Department of Gastroenterology and Hepatology, Royal Surrey NHS Foundation Trust, Guildford, Surrey, UK; Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Brunel Business School, Brunel University, London, UK.
Int J Infect Dis. 2020 Nov;100:264-272. doi: 10.1016/j.ijid.2020.08.059. Epub 2020 Aug 27.
Chronic viral hepatitis (CVH) is a leading contributor to the UK liver disease epidemic, with global migration from high prevalence areas (e.g., South Asia). Despite international guidance for testing high-risk groups in line with elimination targets, there is no consensus on how to achieve this. The objectives of this study were to assess the following: (1) the feasibility of recruiting South Asian migrants to view an educational film on CVH, (2) the effectiveness of the film in promoting testing and increasing knowledge of CVH, and (3) the methodological issues relevant to scale-up to a randomized controlled trial.
South Asian migrants were recruited to view the film (intervention) in community venues (primary care, religious, community), with dried blood spot CVH testing offered immediately afterwards. Pre/post-film questionnaires assessed the effectiveness of the intervention.
Two hundred and nineteen first-generation migrants ≥18 years of age (53% female) were recruited to view the film at the following sites: religious, n = 112 (51%), community n = 98 (45%), and primary care, n = 9 (4%). One hundred and eighty-four (84%) underwent CVH testing; hepatitis B core antibody or hepatitis C antibody positivity demonstrated exposure in 8.5%. Pre-intervention (n = 173, 79%) and post-intervention (n = 154, 70%) questionnaires were completed.
This study demonstrated the feasibility of recruiting first-generation migrants to view a community-based educational film promoting CVH testing in this higher risk group, confirming the value of developing interventions to facilitate the global World Health Organization plan for targeted case finding and elimination, and a future randomized controlled trial. We highlight the importance of culturally relevant interventions including faith and culturally sensitive settings, which appear to minimize logistical issues and effectively engage minority groups, allowing ease of access to individuals 'at risk'.
慢性病毒性肝炎(CVH)是导致英国肝病流行的主要因素之一,全球从高流行地区(例如南亚)移民。尽管国际指南建议按照消除目标对高危人群进行检测,但对于如何实现这一目标尚未达成共识。本研究的目的是评估以下内容:(1)招募南亚移民观看有关 CVH 的教育电影的可行性,(2)电影在促进检测和增加对 CVH 的了解方面的有效性,以及(3)与扩大规模到随机对照试验相关的方法学问题。
在社区场所(初级保健、宗教、社区)招募南亚移民观看电影(干预),并在观看电影后立即提供干血斑 CVH 检测。观看电影前后的问卷评估了干预措施的效果。
共招募了 219 名 18 岁以上的第一代移民(53%为女性)观看电影,这些移民来自以下场所:宗教场所,n = 112(51%),社区场所,n = 98(45%)和初级保健场所,n = 9(4%)。184 人(84%)接受了 CVH 检测;乙型肝炎核心抗体或丙型肝炎抗体阳性表明暴露于 8.5%。完成了干预前(n = 173,79%)和干预后(n = 154,70%)的问卷。
本研究证明了在这一高风险人群中招募第一代移民观看基于社区的教育电影以促进 CVH 检测的可行性,证实了制定干预措施以促进全球世界卫生组织针对目标病例发现和消除的计划的价值,以及未来的随机对照试验。我们强调了文化相关干预措施的重要性,包括信仰和文化敏感的环境,这些措施似乎可以最小化后勤问题并有效地吸引少数群体,使处于危险之中的个人更容易获得。