Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals
Sweeney, L., Owiti, John A, Beharry, Andrew, Bhui, Kamaldeep, Gomes, Jessica, Foster, Graham R and Greenhalgh, Trisha 2015. Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals. BMC Health Services Research. 15 (97).
|Authors||Sweeney, L., Owiti, John A, Beharry, Andrew, Bhui, Kamaldeep, Gomes, Jessica, Foster, Graham R and Greenhalgh, Trisha|
Background: Effective strategies are needed to provide screening and treatment for hepatitis B and C to immigrant groups in the UK at high risk of chronic infection. This study aimed to build an understanding of the knowledge, beliefs and attitudes towards these conditions and their management in a range of high-risk minority ethnic communities and health professionals, in order to inform the design of a screening and treatment programme in primary care.
Methods: Qualitative data collection consisted of three sequential phases- (i) semi-structured interviews with key informants (n = 17), (ii) focus groups with people from Chinese, Pakistani, Roma, Somali, and French- and English-speaking African communities (n = 95), and (iii) semi-structured interviews with general practitioners (n = 6). Datasets from each phase were analysed using the Framework method.
Results: Key informants and general practitioners perceived that there was limited knowledge and understanding about hepatitis B and C within high-risk immigrant communities, and that chronic viral hepatitis did not typically feature in community discourses about serious illness. Many focus group participants were confused about the differences between types of viral hepatitis, held misconceptions regarding transmission, and were unaware of the asymptomatic nature of chronic infection. Most welcomed the idea of a screening programme, but key informants and focus group participants also identified numerous practical barriers to engagement with primary care-based screening and treatment; including language and communication difficulties, limited time (due to long working hours), and (for some) low levels
Conclusions: Strategies to reduce the burden of chronic viral hepatitis in immigrant communities will need to consider how levels of understanding about hepatitis B and C within these communities, and barriers to accessing healthcare, may affect capacity to engage with screening and treatment. Services may need to work with community groups and language support services to provide information and wider encouragement for screening. Primary care services will need ongoing consultation regarding their support needs to deliver hepatitis screening and treatment programmes.
|Journal||BMC Health Services Research|
|Journal citation||15 (97)|
|Accepted author manuscript|
|Web address (URL)||http://dx.doi.org/10.1186/s12913-015-0746-y|
|13 Mar 2015|
|Publication process dates|
|Deposited||24 Apr 2015|
|Accepted||17 Feb 2015|
|Copyright information||© 2015 Sweeney et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.|
LS, JAO, AB, KB, JG and TG have no competing interests to declare. GRF has received funding from pharmaceutical companies developing and/or marketing drugs for the treatment of chronic viral hepatitis – specifically AbbVie, BMS, BI, Gilead, GSK, Idenix, Merck, Novartis, Roche and Springbank Pharmaceuticals- outside the submitted work.
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