
thing in China, will only go when very sick”
Translating our findings
• Develop a set of key liver cancer
prevention messages
• These will be used in a range of
education and communication based
campaigns
• Apply an evidence-based approach
to the development of the messages
Designing health messages to prevent
liver cancer
• Providing information is not enough to alter
health behaviours
• Perceptions of threat + efficacy can influence
behaviours
Witte and Allen,2000.
Efficacy - the degree to whether the person believes
they can perform the recommended action
Response efficacy - the belief is that the
recommended action will be effective
Message design around liver cancer
prevention
• Reduce complacency associated with living CHB
• Increase confidence (efficacy) about preventing liver
cancer
• Increase response efficacy by increasing
understanding about how to access a GP for testing
and treatment
Liver cancer prevention messages
Barriers to reducing liver cancer
• Perception that hepatitis B is common in Chinese
people and less of an issue for those living in
Australia
• Lack of familiarity with Australian health care system
• Perceptions of high costs and waiting period
to see GPs
• No knowledge of useful treatment for hepatitis B
Opportunities to reducing liver cancer
• Clear role for communicating the link between liver
cancer and hepatitis B
• Increase understanding that treatment for hepatitis B
that can reduce the risk of liver cancer
• Invest in policies, programs and systems that will
ensure people to have access to timely diagnosis
and management
Witte and Allen (2000)
Conclusions
• Continue to build the evidence
– In other CALD communities
– Evaluate how key messages
can be meaningful
• Design evidence-based
prevention and awareness
raising programs
• Share knowledge
Thank you
Eliisa Fok
Hepatitis B and Liver Cancer Program Coordinator
http://www.cancervic.org.au/preventing-cancer/hep-b-
liver-cancer
Acknowledgements
• Department of Health, Sexual Health & Viral
Hepatitis Team, Prevention and Population Health
Branch
• Emily Adamson
• Chris Enright, Kerry Haynes and Michael Murphy
References
Turnour CE, Cretikos MA, Conaty SJ. Prevalence of chronic hepatitis B in South Western
Sydney: evaluation of the country of birth method using maternal seroprevalence data.
Aust N Z J Public Health. 2011;35(1):22-6.
Witte, K & Allen, M. A Meta-Analysis of Fear Appeals: Implications for Effective Public
Health Campaigns. Health Education & Behavior, 2000; 27(5):591-615.
MacLachlan J, Allard N, Cowie B. Summary indicators of hepatitis B prevalence, outcomes,
and antiviral therapy by Local Government Area and Medicare Local in Victoria, 2013.
Final Report. Victorian Infectious Diseases Reference Laboratory. 2013.