Exploring the Psychosocial Influences on Hepatitis B and Liver Cancer Disparities

Background Diverse communities from Asia, the Pacific Islands, the Caribbean, and Africa are disproportionately impacted by chronic hepatitis B. Low screening rates and limited engagement with disease management contribute to higher rates of liver cancer. This qualitative study aimed to explore the psychosocial factors influencing health behaviors related to hepatitis B and liver cancer, to inform the development of a public health communication campaign tailored to highly impacted communities. Methods In collaboration with community partners, individuals identifying with each community were purposively selected to participate in this study. Fifteen focus groups, ranging in size from 7 to 12 participants, and two key informant interviews were conducted with individuals from Asian and Pacific Islander, Caribbean, and African communities in the United States (total n = 101). The Health Belief Model and Social Ecological Model guided initial codebook development, with inductive approaches capturing emergent themes identified during analysis. Results Participants described incomplete knowledge of hepatitis B transmission and its link to liver cancer within their communities. These influenced health beliefs and behaviors surrounding screening and care, shaping feelings of self-efficacy and uncertainty regarding prevention and management. Misperceptions about disease risk and management were reproduced within interpersonal relationships, with many describing stigma and social isolation. Family support and culturally embedded social norms were influential in healthcare decisions and seeking. Conclusion This study demonstrates the multi-level influences contributing to low rates of screening and care engagement across impacted communities, highlighting key differences and similarities. These findings reinforce the importance of culturally tailored education that reflects the diversity of communities affected by hepatitis B.