food, water, and casual contact) and to establish facts, particularly ones that encourage testing, vaccination, and followup.

Education Programs

Several educational programs targeting API communities have been successful in disseminating hepatitis B awareness and promoting prevention. Successful programs often build on community partnerships and combine educational resources with increased access to testing, prevention, and care for participants (CDC, 2006; Chao et al., 2009a; Juon et al., 2008; Lin et al., 2007). The Hepatitis B Initiative is a community-based hepatitis B outreach program that partnered with nine Korean American and Chinese American churches in the Baltimore and Washington, DC, metropolitan area to provide culturally and linguistically tailored, faith-based HBV education, testing, and vaccination (Juon et al., 2008). The initiative has generated community support and awareness through word of mouth, articles in local Asian ethnic media, educational sessions and luncheons for API community leaders, and a national conference for API pastors. In 2003–2006, the program tested 1,775 participants for HBV and found that 2% were chronically infected and 61% were not vaccinated. Among 924 unvaccinated participants, nearly all received the first dose of hepatitis B vaccine, 89% received the second, and 79% completed the three-dose series. The Asian American Hepatitis B Program, a collaboration of community groups and academic and community health centers in New York City, provides hepatitis B screening, vaccination, and treatment. The program found that about 15% of newly tested persons had chronic HBV infection, all of whom were born outside the United States and half of whom had been in the country for more than 10 years (CDC, 2006).

The Jade Ribbon Campaign is a program focused on reducing the nationwide health disparity in hepatitis B. This program sponsors community HBV screening and education clinics and partners with over 400 community-based organizations and federal and state agencies to provide culturally and linguistically tailored information and multimedia public-service announcements about hepatitis B burden, risk factors, transmission, prevention, detection, treatment, and followup to the API community and health professionals (Asian Liver Center, 2009; CDC, 2009b). The program’s clinics have found that about 45% of participants were not vaccinated against HBV, 9–13% of participants were chronically infected, and up to two-thirds of those who were chronically infected were unaware of their infection status. Of those who said that they had been vaccinated against HBV, 20% were unprotected and 5% chronically infected (Chao et al., 2009a; Lin et al., 2007). This model has been adapted by a number of cities around the country (Chang et al., 2009; Fernandez, 2008; Hsu et al.,



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