This study aims to examine the potentially modifiable factors underlying racial and geographic disparities in diagnosis and treatment of hepatocellular carcinoma. The first part study involves a qualitative portion, in which participants undergo an hour-long facilitated interview to ensure that our survey instrument includes all aspects of the experience from diagnosis to treatment evaluation for our patients. The results of the qualitative interviews will inform the second part of the study, a closed-ended survey instrument that will be administered to remaining patients. We have worked with experts in epidemiology and social psychology to develop both the interview and survey instrument. The instrument collects important information about each patient’s social situation, history of liver disease, and adherence to screening regimens, in addition to validated items assessing access to care, mistrust of the medical system, and literacy in medicine. To date, we have finished developing the survey and submitted our protocol to the Institutional Review Board. While we await the scientific review process, we have set up our recruitment protocol, identified a research assistant to help recruit patients and administer the survey, and begun developing our qualitative analysis strategy. Once we obtain approval, we plan to begin recruiting patients for the qualitative portion of the study and anticipate that we will identify 25 patients in approximately six weeks. We will then commence our qualitative analysis before making any necessary changes to our survey instrument and administering it to remaining patients. We plan to draft a manuscript to report the results of our qualitative analysis and submit in early 2014. We plan to recruit enough patients to conduct a preliminary analysis of our survey results by March 2014 and submit our results for presentation at a major national meeting.
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