Baharudin Mohd Hafiidz, Mokhtar Siti Aisah, Azman Ahmad Zaid Fattah, Mohd Nazan Ahmad Iqmer Nashriq
Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
Ministry of Health, Kuala Muda District Health Office, Kedah, Malaysia.
PLoS One. 2025 May 22;20(5):e0324718. doi: 10.1371/journal.pone.0324718. eCollection 2025.
The World Health Organization (WHO) has targeted eliminating viral hepatitis as a public health problem by 2030. Thus, high-risk groups such as Methadone Maintenance Therapy (MMT) clients should be targeted for hepatitis C health intervention to increase intention for hepatitis C infection treatment. This study aims to evaluate the effectiveness of theory-based hepatitis C health education and learning module (HEAL) in increasing intention to participate in hepatitis C treatment among MMT clients in Malacca.
A single-blinded cluster randomised control trial was conducted among selected MMT clients from government health clinics in Malacca from July 2023 to February 2024. The clinics involved was randomly allocated into intervention and control groups. The intervention group received HEAL module developed based on the Theory of Planned Behavioural while the control group attended clinic session as usual. Generalized Estimating Equation (GEE) analysis was used for statistical analysis.
GEE shows that there is significant interaction between time and group for both intention for hepatitis C treatment and knowledge on hepatitis C. Intervention group at immediately post intervention follow up had higher intention for hepatitis C treatment as compared to control group (β = 0.56, 95% CI = 0.12, 1.01, p-value < 0.01). However, there were no significant different in intention for hepatitis C treatment between the two group at 3-month post intervention follow up. Furthermore, intervention group had significant higher knowledge at immediately post intervention (β = 8.85, 95% CI = 7.35, 10.36, p-value < 0.001) and at 3-month post intervention (β = 5.25, 95% CI = 3.76, 6.75, p-value < 0.001) as compared to the control group. However, the knowledge level among the intervention group reduces at 3-month post intervention follow up as compared to knowledge level at immediately post intervention follow up.
HEAL module which utilizes motion video and group discussion was effective in increasing MMT client's intention for hepatitis C treatment and knowledge about hepatitis C. However, future research should focus on finding effective strategies to ensure retention of the outcomes of HEAL module intervention over time.
世界卫生组织（WHO）的目标是到2030年消除病毒性肝炎这一公共卫生问题。因此，美沙酮维持治疗（MMT）患者等高危群体应成为丙型肝炎健康干预的目标，以提高丙型肝炎感染治疗的意愿。本研究旨在评估基于理论的丙型肝炎健康教育与学习模块（HEAL）在提高马六甲MMT患者参与丙型肝炎治疗意愿方面的有效性。
2023年7月至2024年2月，在马六甲政府健康诊所选取的MMT患者中进行了一项单盲整群随机对照试验。所涉及的诊所被随机分为干预组和对照组。干预组接受基于计划行为理论开发的HEAL模块，而对照组照常参加诊所课程。采用广义估计方程（GEE）分析进行统计分析。
GEE显示，丙型肝炎治疗意愿和丙型肝炎知识在时间和组间均存在显著交互作用。干预组在干预后立即随访时，丙型肝炎治疗意愿高于对照组（β = 0.56，95%CI = 0.12，1.01，p值<0.01）。然而，在干预后3个月随访时，两组之间丙型肝炎治疗意愿无显著差异。此外，干预组在干预后立即随访时（β = 8.85，95%CI = 7.35，10.36，p值<0.001）和干预后3个月随访时（β = 5.25，95%CI = 3.76，6.75，p值<0.001）的知识水平显著高于对照组。然而，与干预后立即随访时的知识水平相比，干预组在干预后3个月随访时的知识水平有所下降。
利用动态视频和小组讨论的HEAL模块在提高MMT患者的丙型肝炎治疗意愿和丙型肝炎知识方面是有效的。然而，未来的研究应侧重于寻找有效的策略，以确保HEAL模块干预的效果随时间得以保持。
