The specific goal of this project is to develop and evaluate a community-based educational intervention. We developed and implemented culturally integrated liver cancer educational programs for Asian Americans (e.g., Chinese-, Korean-, and Vietnamese-Americans) through outreach, education, research, and training in Maryland. Given these broad objectives, the proposed program will achieve the following specific aims: 

1. Develop educational strategies tailored to the needs of target communities to increase public awareness of liver cancer prevention;
2. Implement theory-driven and culturally integrated community-based cancer intervention programs to increase hepatitis B virus screening through increased cancer awareness, outreach, and accessibility to screening for Asian Americans; and
3. Evaluate the effectiveness of the educational intervention on liver cancer awareness and HBV screening behavior.
    

The objective of this project is to build a sustainable, community-based, participatory program of lay health workers (LHWs) who can promote liver cancer prevention programs among high-risk groups of Asian Americans. This proposed study attempts to implement culturally integrated liver cancer prevention programs for Chinese, Korean, and Vietnamese Americans through outreach, screening, education, research, and training in the Baltimore-Washington Metropolitan Area. The specific aims are: 

1. To develop a training protocol and certificate program for LHWs;
2. To assess the  prevalence of HBV infection; 
3. To implement intervention programs, based on screening test results; and 
4. To evaluate the effectiveness of LHW intervention on adherence to HBV vaccinations among those unprotected. 

The objective of the project is to explore the link between stress and liver inflammation in the clinic-based patient cohort who received treatment for chronic HBV at the Liver Disease Prevention Centre at Thomas Jefferson University Hospital (TJUH). Our main hypothesis is that those who experience stressful life events are more likely to have liver injury/damage than those who do not have. We will test our hypothesis in through the following Specific Aims: 

1. examine the effect of psychosocial factors (e.g., stressful life events, depression) on hepatic inflammation (e.g., ALT, AST, GGT, AFP, HBV DNA viral load, HBeAg), 
2. explore the role of moderators (e.g., social support, coping) in the relationship between psychosocial variables and hepatic disease progression, and 
3. examine mediating role of biological process (e.g., stress hormones) in the effect of psychosocial stress on liver damage. Using a prospective study design, a total of 50 CHB patients who come to the clinic for the follow-up will be recruited.