Knowledge, Attitudes, and Behaviors of Viral Hepatitis Among Recent African Immigrants in the United States: A Community Based Participatory Research Qualitative Study

Essa A. Mohamed, Nasra H. Giama, Hassan M. Shaleh, Linda Kerandi, Abdul M. Oseini, Hager Ahmed Mohammed, Henry Kerandi, Loretta K. Allotey, Ibrahim A. Waaeys, Hamdi A. Ali, Hawa M. Ali, Safra A. Mohamed, Ju Dong Yang, Wudneh O. Gaga, Lily L. Tamire, Awol Windissa, Christi A. Patten, Joyce E. Balls-Berry, Lewis R. Roberts

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: In the United States, hepatocellular carcinoma is the ninth leading cause of cancer mortality. Hepatocellular carcinoma disproportionately affects individuals of African ancestry with the rates being higher amongst individuals of foreign-born African ancestry. This study explored knowledge, attitudes, and behaviors toward viral hepatitis transmission, screening, and vaccination among recent African immigrants in Minnesota and identify ways to improve early detection and screening methods. Methods: A community based participatory research (CBPR) team with minority researchers and community members sought to gain insight on persons of African Ancestry knowledge, attitudes, and behaviors related to viral hepatitis by conducting a qualitative research study. The CBPR team developed a focus group moderator's guide with semi-structured questions related to transmission, screening, and vaccination of viral hepatitis. We conducted seven focus groups using bilingual, bicultural moderators with participants from local Ethiopian, Liberian and Kenyan communities from August 10th, 2014 to October 11th, 2014. Focus groups were audio recorded and transcribed. The CBPR team categorized the data into themes and subthemes with consensus using traditional content analysis. Results: Community partners recruited 63 participants with a majority identifying as male (51%). Participants lacked knowledge of viral hepatitis screening, vaccination, and treatment. Participants were aware of some behaviors that increased risk of acquisition of hepatitis. Participants endorsed a strategy of developing and delivering educational materials for African immigrants. Moreover, access to care and cultural awareness were mentioned as pivotal for prevention and treatment of viral hepatitis. Conclusions: Findings from this pilot study provide insight on areas of research focus. Having a research team consisting of members from the community helped to increase trust and foster an understanding of shared community values. Information from this study provides evidence to support the development culturally appropriate strategies to address disparities in viral hepatitis in these communities.

Original languageEnglish (US)
Article number25
JournalFrontiers in Public Health
StatePublished - Mar 6 2020

Bibliographical note

Funding Information:
The authors would like to thank the study participants, the Pillsbury United Communities, the Brian Coyle Center, the Organization of Liberians in Minnesota, the Liberian Nurses Association, Brookdale Christian Center, and Midpoint Medical Clinic for providing the opportunity to conduct our focus group sessions. We also like to thank Lea Dacy, Sumo Bemah, Jennifer McCormick, Ashok Kumbamu, Abdiwahab Ali, Dekermue Togbah, Abdullahi Sheikh, and the Somali Health Advisory Committee for technical support. Funding. The Mayo Clinic Office of Health Disparities Research Pilot Awards (OHDR/P2014_13), the National Institutes of Health (CA165076 to LR), the Mayo Clinic Center for Cell Signaling in Gastroenterology (P30DK084567), the Mayo Clinic Cancer Center (CA15083), and the Mayo Clinic Center for Clinical and Translational Science (UL1TR000135). In addition, this publication was made possible by CTSA Grant Number UL1 TR002377 from the National Center for Advancing Translational Sciences (NCATS), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIH.

Publisher Copyright:
© Copyright © 2020 Mohamed, Giama, Shaleh, Kerandi, Oseini, Ahmed Mohammed, Kerandi, Allotey, Waaeys, Ali, Ali, Mohamed, Yang, Gaga, Tamire, Windissa, Patten, Balls-Berry and Roberts.


  • African
  • community based research
  • immigrant health
  • liver cancer disparities
  • viral hepatitis


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