Partida Diana, Powell Jesse, Ricco Margaret, Naugle Jessica, Magee Catherine, Zevin Barry, Masson Carmen L, Konadu Fokuo J, Gonzalez Daniel, Khalili Mandana
Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Hennepin Healthcare, Minneapolis, Minnesota, USA.
Open Forum Infect Dis. 2022 Mar 1;9(4):ofac103. doi: 10.1093/ofid/ofac103. eCollection 2022 Apr.
The objective of this study was to evaluate the effectiveness of formal hepatitis C virus (HCV) education on engagement in therapy in persons experiencing homelessness in an on-site shelter-based model of care. As policies to eliminate Medicaid access restrictions to HCV treatment are expanded, patient education is paramount to achieving HCV elimination targets in difficult-to-engage populations including persons experiencing homelessness.
This prospective study was conducted at 4 shelters in San Francisco and Minneapolis from August 2018 to January 2021. Of the 162 HCV Ab-positive participants, 150 participated in a 30-minute HCV education session. Posteducation changes in knowledge, beliefs, barriers to care, and willingness to accept therapy scores were assessed.
Following education, knowledge scores (mean change, 4.4 ± 4.4; < .001) and willingness to accept therapy (70% to 86%; = .0002) increased. Perceived barriers to HCV care decreased (mean change, -0.8 ± 5.2; = .001). Higher baseline knowledge was associated with lesser gain in knowledge following education (coef., -0.7; < .001). Posteducation knowledge (odds ratio, 1.2; = .008) was associated with willingness to accept therapy.
An HCV educational intervention successfully increased willingness to engage in HCV therapy in persons experiencing homelessness in an on-site shelter-based HCV model of care.
本研究的目的是评估在基于现场庇护所的护理模式下，针对丙型肝炎病毒（HCV）进行正规教育对无家可归者接受治疗的参与度的有效性。随着消除医疗补助对HCV治疗准入限制政策的扩大，患者教育对于在包括无家可归者在内的难以参与治疗的人群中实现HCV消除目标至关重要。
这项前瞻性研究于2018年8月至2021年1月在旧金山和明尼阿波利斯的4个庇护所进行。在162名HCV抗体阳性参与者中，150人参加了一场30分钟的HCV教育课程。评估教育后在知识、信念、护理障碍以及接受治疗意愿评分方面的变化。
教育后，知识评分（平均变化，4.4±4.4；P<0.001）和接受治疗的意愿（从70%提高到86%；P=0.0002）有所增加。对HCV护理的感知障碍减少（平均变化，-0.8±5.2；P=0.001）。较高的基线知识水平与教育后知识增加较少相关（系数，-0.7；P<0.001）。教育后的知识水平（优势比，1.2；P=0.008）与接受治疗的意愿相关。
在基于现场庇护所的HCV护理模式下，HCV教育干预成功提高了无家可归者接受HCV治疗的意愿。
