HHS Plan for Asian American, Native Hawaiian and Pacific Islander (AANHPI) Health

Prevent, treat and control Hepatitis B Viral (HBV) infections in AANHPI communities


	HHS Plan for AANHPI Health Introduction HHS Plan Overview HHS Workgroup on AANHPI Issues Goal 1: Prevent, treat and control Hepatitis B Viral (HBV) infections in AANHPI communities Goal 2: Improve data collection in AANHPI communities Goal 3: Align the healthcare workforce with needs of the AANHPI communities Goal 4: Improve health conditions and access to health care services for Native Hawaiians and Pacific Islanders Appendix – Acronyms

Background and Overview:

An estimated 3.5-5.3 million persons are living with viral hepatitis in the United States. Most that are infected remain unaware of their infection and therefore, do not receive care and treatment. About 1.25 million Americans are chronically infected with the hepatitis B virus (HBV). AANHPIs represent nearly half of these chronic HBV-infected persons in the U.S. One in ten AANHPIs in the U.S. suffer from HBV. If not treated, 15%-40% of persons living with viral hepatitis will develop liver cirrhosis or experience other conditions that affect the liver, including liver cancer. The Surveillance for Acute Viral Hepatitis report conducted by CDC estimates that liver cancer incidence is highest among AANHPI men between 46 and 64 years of age. The 2010 Institute of Medicine (IOM) report, "Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C," recommends increasing resources for prevention and treatment, strengthening vaccination requirements and developing a comprehensive public awareness campaign for hepatitis B infection. In response to the report, the Assistant Secretary for Health convened a Viral Hepatitis Interagency Working Group that developed a Departmental action plan: "Hepatitis and Liver Cancer: HHS Action Plan for Prevention and Treatment of Viral Hepatitis, 2011". This action plan will improve national coordination and collaboration for treatment, prevention and control of viral hepatitis particularly HBV infections.

Summary of Strategies:

Develop and implement a national education campaign designed to increase awareness about HBV, educate the public about risk factors, and encourage testing of those at risk through a HBV public service announcement (PSA) which will be aired in metropolitan areas with significant Asian American populations. The PSA will be translated into Chinese, Vietnamese and Korean for relevant in-language programming.
Explore data from the U.S. Behavioral Risk Factor Surveillance Survey to obtain baseline data for a developmental Healthy People 2020 objective about the percentage of AANHPI who have been tested for HBV infection.
Provide support for AANHPI community based organizations to:
1. Develop targeted outreach programs designed to reach specific populations at risk with HBV through culturally sensitive and linguistically appropriate evidence based interventions.
2. Encourage applications for health disparities research and community-based participatory research interventions that target early detection and prevention of HBV in medically underserved AANHPI communities.
3. Develop and disseminate educational materials in a variety of AANHPI languages.
4. Partner with AANHPI organizations to educate their members about chronic viral hepatitis.
Continue to support successful interventions and its dissemination of best practices in other communities.
Train health care providers to screen AANHPI patients living in HBV endemic regions with HBsAg (hepatitis B surface antigen) as an indicator of chronic HBV.

**Prevent, treat and control Hepatitis B Viral (HBV) infections in AANHPI communities**
Hepatitis B Goals	Strategies	Lead Agencies	Benchmarks/Measurable Outcomes
Goal 1: Decrease health disparities of AANHPI populations who are unaware that they have chronic Hepatitis B Virus (HBV) infection by increasing early identification.	Develop and implement a national education campaign designed to increase awareness about HBV, educate the public about risk factors, and encourage testing of those at risk through a HBV PSA which will be aired in metropolitan areas with significant Asian populations. The PSA will be translated into Chinese, Vietnamese and Korean for relevant in-language programming.	OMH	Within one year, develop a national PSA campaign designed to reach 30%-50% of the AANHPIs living in the top ten major metropolitan cities.
Goal 2: Establish targets for the next ten years about the percentage of AANHPI who have been tested for HBV infection.	Use data from the U.S. Behavioral Risk Factor Survey to obtain baseline data for a developmental Healthy People 2020 objective about the percentage of AANHPI who have been tested for HBV infection.	CDC	Obtain baseline data and set targets for a new Healthy People 2020 objective.
Goal 3: Increase capacity of community based organizations that advocate for programs for early detection and prevention of HBV infection in medically underserved AANHPI communities.	1. Provide support for AANHPI community based organizations to develop targeted outreach programs designed to reach specific populations at risk with HBV through culturally-sensitive and linguistically appropriate evidence based interventions.	OMH, CDC	1. Within two years, fund five to seven organizations to provide outreach to communities at risk.
	2. Encourage applications for health disparities research and community-based participatory research interventions that target early detection and prevention of HBV in medically underserved AANHPI communities.	NIH	2. Include HBV in AANHPI as an area of interest in NIH funding opportunity announcements for health disparities research.
	3. Develop and disseminate educational materials in a variety of AANHPI languages.	OMH, CDC	3. Within two years, increase the number of persons who know their HBV status by 25% over baseline in funded communities
	4. Partner with AANHPI organizations to educate their members about chronic viral hepatitis.	OMH, CDC
Goal 4: Decrease the disease burden of HBV infection among AANHPI and improve HBV screening.	Train health care providers to screen AANHPI patients living in HBV endemic regions with HBsAg (hepatitis B surface antigen).	HRSA, CDC	Increase knowledge about chronic HBV infection as well as increase the numbers of individuals who know their hepatitis B status. Increase the percentage of AANHPIs who have been screened for HBsAg. Increase the percentage of AANHPIs who have been screened for HBV, are not infected and who have been successfully vaccinated. Increase the percentage of HBV positive AANHPIs who are referred for treatment.
Goal 5: Reduce the morbidity and mortality of HBV and improve testing, care, and treatment to prevent liver disease and cancer.	Increase the knowledge and skills of health-care providers to perform HBV prevention, care, and treatment services. Improve access to and quality of care and treatment for person infected with hepatitis B and ensure that persons who know that they are infected with HBV receive timely care and treatment. Strengthen surveillance to detect HBV transmission and disease.	CDC	Refer to HHS Action Plan for Prevention and Treatment of Viral Hepatitis, 2011
Goal 6: Reduce Perinatal HBV through intervention.	Develop and evaluate hepatitis B perinatal prevention programs, enhance infant care coordination, care referrals among HBV-infected mothers, and delivery of other preventive services to their household contacts. Ensure that hospitals and birthing centers administer a "birth dose" of hepatitis B vaccine to all neonates prior to discharge. Assess best practices for care coordination provided by perinatal prevention programs.	CDC, NIH	Refer to HHS Action Plan for Prevention and Treatment of Viral Hepatitis, 2011

Content Last Modified: 1/13/2012 4:05:00 PM

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Prevent, treat and control Hepatitis B Viral (HBV) infections in AANHPI communities

Background and Overview:

Summary of Strategies: