Patient Knowledge, Beliefs and Barriers to Hepatitis B Care: Results of a Multicenter, Multiethnic Patient Survey

Nizar A. Mukhtar, Donna M. Evon, Colina Yim, Anna S. Lok, Nadra Lisha, Mauricio Lisker-Melman, Mohamed Hassan, Harry L.A. Janssen, Mandana Khalili

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


BACKGROUND: A greater understanding of the determinants of health behavior among those with and at-risk of chronic hepatitis B virus (HBV) infection is needed for effective design and implementation of public health initiatives.

AIMS: To determine factors associated with (1) willingness to accept HBV antiviral treatment and (2) satisfaction with provider communication regarding HBV care in a diverse cohort of HBV-infected patients.

METHODS: Using a multifaceted model of health behavior, the Health Behavior Framework, we conducted a comprehensive assessment of knowledge, attitudes, beliefs, and barriers to HBV care.

RESULTS: We enrolled 510 patients, with mean age 46 years; 53.1% men; and 71.6% Asian or Hawaiian/Pacific Islander. Patients were knowledgeable about HBV infection, but one-fifth did not think that HBV was a treatable disease; over a quarter felt it was so common among family and friends that it did not concern them, and less than half of patients believed they were likely to have liver problems or transmit HBV to others during their lifetime. Perceived susceptibility to disease risk was the only independent predictor of willingness to accept HBV treatment (β = 0.23, p = 0.0005), and contrary to expectations, having a doctor that speaks the same language was predictive of lower patient satisfaction with provider communication about their HBV care (β = - 0.65, p < 0.0001).

CONCLUSIONS: Patients with greater perceived susceptibility to the health consequences of HBV infection are more likely to accept treatment, and patient-provider language concordance impacts patient satisfaction with communication regarding HBV care in an unexpected direction.

Original languageEnglish (US)
Pages (from-to)434-441
Number of pages8
JournalDigestive Diseases and Sciences
Issue number2
StatePublished - Feb 2021

Bibliographical note

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.


  • HBV education
  • HBV epidemiology
  • HBV prevention
  • HBV treatment
  • Health behavior framework
  • Humans
  • Middle Aged
  • Male
  • Ethnic Groups/psychology
  • Health Knowledge, Attitudes, Practice
  • Young Adult
  • Health Services Accessibility/trends
  • Hepatitis B, Chronic/ethnology
  • Adolescent
  • Adult
  • Female
  • Surveys and Questionnaires
  • Aged
  • Culture

PubMed: MeSH publication types

  • Research Support, Non-U.S. Gov't
  • Multicenter Study
  • Journal Article
  • Research Support, N.I.H., Extramural


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