加拿大埃及移民对丙型肝炎的认知以及筛查和治疗的障碍与促进因素:一项基于理论的定性研究

Perceptions about hepatitis C and barriers and enablers to screening and treatment among Egyptian immigrants to Canada: a theory-informed qualitative study.

作者信息

Mortazhejri Sameh, Thomas Isabella M, Patey Andrea M, Alghamyan Amjad, Cooper Curtis, Mansour Sarah, Pakhale Smita, Presseau Justin, Grimshaw Jeremy M, Greenaway Christina

机构信息

Center for Implementation Research, Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada.

School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada.

出版信息

Int J Equity Health. 2025 Jul 11;24(1):203. doi: 10.1186/s12939-025-02582-4.

Abstract

BACKGROUND

Despite availability of effective screening and treatment for Hepatitis C (HCV), the uptake remains suboptimal. Immigrants from HCV endemic countries comprise 35% of cases in Canada. There is an average 10-year diagnosis delay, causing poor health outcomes and high healthcare system costs. Therefore, we aimed to understand immigrants' perceptions and beliefs about HCV, as well as the barriers and enablers to HCV care among immigrants, with a focus on individuals from Egypt, given the country's high endemic rates of HCV infection and the large Egyptian community in Canada.

METHODS

We established a Community Advisory Group to provide advice at all stages. We used a qualitative-descriptive design guided by the Common-Sense Self-Regulation Model and Theoretical Domains Framework to perform semi-structured interviews with adult immigrants from Egypt (with or without HCV) in Ottawa, Canada. Sampling continued until thematic saturation was achieved. The interviews were double-coded and key findings were identified.

RESULTS

We conducted interviews with 18 individuals (eight females, ten males), including 12 who had undergone HCV screening. Among them, seven had tested positive, and all had received treatment. While all participants were aware of HCV, misconceptions and a lack of knowledge regarding its symptoms, modes of transmission, and treatment options were prevalent. Many stated that they would not seek screening in the absence of significant symptoms. Perceived stigma associated with HCV and experiences of ethnocultural discrimination discouraged some individuals from seeking care. Additionally, challenges such as limited access to family doctors and long wait times were frequently cited as barriers. However, those who had received HCV treatment reported positive experiences and remained engaged in follow-up care.

CONCLUSION

There is an urgent need to improve access to care for immigrants from endemic countries to eliminate HCV in Canada. We took a systematic, theory-informed approach to understand lived experiences and views among Egyptian immigrants in Canada. We identified key factors contributing to the low uptake of HCV screening and treatment. These findings will inform a theory-based intervention to optimize HCV care in immigrant communities.

摘要

背景

尽管有针对丙型肝炎(HCV)的有效筛查和治疗方法,但接受度仍不理想。来自HCV流行国家的移民占加拿大病例的35%。平均诊断延迟10年,导致健康状况不佳和医疗系统成本高昂。因此,鉴于埃及HCV感染流行率高且在加拿大有庞大的埃及社区,我们旨在了解移民对HCV的认知和信念,以及移民中HCV护理的障碍和促进因素,重点关注来自埃及的个人。

方法

我们成立了一个社区咨询小组,在各个阶段提供建议。我们采用了以常识自我调节模型和理论领域框架为指导的定性描述性设计,对加拿大渥太华的成年埃及移民(有或无HCV)进行半结构化访谈。抽样持续进行,直至达到主题饱和。访谈进行了双重编码,并确定了关键发现。

结果

我们对18人(8名女性,10名男性)进行了访谈,其中12人接受过HCV筛查。其中7人检测呈阳性,且均接受了治疗。虽然所有参与者都知晓HCV,但对其症状、传播方式和治疗选择存在误解和知识欠缺的情况很普遍。许多人表示,没有明显症状就不会寻求筛查。与HCV相关的耻辱感以及种族文化歧视经历使一些人不愿寻求治疗。此外,诸如难以获得家庭医生服务和等待时间长等挑战经常被提及为障碍。然而,那些接受过HCV治疗的人报告了积极的经历,并继续接受后续护理。

结论

迫切需要改善流行国家移民获得护理的机会,以在加拿大消除HCV。我们采用了一种系统的、基于理论的方法来了解加拿大埃及移民的生活经历和观点。我们确定了导致HCV筛查和治疗接受度低的关键因素。这些发现将为基于理论的干预措施提供信息,以优化移民社区的HCV护理。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索