The Kirby Institute, University of New South Wales, Sydney, Australia.
The Kirby Institute, University of New South Wales, Sydney, Australia; Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
Int J Drug Policy. 2024 Jul;129:104461. doi: 10.1016/j.drugpo.2024.104461. Epub 2024 Jul 5.
Australia's prisons have a high chronic hepatitis C (HCV) prevalence (8 %). Antiviral therapies and prison-based hepatitis services are available, but only a minority of those eligible are being treated. Improving the HCV public health literacy of the prison sector via targeted education may overcome key barriers to scale-up treatment. This paper describes the: i) HCV public health literacy of the prison setting; ii) barriers and solutions for HCV education and service engagement; iii) HCV education program co-design and development processes; and iv) HepPEd resources.
A national needs assessment was conducted to analyse the HCV public health literacy of the target audience groups in the prisons (healthcare providers; custodial officers; people in prison) to inform development of a prison-specific HCV education program (HepPEd). Structured interviews were conducted with key informants (n = 40). Three National Steering Committees, one for each target group, were convened to co-design and develop HepPEd.
Only healthcare providers involved with hepatitis care were considered to have 'good' to 'very good' HCV health literacy (including knowledge, attitudes, and capabilities), with all other groups considered less favourably. Key barriers identified included being time poor (healthcare providers), poor motivation (custodial officers) and stigma (people in prison). Peer education delivery was considered a key facilitator for custodial officers and people in prison. A suite of multi-modal resources addressing the perceived gaps in HCV health literacy was developed, with a broad theme of 'Let's talk about hep C'. Delivery of HepPEd was designed to overcome key barriers and utilise facilitators for each group.
Significant gaps in HCV health literacy were perceived amongst the target audience groups. The comprehensive co-design and development processes utilised in HepPEd suggest the program will be well-placed to improve the HCV public health literacy of the prison sector and thereby enhance HCV testing and treatment rates amongst people in prison.
澳大利亚的监狱中慢性丙型肝炎（HCV）的患病率较高（8%）。现已有抗病毒疗法和监狱内肝炎服务，但仅有少数符合条件的人得到了治疗。通过有针对性的教育提高监狱部门的 HCV 公共卫生知识水平，可能有助于克服扩大治疗规模的关键障碍。本文描述了：i）监狱环境中 HCV 的公共卫生知识水平；ii）HCV 教育和服务参与的障碍和解决方案；iii）HCV 教育项目的共同设计和开发过程；以及 iv）HepPEd 资源。
进行了一项全国性需求评估，以分析监狱中目标受众群体（医疗保健提供者；狱警；囚犯）的 HCV 公共卫生知识水平，为制定监狱专用 HCV 教育计划（HepPEd）提供信息。对 40 名关键信息提供者进行了结构式访谈。召集了三个国家指导委员会，分别针对每个目标群体，共同设计和开发 HepPEd。
只有参与肝炎护理的医疗保健提供者被认为具有“良好”到“非常好”的 HCV 健康素养（包括知识、态度和能力），而其他所有群体的评价都较差。确定的主要障碍包括时间紧张（医疗保健提供者）、动机不足（狱警）和耻辱感（囚犯）。同伴教育被认为是狱警和囚犯的一个关键促进因素。针对 HCV 健康素养方面的认知差距开发了一系列多模式资源，主题广泛，涵盖“让我们谈谈丙型肝炎”。HepPEd 的实施旨在克服每个群体的主要障碍并利用促进因素。
目标受众群体普遍存在 HCV 健康素养方面的显著差距。HepPEd 中使用的综合共同设计和开发过程表明，该计划将很好地提高监狱部门的 HCV 公共卫生知识水平，从而提高监狱中人群的 HCV 检测和治疗率。
