A community- based hepatitis B linkage-to-care program: a case study on Asian Americans chronically infected with hepatitis B virus

Hyun, Chul S.; Ventura, William R.; Kim, Soon S.; Yoon, Soyoung; Lee, Seulgi

doi:10.1186/s41124-016-0006-8

Cited by 8 publications

(8 citation statements)

References 17 publications

(26 reference statements)

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“…The PN offered a culturally and linguistically tailored navigator program in coordinating access to clinical care by providing the subjects with the available healthcare resources in the community. The PN initially assessed each subject to determine his or her background and needs, and subsequently communicated with the subjects to direct them to meet 37 The high linkage rate of 88% from the CHB group in the current study also supports the critical role of the PN program in facilitating the linkage.…”

Section: Role Of the Patient Navigator In Linkagementioning

confidence: 72%

Patient Navigator Facilitated Text Messaging Intervention Improves Linkage to care in Viral Hepatitis B: A Pilot Study

Hyun¹,

Yoon²,

Kim³

et al. 2017

JournalMTM

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Background: Despite the high prevalence of chronic hepatitis B (CHB) in Asian Americans and other ethnic groups, a majority of these populations remains unscreened and unprotected. A large percentage of those who are chronically infected with hepatitis B virus (HBV) are not linked to care owing to a poor health care access. The purpose of this study was to evaluate the use of mobile text messaging in engaging individuals with hepatitis B or at risk for it, and to assess their acceptance of text messaging interventions. Materials and Methods:A total of 32 individuals who were either chronically infected with HBV or non-immune to HBV were assigned to a patient navigator (PN), who subsequently arranged for the subjects to communicate through text messaging. The frequency and contents of messages between the subjects and the PN were evaluated. After the three month intervention period, results on linkage to care (LTC) were obtained. A self-report questionnaire was employed to assess the subjects' feedback on the use of text messaging.Results: All of 32 participants responded to the PNs with either text messaging or phone calls. The most frequent message themes were finding doctors and appointment reminders. Fourteen of 16 HBV infected subjects were linked to physicians, and all of 16 non-immune subjects received one or two vaccinations. The survey revealed strong receptivity to and acceptance of the use of text messaging.Conclusions: Mobile text messaging intervention provides a platform for patients to engage with medical personnel, thereby improving their access to healthcare.

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Section: Role Of the Patient Navigator In Linkagementioning

confidence: 72%

Patient Navigator Facilitated Text Messaging Intervention Improves Linkage to care in Viral Hepatitis B: A Pilot Study

Hyun¹,

Yoon²,

Kim³

et al. 2017

JournalMTM

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“…The continual monitoring and management of CHB patients are paramount in successful linkage in care of CHB. Although our study did not employ a control group, followed in the absence of a community campaign, the current and previous studies have demonstrated a significant lack of LTC in HBV infected patients [6, 9, 11, 12, 18]. For instance, it was estimated that 40% of the HBV infected subjects screened in community settings were linked to care [16, 17].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, increasing health literacy may help improve patients’ understanding of the need for LTC, and that understanding will, in turn, lead to higher demand for access to care and thus for health insurance. Further, a patient navigator program, which has been shown to enhance access to care in hepatitis B [12, 29, 30], may be implemented to further facilitate LTC efforts.…”

Section: Discussionmentioning

confidence: 99%

“…More important, many of the CHB patients who are aware of their infections are not accessing care. The current lack of access to care is attributable to numerous barriers known to impede adequate healthcare access in ethnic minority populations, resulting in poor LTC [9–12]. LTC, which refers to a first visit to a physician following the diagnosis of chronic HBV infection, is an essential step in engaging patients chronically infected with HBV and persuading them to get follow-up care.…”

Section: Introductionmentioning

confidence: 99%

“…More recently, in 2011, the US Department of Health and Human Services (HHS) introduced its “Action Plan for the Prevention, Care and Treatment of Viral Hepatitis” to provide a roadmap for educating providers and communities, and to improve LTC to reduce the impact of CHB in high risk populations [13, 14]. Despite all these efforts, a majority of infected persons may remain unaware of their infections, and only a small proportion of the infected population is accessing adequate care [9–12].…”

Section: Introductionmentioning

confidence: 99%

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Long term outcome of a community-based hepatitis B awareness campaign: eight-year follow-up on linkage to care (LTC) in HBV infected individuals

Hyun

Ko²,

Lee

et al. 2019

BMC Infect Dis

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Background Chronic hepatitis B (CHB) is a major cause of liver-related morbidity and mortality. High HBV prevalence in immigrants and ethnic minorities and numerous barriers to healthcare access are associated with serious health disparities in the United States. Reportedly, self-awareness of HBV infection is low, suggesting a greater need for effective screening and education. Further, low levels of linkage to care (LTC) (completion of a first doctor’s visit after the diagnosis of chronic HBV infection) may be responsible for the lack of engagement over the continuum of care and for needed services. Methods Demographics and survey data were obtained from 97 Korean American adults chronically infected with HBV, initially identified through a series of community screening events in northern New Jersey between Dec. 2009 and June 2015. Eight year follow-up on these HBV-infected individuals was obtained to determine their access to care, and thus the efficacy of a campaign to improve LTC. The participants’ self-awareness of HBV infection and other factors for LTC were also evaluated. Results Of a total of 97 HBV-infected participants (age range 30 to 79), 74 were aware of their infections at screening. The remaining 23 had been unaware of their infections until screening. Eight years after the campaign, some 66 of these 97 individuals accessed care (LTC rate 68%). Health insurance status, presence or absence of symptoms and level of knowledge of CHB were among the most significant factors in LTC. Conclusion A community-based hepatitis B screening and education campaign can be instrumental in prompting HBV infected individuals to access care, as demonstrated in the cumulative increase in LTC in our cohort. Despite many years of awareness of HBV infection, many are not accessing care owing to a lack of health insurance, suggesting a pressing need for advocacy and health education to improve access to affordable coverage in the Asian American population. Community efforts and strategies similar to the ones employed in the current study may serve as a model to improve the engagement of HBV-infected individuals in high risk immigrant populations.

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Hepatitis B virus screening in Asian immigrants: Community‐based campaign to increase screening and linkage to care: A cross‐sectional study

Win

King

et al. 2023

Health Science Reports

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Background and Aims: Despite established screening guidelines, many Asian immigrants remain unscreened. Furthermore, those with chronic hepatitis B (CHB) are not linked to care citing multiple barriers. The objective of this study was to determine the role of our community-based hepatitis B virus (HBV) campaign on HBV screening and the success of linkage to care (LTC) efforts.Methods: Asian immigrants from the New Jersey and New York metropolitan areas were screened for HBV from 2009 to 2019. We started to collect LTC data starting in 2015, and those found to be positive were followed up. In 2017, because of low LTC rates, nurse navigators were hired to aid in the LTC process. Those excluded from the LTC process included those who were already linked to care, declined, and/ or had moved or passed away.Results: Total of 13,566 participants were screened from 2009 to 2019, of which, the results for 13,466 were available. Of these, 372 (2.7%) were found to have positive HBV status. Approximately 49.3% were female and 50.1% were male, and the rest were of unknown gender. A total of 1191 (10.0%) participants were found to be HBV negative but required vaccination. When we started to track LTC, we found 195 participants that were eligible for LTC between 2015 and 2017 after the exclusion criteria were applied. It was found that only 33.8% were successfully linked to care in that time period. After hiring nurse navigators, we saw LTC rates increase to 85.7% in 2018 and to 89.7% in 2019. Conclusion:HBV community screening initiatives are imperative to increase screening rates in the Asian immigrant population. We were also able to demonstrate that nurse navigators can successfully help increase LTC rates. Our HBV community screening model can address issues with barriers to care including lack of access in comparable populations.

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A community- based hepatitis B linkage-to-care program: a case study on Asian Americans chronically infected with hepatitis B virus

Cited by 8 publications

References 17 publications

Patient Navigator Facilitated Text Messaging Intervention Improves Linkage to care in Viral Hepatitis B: A Pilot Study

Patient Navigator Facilitated Text Messaging Intervention Improves Linkage to care in Viral Hepatitis B: A Pilot Study

Long term outcome of a community-based hepatitis B awareness campaign: eight-year follow-up on linkage to care (LTC) in HBV infected individuals

Hepatitis B virus screening in Asian immigrants: Community‐based campaign to increase screening and linkage to care: A cross‐sectional study

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