LHW Project – Liver Cancer Disparities

Lay Health Worker Model
to Reduce Liver Cancer Disparities

Project Funding: This project is funded by the National Cancer Institute(NCI)/John Hopkins University.

Project Background: The insights gained from this project will be valuable in implementing liver cancer prevention programs for other non-English speaking populations who are at high-risk for HBV infection and will help address health disparities among immigrant populations.  For this project, our research team worked closely with Dr. Hee-Soon Juon at the Sidney Kimmel Medical College at Thomas Jefferson University.

Project Aims:

The goal of this study is to implement culturally integrated, liver cancer prevention programs for Chinese, Korean, and Vietnamese Americans through outreach, screening, education, research, and training in the Baltimore-Washington Metropolitan Area. In order to fulfill this goal, we worked towards achieving the following specific aims:

  1. To develop a training protocol and certification program for LHWs to conduct sustainable, community-based liver cancer prevention programs
  2. To assess the true prevalence of hepatitis B virus infection by providing HBV screening tests for Chinese, Korean, and Vietnamese Americans
  3. To implement a tailored intervention based on HBV screening results
    • Provide LHW-led intervention programs to promote adherence to HBV vaccinations for those who are unprotected
    • Provide patient-navigation services for antiviral therapy and adherence to follow-up treatment to those who are infected with HBV
  4. To investigate the molecular epidemiology of hepatitis B among infected Asian Americans
    • Assess the molecular markers (e.g., HBV genotyping), HBsAg quantitation, and polymerase mutations
    • Assess environment factors (e.g., exposure to Aflatoxin in foodstuffs)
    • Build databases for future cohort or case-control studies

Program Design: This project utilized a community-based participatory approach to help build a sustainable, liver cancer prevention program that is conducted by lay health workers (LHWs).  After receiving training and certification through our project, LHWs aided in the recruitment of eligible participants for hepatitis B virus (HBV) screening, conductedd telephone interventions, provided community education to increase liver cancer awareness, and provided follow‐up resources for HBV vaccinations.  Participants consisted of Chinese, Korean, and Vietnamese Americans residing within the Baltimore-Washington Metropolitan Area. This project also included biospecimen banking which will contribute to future research aimed towards liver cancer prevention. 

Our project is interdisciplinary in nature and has worked to form strong partnerships among the Sidney Kimmel Medical College, Johns Hopkins School of Medicine, University of Maryland School of Public Health, Hepatitis B Initiative-DC (HBI-DC), and other community-based organizations (CBOs) in the Baltimore-Washington Metropolitan Area. This collaboration between the research community and CBOs will contribute to increasing access to and utilization of culturally and linguistically appropriate LHW-led liver cancer prevention programs, improving cancer survival rates, and reducing mortality with early diagnosis of cancer.