Table 6.

Application of survey findings to San Francisco Hep B Free outreach strategies

Findings	Application
High level of recognition of the term “hepatitis B”, but lack of knowledge about correct prevention methods due to confusion with hepatitis A and belief that general good diet hygiene can prevent hepatitis B transmission. Also, current level of knowledge about hepatitis B did not compel most to seek testing	Simpler messaging to convey the basic concepts about hepatitis B disease and transmission. Aside from emphasizing that hepatitis B cannot be prevented solely through a healthy diet and exercise and that most Asians are infected via vertical transmission, we also found that: (1) the “1 in 10 are infected” message effectively conveyed how common hepatitis B infection is within the Asian community, and (2) the “which one deserves to die?” tagline effectively conveyed the potential deadly consequence of infection
Most respondents held a high level of trust that their primary care providers would know what diseases they are at higher risk for, to test them for these diseases as part of their routine physical and to inform them of the results	More intensive outreach to primary care providers urging them to test and vaccinate Asians due to their high level of trust in the medical community, and to improve communication with patients regarding hepatitis test results Promoting the Hep B Free Clinician’s Honor Roll to recognize clinicians who have signed a pledge to test patients at risk for chronic hepatitis B infections in accordance with CDC guidelines. Our goal is to have 90% of primary care clinicians in San Francisco complete this pledge Producing a handout (“Ask sheet”) that people can take to providers to request testing. Its purpose is to help patients initiate conversation with their providers about testing, and to serve as an education piece and reference sheet for providers
While memorable, respondents were confused about the upbeat image associated with the B a Hero campaign, as well as how one can be a hero in the context of hepatitis B	Use of more appropriate imagery to convey the seriousness of hepatitis B infection, (relating it to its serious consequence of liver cancer), as well as increased risk for infection among Asian Americans. The 2010 “Which One Deserves To Die?” campaign incorporates more serious imagery about cancer as a possible consequence of hepatitis B infection in its messaging
Sources of health information were homogeneous among Cantonese speakers, mostly through health columns in Chinese newspapers and Chinese news talk shows, as well as pamphlets from trusted institutions. English-speakers used a wider array of sources	Two different sets of messaging and outreach methods are needed, not just separated by language needs but also considering age and level of acculturation. While Cantonese speakers may be reached largely through in-language media, English-speakers may need to be reached through a larger variety of portals, such as providing information on internet. This finding validated outreach strategies already being used by SF Hep B Free
Inconsistent translation of hepatitis B in Chinese media	Use of consistent terminology in all campaign outreach materials