The PEN-3 model guided the qualitative analysis
and interpretation. Our analysis focused on the domain
of Relationships and Expectations and Cultural Empowerment to inform the development of
a culturally targeted intervention for African-born
individuals. Within the Relationships and Expectations
domain, themes and subthemes emerged and
were categorized as: Perceptions, defined as the
individual’s knowledge, attitudes, values, or beliefs
that either facilitate or hinder their motivation or
decision-making to maintain or change their health
beliefs related to HBV screening; Enablers, defined
as the societal, systematic, or structural influences
that either enhance or create barriers to
maintain or change health beliefs and practices related
to HBV screening; or Nurturers, defined
as supportive or discouraging influences the individual
receives from their significant others. The
PEN-3 model also applies values to each theme19
and are categorized as: Positive for values and
relationships that promote HBV screening; Existential
for values and beliefs that are practiced
or held but do not hinder or facilitate HBV screening;
or Negative for values and relationships that
negatively influence the decision-making or actions
to access screening for HBV. These domains and
dimensions are illustrated in Table 3. The following
sections describe the salient themes that emerged
and are applicable to the development of the culturally
targeted intervention.