Table 3. Health Behavior Framework Constructs and Sample Messages Addressing Communication With Provider and Health Beliefs In 4 Asian American Populations.

Construct	Vietnamese American (Content of Bilingual Booklet)	Hmong American (Content of Flip Chart)	Korean American (Content of Bilingual Booklet)	Cambodian American (Content of Flipchart)
Communication with provider: 3 of the 4 populations were encouraged to show print materials to their doctor to facilitate communication. Hmong were assisted by lay health workers.	Photo of patient and co-ethnic doctor discussing liver. Bring this pamphlet to your doctor or clinic and ask for hepatitis B blood tests to check for hepatitis B surface antigen (HBsAg) and hepatitis B surface antibody (HBsAb). If you have never been infected with hepatitis B, you should ask the doctor to vaccinate you against it. The hepatitis B vaccine is very effective.	How do I request the test from my doctor? Kashia (Name of project in the community) can help you call a doctor to schedule an appointment for the blood test.	Please read the content of this booklet and make an appointment to get tested for hepatitis B today. Tell your doctor that you want to get tested for hepatitis B because it is common in your community and that you’re worried about it. Give your doctor the Hepatitis B Information for Physicians Brochure that is included in the take-home packet.	Most doctors will order a hepatitis B test if you ask for one. Tell the doctor you recently received information about hepatitis B from a community health worker. Tell the doctor you heard about the hepatitis B test and vaccine. Show the doctor your hepatitis B pamphlet.
Perceived susceptibility: Increased risk for hepatitis B infection was conveyed in a similar way for all groups	About 1 in 7 Vietnamese Americans has hepatitis B virus infection.	Anybody can get hepatitis B. Two of 10 Hmong know someone who is infected with hepatitis B. Hmong experienced 5 times higher incident rate of liver cancer than non-Hispanic whites.	Graphs showing that 1 in 100 Americans is infected with hepatitis B, but 12 in 100 Koreans. HBV is 100 times more infectious than the AIDS virus.	Figures showing that Cambodians are much more likely to be infected with hepatitis B than other groups. Hepatitis B infection is very common among Cambodians. Hepatitis B affects Cambodians over 10 times more than other groups of people.
Perceived severity: Similar content in all 4 groups but Vietnamese and Korean received more information than Hmong and Cambodian.	Can cause short-term and/or long-term liver inflammation (hepatitis), liver failure, cirrhosis and cancer. For chronic carriers: Without proper care, 1 in 4 people with chronic hepatitis B will eventually develop a fatal liver disease.	Hepatitis B can cause severe infection of the liver. Hepatitis B can cause liver cancer and death.	Hepatitis B causes 80% of liver cancer cases among Korean Americans. If untreated, it could cause liver disease and lead to liver cancer. The disease can damage your liver even without your knowledge.	Hepatitis B can cause serious health problems such as liver cancer.
Cultural factors	Focus on family and community through multiple pictures of Vietnamese couples, families and groups	Photos of Hmong people, traditional attire, depiction of traditional activities (cultural performance art); primary use of photos, graphics and visual art – very little text; delivery of intervention orally by lay health workers.	Photos of Koreans evoking importance of family, pride in Korean culture (calligraphy, dancing, traditional attire). Collectivism and focus on family benefits: “Now I can take action to protect my health and my family’s health.”	Photo of Buddhist Temple in Cambodia. Collectivism/focus on family benefits: “Knowing your hepatitis B test result can protect your family and help future generations of Cambodians.”
Barriers/supports	Most health insurance covers hepatitis B testing and vaccination. If you don’t have health insurance or cannot afford testing or vaccination, please contact the following partner agencies in your area to find out what services are available (list of local agencies).	Language barrier: Kashia can interpret for you at the appointment. Fear of finding hepatitis B infection: Kashia can help people who test positive for hepatitis B to get treatment and follow-up.	Many organizations offer this test at health fairs or through special programs. See the resource guide included in the take-home package. Lack of time: Losing time is losing a little, but losing your health is losing everything.	The hepatitis B blood test can be done at any doctor’s office or clinic, does not require any preparation, takes just a couple of minutes, and only requires a small amount of blood.