Chronic HBV Management for Asian American
Chronic HBV Management for Asian American
About 75% of liver cancers are attributed to chronic hepatitis B (CHB). An estimated 2.2
 million individuals in the U.S. have CHB. Although Asian Americans make up 6% of total U.S.
 population, they account for over 58% of Americans with CHB. Prevalence rates of CHB range
 from 8% to 13% in Asian Americans vs 1% in Non-Hispanic whites (NHW). Asian Americans are
 8-13 times more likely to develop liver cancer with 60% higher death rate than NHW. Regular
 monitoring of CHB is vital in preventing HCC. Research indicates that regular monitoring
 (e.g., every six months doctor visit; blood tests) combined with antiviral treatment when
 appropriate, is critical to reduce the risk of liver disease (including HCC). Unfortunately,
 treatment effectiveness diminishes if CHB patients do not adhere to long-term monitoring and
 treatment guidelines. Adherence among Asian Americans with CHB is low. Poor healthcare access
 and significant cultural barriers prevent long-term adherence to monitoring and optimal
 treatment, placing Asian Americans at disproportionately high risk for HCC and increased
 healthcare costs.

 Building on previous studies, the investigators will use a virtual patient navigation (VPN)
 toolkit system (a web/mobile application) to help CHB patients improving their liver disease
 management.
Liver cancer is the second-leading cause of cancer deaths worldwide, which increased at the
 highest rate of all cancers in the U.S between 2003 and 2012. Asian Americans have the
 highest incidence and mortality rates of hepatocellular carcinoma (HCC) of all U.S.
 racial/ethnic groups. About 75% of liver cancers are attributed to chronic hepatitis B (CHB).
 An estimated 2.2 million individuals in the U.S. have CHB. Although Asian Americans make up
 6% of total U.S. population, they account for over 58% of Americans with CHB. Prevalence
 rates of CHB range from 8% to 13% in Asian Americans vs 1% in Non-Hispanic whites (NHW).
 Asian Americans are 8-13 times more likely to develop liver cancer with 60% higher death rate
 than NHW. Regular monitoring of CHB is vital in preventing HCC. Research indicates that
 regular monitoring (e.g., every six months doctor visit; blood tests) combined with antiviral
 treatment when appropriate, is critical to reduce the risk of liver disease (including HCC).
 Unfortunately, treatment effectiveness diminishes if CHB patients do not adhere to long-term
 monitoring and treatment guidelines. Adherence among Asian Americans with CHB is as low. Poor
 healthcare access and significant cultural barriers prevent long-term adherence to monitoring
 and optimal treatment, placing Asian Americans at a disproportionately high risk for HCC and
 increased healthcare costs.

 Building on previous studies, the investigators will use a virtual patient navigation (VPN)
 toolkit system (a web/mobile application) to help CHB patients improving their liver disease
 management. This study addresses DHHS and NIH National top priorities, Institute of
 Medicine's national goal of eliminating HBV and urgent need to evaluate evidence-based
 interventions that can be integrated into primary care setting and other relevant settings.

 The specific aims of the study are:

 Aim 1 (Primary) Evaluate comparative effectiveness of Text Message (TM) vs VPN+TM in
 improving long-term adherence to monitoring (regular doctor visit; blood tests) at 12- and
 18- month follow ups. Aim 2 (Secondary) Compare the effectiveness of TM vs VPN+TM in
 improving and sustaining medication adherence (measured through self-report and electronic
 monitoring) among Asian Americans with CHB who meet antiviral treatment guidelines. Aim 3
 (Exploratory) Examine mediators of intervention effectiveness, including information
 (knowledge), motivation, and self-efficacy, as well as dose-response.
Inclusion Criteria:

 -  1. Age 18 and above

 -  2. Self-identified Chinese, Korean or Vietnamese ethnicity

 -  3. Chronic HBV infection with positive HBV surface antigen (HBsAg)

 -  4. Non-compliant to HBV monitoring and treatment guidelines

 Exclusion Criteria:

 -