A social media-based intervention, delivered via the KakaoTalk messenger service, was effective in promoting screening for hepatitis B in the Korean-American community, according to results published in Digital Health.

Hepatitis B virus (HBV) affects 300 million people around the world. Asian Americans make up more than 50 percent of people with HBV in the United States. Compared with white people, Asian Americans are 10 times more likely to have hepatitis B. This leads to a higher risk of liver cancer. According to the Centers for Disease Control and Prevention (CDC), HBV screening is recommended for foreign-born individuals from areas with higher than 2 percent prevalence of the virus, which includes many Asian nations. But limited English proficiency can prove to be a barrier to diagnosis and care. People may not be aware they carry HBV because it is often asymptomatic.

“The high prevalence of HBV infection and liver cancer mortality rates in Asian Americans is one of the most neglected and understudied cancer disparities,” Y. Alicia Hong, PhD, of the George Mason University in Virginia, said in a press release. “We advocate for more research and practice to deliver culturally tailored public health programs for underserved populations via social media apps used by the target groups.”

Since the COVID-19 pandemic has stalled community-based and in-person efforts to improve HBV screening in this at-risk community, researchers sought a different avenue. Hong’s team and the Korean American Outreach Group created a mobile health program called “Let’s Talk About Liver Cancer” for Korean Americans. Modifying a CDC media campaign, the researchers aimed to encourage HBV screening and prevent liver cancer in this population using a social media intervention.

From February through October 2020, the team recruited 100 Korean Americans from the Washington, D.C., area through social media. Using short video and images, culturally specific messages were sent to participants over four weeks through KakaoTalk, a free Korean social media app. Three times a week, participants received multimedia information on a particular aspect of HBV transmission, liver cancer risk, testing and vaccination.

The study included 100 participants with an average age of 60 years. Of these, 56 were women and most had lived in the United States for more than 20 years. Some 84 percent of the participants had limited English proficiency and 21 percent had a history of hepatitis or liver cancer in their family.

Some 95 percent of participants turned in their follow-up survey after the social media intervention. The researchers noted vast gains in the participants’ knowledge about HBV, infection risks, the benefits of testing and the prevention of liver cancer. The participants also showed a greater sense of self-efficacy, meaning a belief that they could take the necessary steps to achieve a specific goal of testing for HBV. These improvements were similar to those seen with in-person interventions in this community.

“This is one of the first social media-based liver cancer prevention programs designed specifically for Korean Americans,” said Hong. “It’s amazing that we successfully piloted it during the pandemic, as it was delivered via a popular social media app.”

Click here to read the study in Digital Health.

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