An interview guide was developed using the
PEN-3 model’s3 domains of Cultural Identity,
Relationships and Expectations, and Cultural
Empowerment. The PEN-3 model was specifically
designed to elicit information that is culturally
driven and it postulates that health care seeking
behavior is determined by facilitators that increase
care seeking (eg, insurance, sympathetic providers)
and barriers that reduce care seeking (eg, lack
of symptoms, logistics). This model was chosen because
our target population represents a minority
culture in the US and is similar to the Afro-centric
communities targeted to develop the conceptual
model. The topics covered in the interview included
general knowledge of HBV, perceptions about
seeking health care, views of the medical system,
barriers to attending screening, and facilitators for
screening. Questions from the interview guide are
shown on Table 1.