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Hepatitis B Testing and Vaccination of Asian Americans in a Community Setting

Hepatitis B Testing and Vaccination of Asian Americans in a Community Setting. Janet Zola, MPH Asian American and Pacific Islander Summit September 15, 2006. Authors. San Francisco Department of Public Health Communicable Disease Prevention Unit Janet Zola, MPH Amy Pine, MPH

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Hepatitis B Testing and Vaccination of Asian Americans in a Community Setting

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  1. Hepatitis B Testing and Vaccination of Asian Americans in a Community Setting Janet Zola, MPH Asian American and Pacific Islander Summit September 15, 2006

  2. Authors • San Francisco Department of Public Health • Communicable Disease Prevention Unit Janet Zola, MPH Amy Pine, MPH Path Fu, BS • Asian Liver Center at Stanford University Samuel So, MD, FACS Jordan Su, MBA Eric Sue, BS

  3. Background • SF Population: 780,000 • API Population: 254,000 (33%) • Chinese American: 156,000 (20%) • Now have a chronic hepatitis B registry • SF one of a handful of CA jurisdictions able to purchase adult hepatitis vaccine

  4. 3 For Life Project Description • Partnership between Asian Liver Center at Stanford University and San Francisco Department of Public Health (SFDPH) • Community Partner: neighborhood YMCA • Low-cost hepatitis A and B vaccination, including hepatitis B testing • 1st and 3rd Saturday every month (September 2004 – September 2005) • Target group – Foreign born Chinese American

  5. 3 for Life Pricing Structure

  6. 3 for Life Volunteers • Extensive volunteer effort • ALC recruited and trained over 120 volunteers (16-66 yrs) • via local universities and high schools • Mostly bilingual • 10-15 volunteers needed on any given Saturday • ~1,300 total volunteer hours

  7. 3 for Life Marketing Tools • Well attended press conference with local dignitaries • Flyers (English/Chinese) • Paid PSAs (typically 2 days before event): • Chinese newspapers • Chinese television • Cantonese/Mandarin Chinese radio stations

  8. Press Conference

  9. Marketing Successes

  10. 3 for Life Project Findings

  11. 3 for Life Testing ResultsAPI Only: n= 1095 (1007 tested) • HBsAg Positive 10.2% • ~20% women of child bearing age • HBsAb Positive 40.1% • ~ immune • HBsAg/HBsAb Negative 49.7% • ~ vulnerable to infection • All tested participants received result letters w/in 2-3 weeks explaining results and offering recommendations

  12. 3 For Life Project Demographics

  13. 3 For Life Participant Demographics API Only: n= 1095 • Average age 46 yrs (range 18-88) • Ages 18-45 yrs 45.6% • Foreign Born 84.4%

  14. 3 for Life Participant Demographics API Only: n= 1095 Health Provider for regular check-up: Health Provider seen when ill:

  15. 3 for Life Survey Findings API Only: n= 1095

  16. 3 for Life Survey Findings API Only: n= 1095

  17. Personnel $55,589 Operations: Non-Medical Advertising $27,254 Design $ 7,000 Food $ 5,607 Equipment $ 5,925 Postage $ 1,563 Supplies $10,362 Travel $ 8,434 Misc/Other $11,148 Total $77,629 Operations: Medical Hep A Vaccine $14,893 Hep B Vaccine $ 8,366 Combo A/B Vax $67,508 Medical Supplies $ 3,759 Testing $28,015 Total $122,541 Total Exp $255,459 Total Revenue $98,325 TOTAL ($157,434) 3 for Life Project Costs

  18. Results Summary • Over 1200 people tested • More than 3000 shots administered • 10% tested positive for chronic HBV • 40% tested positive for immunity • 50% of at risk for infection • Vaccination completion rate = 89%!

  19. Lessons Learned • Public/Private partnership very effective • Local Media Works • Culturally and linguistically appropriate • Target population responsive • People willing to pay for service of value • Education on chronic HBV infection is needed for both target population AND primary care medical providers

  20. Lessons Learned (continued) • Target outreach toward 18-45 year olds • Limit vaccinations to hepatitis B • Important to test for both HBsAg and HBsAb • Build in follow-up for HBsAg positives • Create effective education and counseling opportunities

  21. 3 for Life Project Goals • Raise awareness among target population, and health care providers, about: • Prevalence and risks of HBV and liver cancer in Asian community • Importance of hepatitis B testing, vaccination and appropriate monitoring of chronically infected • Gain information about barriers regarding hepatitis B testing and vaccination for Asian adults. • Create a model that can be replicated

  22. Successes • Project findings disseminated at 17 venues, 7 of them National Conferences • Three replications of model: • Los Angeles / Honolulu / San Francisco (UCSF) • Outreach and education to local primary care providers focus of current efforts • Developing tools to assist with testing protocols • Working with community partners to increase awareness and understanding

  23. Janet Zola, MPH San Francisco Dept. of Public Health Janet.zola@sfdph.org 415-554-2790 Jordan Su, MBA Asian Liver Center at Stanford University Jordansu@standford.edu 650-736-1883 Contact Information

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