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Community outreach may reduce the risk of liver cancer

October 11, 2016

(PHILADELPHIA) - Liver cancer is more common among Asian Americans in part because they are at high risk of HBV infection. One out of 12 Asian Americans carries the virus, accounting for more than half of the cases in the US. Although the HBV vaccine is now given at birth in many countries throughout the world, a large portion of Asian American adults remain unprotected and at risk for developing cancer, because the virus, which can cause liver cancer, is endemic in many Asian and Sub-Saharan African countries. A new Thomas Jefferson University study of Asian Americans living in the Baltimore Washington metropolitan area shows that community outreach workers, or so-called lay health workers (LHW), may help bridge that gap by ensuring the medical information is understood.

The study aimed to identify effective approaches to increase HBV vaccinations. Most LHW studies conducted in Asian American communities have focused on increasing self-reported hepatitis B screening and knowledge, but very few went on to study whether the full course of hepatitis B vaccinations was completed.

In their study, Hee-Soon Juon Ph.D., a Professor of Medical Oncology and researcher at the Sidney Kimmel Cancer Center at Jefferson and colleagues developed a training program for lay health workers who may not have had backgrounds in healthcare, but who were members of the Asian American communities. The researchers also evaluated the program's ability to increase the number of completed vaccinations in a randomized controlled trial. Their research was published in the journal PLOS ONE.

Between April 2013 and March 2014, Dr. Juon and colleagues recruited 645 Chinese, Korean, and Vietnamese participants to complete a survey and be screened for HBV. Of those, 232 were identified as being at-risk for contracting HBV and were randomized into either a group that either received educational pamphlets about the HBV vaccine by mail or one that received pamphlets plus a three reminder calls that gave participants a chance to discuss any hesitations with a member of the community who spoke their language.

The results showed that those who received phone-call follow ups were more likely to have one or more vaccinations than those who only received educational pamphlets, they were also more likely to have the full course of HBV vaccine plus booster shots. When asked what motivated them, 70 percent of those vaccinated said that the personal calls were the main motivating factor.

The researchers are now planning new methods of outreach that employ social media tools and video.
For more information, contact Edyta Zielinska, 215-955-5291,

Article reference: J Juon et al., "Lay Health Worker Intervention Improved Compliance with Hepatitis B Vaccination in Asian Americans: Randomized Controlled Trial," PLOS ONE, doi:10.1371/journal.pone.0162683, 2016.

About Jefferson

Jefferson, through its academic and clinical entities of Thomas Jefferson University and Jefferson Health, is reimagining health care for the greater Philadelphia region and southern New Jersey. Since its mergers with Abington Health and Aria Health, Jefferson now has 23,000 people dedicated to providing the highest-quality, compassionate clinical care for patients, educating the health professionals of tomorrow, and discovering new treatments and therapies to define the future of care. With a university and hospital that date to 1824, today Jefferson is comprised of six colleges, nine hospitals, 32 outpatient and urgent care locations, and a multitude of physician practices throughout the region, serving more than 96,000 inpatients, 363,000 emergency patients and 1.9 million outpatient visits annually.

For more information and a complete listing of Jefferson services and locations, visit

Thomas Jefferson University

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