Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals

Sweeney, Lorna; Owiti, John Arianda; Beharry, Andrew; Bhui, Kamaldeep; Gomes, Jéssica Menezes; Foster, Graham R.; Greenhalgh, Trisha

doi:10.1186/s12913-015-0746-y

Cited by 31 publications

(39 citation statements)

References 64 publications

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“…Examination of knowledge levels, awareness and misconceptions held by individuals within the target populations found common misconceptions regarding transmission routes, participants erroneously identifying sharing food and utensils as a route of infection . Transmission by sexual intercourse was correctly identified by 50%‐66% of survey respondents and 80% of patients with CHB .…”

Section: Resultsmentioning

confidence: 94%

Improving access to health care for chronic hepatitis B among migrant Chinese populations: A systematic mixed methods review of barriers and enablers

Vedio

Liu

Lee

et al. 2017

Journal of Viral Hepatitis

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SummaryMigrant Chinese populations in Western countries have a high prevalence of chronic hepatitis B but often experience poor access to health care and late diagnosis. This systematic review aimed to identify obstacles and supports to timely and appropriate health service use among these populations. Systematic searches resulted in 48 relevant studies published between 1996 and 2015. Data extraction and synthesis were informed by models of healthcare access that highlight the interplay of patient, provider and health system factors. There was strong consistent evidence of low levels of knowledge among patients and community members; but interventions that were primarily focused on increasing knowledge had only modest positive effects on testing and/or vaccination. There was strong consistent evidence that Chinese migrants tend to misunderstand the need for health care for hepatitis B and have low satisfaction with services. Stigma was consistently associated with hepatitis B, and there was weak but consistent evidence of stigma acting as a barrier to care. However, available evidence on the effects of providing culturally appropriate services for hepatitis B on increasing uptake is limited. There was strong consistent evidence that health professionals miss opportunities for testing and vaccination. Practitioner education interventions may be important, but evidence of effectiveness is limited. A simple prompt in patient records for primary care physicians improved the uptake of testing, and a dedicated service increased targeted vaccination coverage for newborns. Further development and more rigorous evaluation of more holistic approaches that address patient, provider and system obstacles are needed.

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Section: Resultsmentioning

confidence: 94%

Improving access to health care for chronic hepatitis B among migrant Chinese populations: A systematic mixed methods review of barriers and enablers

Vedio

Liu

Lee

et al. 2017

Journal of Viral Hepatitis

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show abstract

“…Our ndings hence have implications in terms of hepatitis and HIV prevention and health promotion. Health interventions will not be achieved in this migrant community without a strong involvement of the community itself (17) and a change in several practices and norms. Actions proposed hereby derive from discussions with interviewees and from the FGD, and are embedded in the Sorenson model (20).…”

Section: Implications For Health Promotion Interventionsmentioning

confidence: 99%

“…We strongly propose that in this case, health promotion including prevention interventions, need to be developed in partnership with communities (17).…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Cailhol

Khan

2020

Preprint

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BackgroundSeine-Saint-Denis is a deprived departement (French administrative unit) in the North-East of Paris, France, hosting the majority of South Asian migrants in France. In recent years, the number of migrants from Pakistan, which has a high prevalence of hepatitis C globally, increased. As a corollary, this study addressed the high proportion of Pakistani patients in the infectious diseases clinic of a local hospital, diagnosed with hepatitis C, but also hepatitis B and Human Immunodeficiency Virus (HIV). It explored genealogies and beliefs about hepatitis and HIV transmission, including community, sexual and blood risk behaviours. The aim was to understand the ways these risk factors reduce or intensify both en route and once in France, in order to devise specific forms of community health intervention.MethodsThe study took place at Avicenne University-Hospital in Seine-Saint-Denis, and its environs, between July and September 2018. The design of the study was qualitative, combining semi-structured interviews, a focus group discussion, and ethnographic observations. The sample of Pakistani participants were selected from those followed-up for chronic hepatitis C, B, and/or HIV at Avicenne, and who had arrived after 2010 in Seine-Saint-Denis.ResultsThirteen semi-structured interviews were conducted, until saturation was reached. All participants were men from rural Punjab province. Most took the Eastern Mediterranean human smuggling route. Findings suggest that vulnerabilities to hepatitis and HIV transmission, originating in Pakistan, are intensified along the migration route and perpetuated in France. Taboo towards sexuality, promiscuity in cohabitation conditions, lack of knowledge about transmission were amongst the factors increasing vulnerabilities. Participants suggested a number of culturally-acceptable health promotion interventions in the community, such as outreach awareness and testing campaigns in workplaces, health promotion and education in mosques, as well as web-based sexual health promotion tool to preserve anonymity. ConclusionsOur findings highlight the need to look at specific groups at risk, related to their countries of origin. In-depth understandings of such groups, using interdisciplinary approaches such as were employed here, can allow for culturally adapted, tailored interventions. However, French colour-blind policies do not easily permit such kinds of targeted approach and this limitation requires further debate.

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“…Health interventions will not be achieved in this migrant community without a strong involvement of the community itself (21) and a change in several practices and norms. Actions proposed hereby derive from discussions with interviewees and from the FGD, and are embedded in the Sorenson model (23).…”

Section: Implications For Health Promotion Interventionsmentioning

confidence: 99%

“…Finally, we considered opportunities for community-level prevention in France, together with participants and with community-stakeholders. Indeed, health promotion including prevention interventions, need to be built with communities (21).…”

Section: Introductionmentioning

confidence: 99%

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Cailhol

Khan

2019

Preprint

View full text Add to dashboard Cite

show abstract

Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals

Cited by 31 publications

References 64 publications

Improving access to health care for chronic hepatitis B among migrant Chinese populations: A systematic mixed methods review of barriers and enablers

Improving access to health care for chronic hepatitis B among migrant Chinese populations: A systematic mixed methods review of barriers and enablers

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

Chronic hepatitis and HIV risks amongst Pakistani migrant men in a French suburb and insights into health promotion interventions: the ANRS Musafir qualitative study

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