1. Increasing Hepatitis B Screening Among Korean Church Attendees Roshan Bastani, PhDPrincipal Investigator Roshan Bastani, PhDPrincipal Investigator Vicky Taylor, MD, MPH Co-Principal Investigator (FHCC) Vicky Taylor, MD, MPH Co-Principal Investigator (FHCC) Beth Glenn, PhD Co-Investigator Beth Glenn, PhD Co-Investigator Annette Maxwell, DrPH Co-Investigator Annette Maxwell, DrPH Co-Investigator Angela Jo, MD, MPHCo-Investigator Angela Jo, MD, MPHCo-Investigator Weng Kee Wong, PhD Co-Investigator Weng Kee Wong, PhD Co-Investigator UCLA School of Public Health, Jonsson Comprehensive Cancer Center, Division of Cancer Prevention & Control Research Study funded by the National Cancer Institute

2. Focus on Korean Americans Up to 12% of Koreans chronically infected with hep B No liver cancer prevention efforts targeting Koreans 2 nd highest liver cancer rates among Asians Low hep B serologic testing rates 3rd most populous Asian group Immigrant population = greater hep B risk

3. Results of Pilot Study in Korean Community 141 Korean Americans from churches and a clinic Only 56% ever had a hepatitis B test 34% did not know Koreans at higher risk for hepatitis B Only 36% knew hepatitis B infection can be lifelong Common barriers to testing Fear of a bad diagnosis (75%) Cost of test (61%) Time (46%) Church preferred site to receive health information vs. worksite, clinic, health fair

4. Rationale for Church-Based Intervention 80% of Koreans attend church regularly Church-based programs successful in other minorities No evidence based programs for hepatitis B Small group: Cost-efficient & consistent Adaptation necessary: for content & ethnicity More likely to be sustained after grant

5. Study Design Intervention Churches N=20 6-Month Telephone Follow-up Interview Identification of Churches (n = 40) In-Person Baseline Interview N = 448 Hepatitis B Small Group Session Comparison Churches N=20 In-Person Baseline Interview N = 448 Physical Activity/Nutrition Small Group Session

6. The Health Behavior Framework Barriers/Supports Intentions Hepatitis B serologic testing Demographics Medical History Insurance Institutional Factors Language differences Navigation problems I N T E R V E N T I O N S Individual Factors Knowledge Communication & rapport with provider Health Beliefs Social Support Cultural Factors

7. Group Intervention Session: Process Information presented verbally, visually and in-print to enhance interest & retention Blend of discussion group & educational presentation Group format Social norms & Active participation Culturally competent intervention Assures acceptance & effectiveness

8. Strengths of Projects Adaptation of existing church based programs focused on increasing hepatitis B testing Opportunity to document process of adaptation Utilizing a rigorous evaluation Collaboration across CPCRN network sites will allow for: Sharing of complementary expertise and experiences Understanding of similarities and differences between Koreans and Chinese Lessons learned can be used to adapt programs for other ethnic groups at risk for hepatitis B and liver cancer