Patient-Centered Care and Asian Americans

Liver cancer and hepatitis B are major health disparities for Asian Americans, while
hepatitis C is a rising problem. Little is known about how to improve the quality of health
care Asian Americans receive in general and for viral hepatitis in particular. Technology,
specifically mobile applications, potentially can provide a flexible and efficient way to
address these challenges. This proposed project seeks to develop, implement, and test an
intervention to increase hepatitis B and C screening for Asian Americans in 2 healthcare
systems in the San Francisco Bay Area.

The research team will develop, implement, and evaluate the efficacy of an interactive,
patient- centered mobile application for use on a tablet computer to increase the rate of
hepatitis B and C screening among unscreened Asian Americans age 18 and older. The team will
use their experience from a successful track record in health promotion to develop the
intervention by working with patients, community leaders and advocates, clinical staff,
healthcare providers, and healthcare system administrators from a county safety net system
and an academic primary care practice in the San Francisco Bay Area. The mobile application
will include video clips with a physician (Video Doctor) addressing patient concerns
regarding hepatitis B and C screening in the patient's preferred language, English, Chinese,
or Vietnamese. A patient who has not been screened for hepatitis B will answer questions
about his or her characteristics and preferences using the mobile application. The mobile
application will then show 30-60 seconds video clips with messages that address the patient's
responses related to hepatitis B screening and that are delivered by an actor playing a
physician. Those who are born between 1945 and 1965 also receive messages about hepatitis C
screening. At the end, the tablet computer will generate a provider alert to let the treating
provider know what the patient's preferences are regarding testing for viral hepatitis.

Once developed, the intervention will then be used in combination with a physician panel
notification and tested against physician panel notification only in a randomized controlled
trial to see which approach is better in increasing the rate of hepatitis B and C screening.
The team will also work with the 2 healthcare system to ensure that the interventions will be
practical and easily adopted once the study is over. The findings of this project will
greatly expand understanding about how to use technology- based interventions to improve
quality of healthcare in diverse patient populations.