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Ibrahim Y, Zovich B, Ansah B, Freeland C, Jackson M, Tu T, Cohen C. Quality of life of people living with chronic hepatitis B: The role of social support system. PLOS Glob Public Health 2024; 4:e0003103. [PMID: 38669220 PMCID: PMC11051608 DOI: 10.1371/journal.pgph.0003103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 03/20/2024] [Indexed: 04/28/2024]
Abstract
People living with chronic hepatitis B (PLCHB) are recommended to follow a lifelong monitoring regimen and face increased risk of liver cancer. Additionally, PLCHB frequently encounter stigma and discrimination, and relationship disruptions because of their chronic hepatitis B (CHB). Social support plays a key role in coping with chronic illnesses; however, this is inadequately assessed for PLCHB. This study aims to assess the physical, social, and mental impacts of living with CHB, the strategies PLCHB utilize to cope with their disease, and how social support-or lack of-impacts their journey with hepatitis B. The study was promoted through the Hepatitis B Foundation social media platforms, interested individuals filled-in a form expressing their interest to participate. The researcher conducted 24 telephone interviews in English, with PLCHB ≥18 years of age residing in the United States (U.S.) and Canada. Questions focused on the lived experiences of CHB and explored social support mechanisms that helped PLCHB. PLCHB experience a wide range of impacts (physical, social, and mental) that negatively affect their quality of life. Participants reported that receiving social support from their close network of individuals, hepatitis B community, or healthcare providers positively influenced their perspective on their future health and helped them adhere to treatment. The physical, social, and mental impacts of living with hepatitis B significantly affect the quality of life of PLCHB, calling for more research to document these impacts, and design integrated care models to address them. Social support appears to play an essential role in helping PLCHB cope with their disease and should be further studied.
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Affiliation(s)
- Yasmin Ibrahim
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Beatrice Zovich
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Bright Ansah
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Catherine Freeland
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Michaela Jackson
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Thomas Tu
- Storr Liver Centre, Westmead Clinical School and Westmead Institute for Medical Research, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
- Sydney Institute for Infectious Diseases, University of Sydney at Westmead Hospital, Westmead, Australia
- HepBCommunity.org, Sydney, Australia
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
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Zovich B, Freeland C, Moore H, Sapp K, Qureshi A, Holbert R, Zambrano J, Bhangoo D, Cohen C, Hass RW, Jessop A. Dismantling Barriers to Hepatitis B and Delta Screening, Prevention, and Linkage to Care among the PWUD Community in Philadelphia. Viruses 2024; 16:628. [PMID: 38675969 PMCID: PMC11054430 DOI: 10.3390/v16040628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024] Open
Abstract
The prevalence of hepatitis B and delta viruses (HBV/HDV) among people who use drugs (PWUD) remains largely unknown. In the context of one Philadelphia-based harm reduction organization (HRO), this study aimed to assess HBV/HDV prevalence and facilitate linkage to care. Participants completed a demographic HBV/HDV risk factor survey and were screened for HBV and reflexively for HDV if positive for HBV surface antigen or isolated core antibody. Fisher's exact tests and regression were used to understand relationships between risks and HBV blood markers. Of the 498 participants, 126 (25.3%) did not have hepatitis B immunity, 52.6% had been vaccinated against HBV, and 17.9% had recovered from a past infection. Eleven (2.2%) participants tested positive for isolated HBV core antibody, 10 (2.0%) for HBV surface antigen, and one (0.2%) for HDV antibody. History of incarceration was associated with current HBV infection, while transactional sex and experience of homelessness were predictive of previous exposure. This study found high rates of current and past HBV infection, and a 10% HBV/HDV co-infection rate. Despite availability of vaccine, one quarter of participants remained vulnerable to infection. Findings demonstrate the need to improve low-threshold HBV/HDV screening, vaccination, and linkage to care among PWUD. The study also identified gaps in the HBV/HDV care cascade, including lack of point-of-care diagnostics and lack of support for HROs to provide HBV services.
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Affiliation(s)
| | | | - Holly Moore
- Hepatitis B Foundation, Doylestown, PA 18902, USA
| | - Kara Sapp
- Hepatitis B Foundation, Doylestown, PA 18902, USA
| | | | - Rachel Holbert
- HepTREC at Prevention Point Philadelphia, Philadelphia, PA 19134, USA
| | | | - Daljinder Bhangoo
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, PA 18902, USA
| | - Richard W. Hass
- Jefferson College of Population Health, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Amy Jessop
- HepTREC at Prevention Point Philadelphia, Philadelphia, PA 19134, USA
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Freeland C, Adjei C, Wallace J, Wang S, Hicks J, Adda D, James C, Cohen C. Survey of lived experiences and challenges in hepatitis B management and treatment. BMC Public Health 2024; 24:944. [PMID: 38566070 PMCID: PMC10986103 DOI: 10.1186/s12889-024-18425-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
Almost 300 million people are living with chronic hepatitis B infection worldwide and most remain undiagnosed and at risk for liver cancer. In 2015 the World Health Organization (WHO) developed guidelines for the prevention, care, and treatment of persons with chronic hepatitis B and in early 2023 began to work on updating these guidelines. In March 2023, a self-administered, anonymous online survey was launched, aiming to identify patient preferences related to the clinical management of hepatitis B including current management, treatment, and care experiences, preferences regarding engagement with providers, and preferences related to simplifying hepatitis B care access. A sample of 560 individuals living with hepatitis B (self-identified as HBsAg positive) from 76 countries completed the survey. Key findings demonstrated that less than half (49%, N = 268) of participants regularly visited a doctor to check the health of their liver (every 6-12 months), with 37% of participants prescribed antiviral medication by a specialist (82%, N = 167) or general practitioner (13%, N = 26). Participants reported not being actively involved in care decision making with their providers (42%, N = 217), with an overwhelming majority wanting to participate in hepatitis B management and treatment choices (85%, N = 435). Participants provided qualitative and quantitative details using open-ended responses within the survey about challenges with medication affordability and receiving care from a knowledgeable provider. Overall findings demonstrated key gaps in care, management, and treatment access related to hepatitis B: identifying these gaps can be used to identify areas for improvement along the care continuum for viral hepatitis. The survey found a need for the comprehensive simplification of clinical management and health care services related to hepatitis B. A thematic analysis of the open-ended survey responses highlighted major overarching themes including the cost and access burdens associated with hepatitis B management and treatment, and challenges in finding knowledgeable providers. Results from this mixed methods survey were used to inform the WHO hepatitis B guidelines update. Efforts should continue to explore public health approaches to address barriers and facilitators to testing, care, and treatment for people with hepatitis B to improve awareness of hepatitis B and access, care, and treatment among patients and providers.
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Affiliation(s)
| | | | - Jack Wallace
- Burnet Institute, Melbourne, Australia
- Centre for Social Research in Health, University of New South Wales, Sydney, Australia
| | - Su Wang
- Saint Barnabas Medical Center, Livingston, NJ, USA
| | | | - Danjuma Adda
- World Hepatitis Alliance, London, UK
- CFID Taraba, Taraba, Nigeria
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Freeland C, Lo W, Kabagambe K, Wang S, Adda D, Graham CS, Gish R, Cohen C. Urgent need for lived experience in hepatitis B guideline development. Lancet Gastroenterol Hepatol 2024; 9:282-284. [PMID: 38272054 DOI: 10.1016/s2468-1253(23)00455-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024]
Affiliation(s)
| | - Wendy Lo
- Hepatitis B Foundation, Doylestown, PA, USA
| | - Kenneth Kabagambe
- The National Organisation for People Living with Hepatitis B, Kampala, Uganda
| | - Su Wang
- Hepatitis B Foundation, Doylestown, PA, USA; Center for Asian Health & Viral Hepatitis Programs, Cooperman Barnabas Medical Center, Livingston, NJ, USA
| | | | - Camilla S Graham
- Division of Infectious Diseases, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Huỳnh TB, Tina Nguyễn D, Vũ N, Carroll-Scott A, Wong C, Freeland C, Parvanta C. Perceived Benefits and Barriers to Implementing Occupational Health Recommendations Among Immigrant-Owned Nail Salons in the Greater Philadelphia Region. Health Promot Pract 2024; 25:77-86. [PMID: 36924273 DOI: 10.1177/15248399231160461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Introduction. Immigrant nail salon owners and employees face multiple barriers to accessing occupational health training and services. We formed an academic-community-based organization-business owner partnership-unique in that all partners were culturally congruent-to develop a pilot intervention program for the nail salon community. Methods. Eighteen individuals (nine salon owners and nine employees) from the Greater Philadelphia region received the training in their native language and provided feedback through in-depth qualitative interviews. Interview guide was developed using the Consolidated Framework for Implementation Research (CFIR). Themes of perceived benefits and barriers were identified and aligned with relevant CFIR constructs to gain better understanding of the implementation challenges. Results. Reported benefits of program were improved knowledge of the workplace hazards and safety practices, and the potential to attract more customers and retain employees. Perceived barriers to implementing recommended practices were limited availability of safer products and high cost, challenges communicating with customers, lack of engagement from some owners, organizational management practices affecting employees' motivation, and limited partnership with local government to assist small immigrant-owned businesses. Conclusions. Our study revealed multiple factors that pit long-term health protection of nail salon workers against the economic viability of the businesses that employ them. Our research highlights the need to (1) advocate for federal policies making safer products to be more accessible to the masses, (2) establish local policy and culturally appropriate technical support programs that engage community-based organizations, and (3) develop economic opportunities and mentorship for immigrant entrepreneurs to operate profitable healthy salons.
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Affiliation(s)
| | | | - Nga Vũ
- VietLead, Philadelphia, PA, USA
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Freeland C, Sreepathi V, Hass RW, Fenkel JM, Torgersen J, Rothstein K, Cohen C, Gish RG. The importance of triple panel testing for hepatitis B and the burden of isolated anti-hepatitis B core antibodies within a community sample. J Virus Erad 2023; 9:100358. [PMID: 38174110 PMCID: PMC10761777 DOI: 10.1016/j.jve.2023.100358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Within the United States (US), 2.4 million individuals are living with chronic hepatitis B, but less than 20% are diagnosed. Isolated anti-hepatitis B core (iAHBc) antibodies indicate serology in an individual that is positive for anti-HBc antibodies, while negative for surface antigen (HBsAg) and surface antibodies (anti-HBs). A result of iAHBc could indicate a chronic occult bloodstream infection, necessitating further testing. This study assesses the prevalence and risk factors associated with anti-HBc and iAHBc within community high-risk screening in Greater Philadelphia. Participants (n = 177) were screened for HBsAg, anti-HBs, and anti-HBc during community screening events in 2022. Chi-square tables and Firth logistic regression were used to describe the data and to assess the odds of iAHBc. The findings indicate that there was an iAHBc prevalence of 7.3% (n = 13) within our study. The odds of anti-HBc were increased for immigrants from the Western Pacific (4.5%) and Africa (11.9%). Individuals born in Africa had 7.93 greater odds for iAHBc than those born in the Americas, and these odds are multiplied by 1.01 for every 1-year increase in age. Our data show a high burden of iAHBc within high-risk and often hard-to-reach communities. Triple panel screening should be incorporated into all HBV screening programs, in accordance with current Centers for Disease Control and Prevention (CDC) universal screening recommendations, to ensure a comprehensive picture of the disease burden and reduce the risk of missing people with occult hepatitis B and those at risk for viral reactivation or liver complications.
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Affiliation(s)
| | - Vivek Sreepathi
- Thomas Jefferson University, College of Population Health Science, Philadelphia, PA, USA
| | - Richard W. Hass
- Thomas Jefferson University, College of Population Health Science, Philadelphia, PA, USA
| | - Jonathan M. Fenkel
- Thomas Jefferson University, Sidney Kimmel Medical College, Philadelphia, PA, USA
| | - Jessie Torgersen
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - Kenneth Rothstein
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
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Wang M, Qureshi A, Johnson N, Mansalay A, Muhr A, Abatemarco DJ, Freeland C. A Health Belief Model Examination of Factors Related to Hepatitis B Screening Among African Immigrants in Philadelphia. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01841-w. [PMID: 37878235 DOI: 10.1007/s40615-023-01841-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
Chronic hepatitis B infection is a leading cause of liver cancer worldwide. In the USA, African immigrants (AI) have high hepatitis B virus (HBV) infection rates but low HBV knowledge and screening rates. Research about HBV among AI living in Philadelphia is particularly limited. This study aims to assess barriers to and factors influencing HBV screening in the Philadelphia AI population. African and Caribbean-born adults in Greater Philadelphia were recruited for phone interviews at community health fairs hosted by the African Cultural Alliance of North America (ACANA) and the African Family Health Organization (AFAHO) in partnership with the Hepatitis B Foundation. Seventeen interviews were recorded, transcribed, and coded independently by two members of the research team using NVivo software. Themes and subthemes were created by analysis of the codes and arranged under Health Belief Model (HBM) concepts. Major perceived barriers included lack of HBV knowledge and awareness and cultural challenges related to health care access, preventive care, fear, and stigma. Participants recommended using community organizations and programs to spread awareness about HBV and serve as cues to action. In-person education was emphasized due to lack of access to and knowledge of technology such as Zoom. While HBV educational sessions have been implemented in this population, they have not been consistent or far-reaching. The results of this study can contribute to the implementation of a comprehensive AI-specific HBV education and screening program through partnerships with community organizations to ensure that all high-risk individuals in the Philadelphia area are screened.
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Affiliation(s)
- Makala Wang
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Nettie Johnson
- African Cultural Alliance of North America, Philadelphia, PA, USA
| | - Abu Mansalay
- African Cultural Alliance of North America, Philadelphia, PA, USA
| | - Ava Muhr
- African Cultural Alliance of North America, Philadelphia, PA, USA
| | | | - Catherine Freeland
- Hepatitis B Foundation, Doylestown, PA, USA.
- Thomas Jefferson University, Philadelphia, PA, USA.
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Freeland C, Kanu F, Mohammed Y, Nwokoro UU, Sandhu H, Ikwe H, Uba B, Asekun A, Akataobi C, Adewole A, Fadahunsi R, Wisdom M, Akudo OL, Ugbenyo G, Simple E, Waziri N, Vasumu JJ, Bahuli AU, Bashir SS, Isa A, Ugwu GO, Obi EI, Binta H, Bassey BO, Shuaib F, Bolu O, Tohme RA. Barriers and facilitators to hepatitis B birth dose vaccination: Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria. PLOS Glob Public Health 2023; 3:e0001332. [PMID: 37289735 DOI: 10.1371/journal.pgph.0001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/04/2023] [Indexed: 06/10/2023]
Abstract
Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowledge, limited availability of HepB-BD to vaccination days only, misconceptions about HepB-BD vaccination, challenges in health facility staffing capacity, costs associated with vaccine transportation, and concerns related to vaccine wastage. Facilitators of timely HepB-BD vaccination included: vaccine availability, storage, and hospital births occurring during immunization days. Overarching themes identified as barriers among pregnant women were lack of hepatitis B knowledge, limited understanding of HepB-BD importance, and limited access to vaccines for births occurring outside of a health facility. Facilitators were high vaccine acceptance and willingness for their infants to receive HepB-BD if recommended by providers. Findings indicate the need for enhanced HepB-BD vaccination training for HCWs, educating pregnant women on HBV and the importance of timely HepB-BD, updating policies to enable HepB-BD administration within 24 hours of birth, expanding HepB-BD availability in public and private hospital maternity wards for all facility births, and outreach activities to reach home births.
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Affiliation(s)
- Catherine Freeland
- Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America
| | - Florence Kanu
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Yahaya Mohammed
- Department of Medical Microbiology and Parasitology, College of Health Sciences, Usmanu Danfodiyo University, Sokoto, Nigeria
- African Field Epidemiology Network, Abuja, Nigeria
| | - Ugochukwu Uzoechina Nwokoro
- African Field Epidemiology Network, Abuja, Nigeria
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Hardeep Sandhu
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Hadley Ikwe
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Centers for Disease Control and Prevention Nigeria, Abuja, Nigeria
| | - Belinda Uba
- African Field Epidemiology Network, Abuja, Nigeria
- National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria
| | - Adeyelu Asekun
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Centers for Disease Control and Prevention Nigeria, Abuja, Nigeria
| | - Charles Akataobi
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Adefisoye Adewole
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Rhoda Fadahunsi
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Margeret Wisdom
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Okeke Lilian Akudo
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Gideon Ugbenyo
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Edwin Simple
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - Ndadilnasiya Waziri
- African Field Epidemiology Network, Abuja, Nigeria
- National Stop Transmission of Poliomyelitis, Abuja, Nigeria
| | - James Jacob Vasumu
- Adamawa State Primary Health Care Development Agency, Yola, Adamawa State, Nigeria
| | - Abubakar Umar Bahuli
- Adamawa State Primary Health Care Development Agency, Yola, Adamawa State, Nigeria
| | | | - Abdullahi Isa
- Adamawa State Primary Health Care Development Agency, Yola, Adamawa State, Nigeria
| | - George Onyemachi Ugwu
- Department of Obstetrics and Gynaecology, College of Medicine, University of Nsukka, Nsukka, Nigeria
- Enugu State Primary Health Care Development Agency, Enugu, Nigeria
| | | | - Haj Binta
- National Emergency Routine Immunization Coordination Centre, Abuja, Nigeria
- Department of Community Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria/ University of Nigeria Teaching Hospital, Enugu, Nigeria
| | | | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Omotayo Bolu
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- Centers for Disease Control and Prevention Nigeria, Abuja, Nigeria
| | - Rania A Tohme
- Global Immunization Division, United States, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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Silliman M, Alber JM, Gib S, Gee M, Conover S, Chan C, Cohen C, Freeland C, Racho R. Comparing lengths and inclusion of information in storytelling videos: Implications for Hepatitis B education. PEC Innov 2022; 1:100049. [PMID: 37213761 PMCID: PMC10194295 DOI: 10.1016/j.pecinn.2022.100049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/21/2022] [Accepted: 05/04/2022] [Indexed: 05/23/2023]
Abstract
Objectives This study examined whether adding disease-specific facts into storytelling videos and altering video length would lead to differences in overall ratings of the video and the storyteller, as well as hepatitis B prevention beliefs, among Asian American and Pacific Islander adults. Methods A sample of Asian American and Pacific Islander adults (N = 409) completed an online survey. Each participant was randomly assigned to 1 of 4 conditions that varied in video length and use of additional hepatitis B facts. Linear regressions were used to examine differences in outcomes (i.e., video rating, speaker rating, perceived effectiveness, hepatitis B prevention beliefs) by conditions. Results Condition 2, which added facts to the original full-length video, was significantly related to higher speaker ratings (i.e., the storyteller's rating) compared to Condition 1, the original full-length video with no added facts, p = 0.016. Condition 3, which added facts to the shortened video, was significantly related to lower overall video ratings (i.e., how much participants liked the videos overall) compared to Condition 1, p = 0.001. There were no significant differences in higher positive hepatitis B prevention beliefs across conditions. Conclusions Results suggest that adding disease-specific facts to storytelling for patient education may improve initial perceptions of storytelling videos; however, more research is needed to examine long-term effects. Innovation Aspects of storytelling videos such as length and additional information have been rarely explored in storytelling research. This study provides evidence that exploring these aspects is informative to future storytelling campaigns and disease-specific prevention.
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Affiliation(s)
- Miriam Silliman
- California Polytechnic State University, Department of Kinesiology and Public Health, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA 93401, USA
| | - Julia M. Alber
- California Polytechnic State University, Department of Kinesiology and Public Health, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA 93401, USA
- Corresponding author at: Department of Kinesiology and Public Health, Center for Health Research, California Polytechnic State University, 1 Grand Avenue, Office 43A-367, San Luis Obispo, CA 93407, USA.
| | - Siena Gib
- California Polytechnic State University, Department of Kinesiology and Public Health, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA 93401, USA
| | - Michelle Gee
- California Polytechnic State University, Department of Kinesiology and Public Health, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA 93401, USA
| | - Sydney Conover
- California Polytechnic State University, Department of Kinesiology and Public Health, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA 93401, USA
| | - Cindi Chan
- California Polytechnic State University, Department of Kinesiology and Public Health, San Luis Obispo, 1 Grand Avenue, San Luis Obispo, CA 93401, USA
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA, 18902, USA
| | - Catherine Freeland
- Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA, 18902, USA
| | - Rhea Racho
- Hepatitis B Foundation, 3805 Old Easton Road, Doylestown, PA, 18902, USA
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Ha YP, Sun Y, Wilkinson J, Wang S, Chien L, Wu M, Wang E, Freeland C. Implementation and outcomes of a remote hepatitis B screening program designed to overcome COVID‐19 pandemic‐related disruptions to community‐based screenings for Asians in Greater Philadelphia: A descriptive study. Health Sci Rep 2022; 5:e761. [PMID: 35949689 PMCID: PMC9358531 DOI: 10.1002/hsr2.761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yoonhee P. Ha
- Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
- Community Scholars‐in‐Residence Program, Community Engagement and Research Core University of Pennsylvania Philadelphia Pennsylvania USA
- Center for Public Health Initiatives University of Pennsylvania Philadelphia Pennsylvania USA
- Penn Medicine Center for Health Equity Advancement Philadelphia Pennsylvania USA
- Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia Pennsylvania USA
| | - Yusha Sun
- Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Jack Wilkinson
- Department of Psychiatry, Weill Cornell Medicine Child and Adolescent Psychiatry Fellowship Program New York‐Presbyterian Hospital and Columbia College of Physicians and Surgeons New York New York USA
| | - Sonia Wang
- Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Lillian Chien
- Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
| | - Marisa Wu
- Sidney Kimmel Medical College Thomas Jefferson University Philadelphia Pennsylvania USA
| | | | - Catherine Freeland
- Hepatitis B Foundation Doylestown Pennsylvania USA
- College of Population Health Thomas Jefferson University Philadelphia Pennsylvania USA
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Freeland C, Mendola L, Cheng V, Cohen C, Wallace J. The unvirtuous cycle of discrimination affecting people with hepatitis B: a multi-country qualitative assessment of key-informant perspectives. Int J Equity Health 2022; 21:77. [PMID: 35642059 PMCID: PMC9158347 DOI: 10.1186/s12939-022-01677-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
Background An estimated 296 million individuals live with chronic hepatitis B worldwide, most have not been diagnosed and remain at risk of liver disease and cancer. People with hepatitis B often face discrimination that denies them employment or education opportunities, results in unfair treatment at work or in school, limits their ability to emigrate to certain countries, and in some cases prohibits them from serving in the military. Discrimination specific to hepatitis B has not been widely documented within the literature. This study aims to investigate and describe hepatitis B related discrimination, document discrimination occurring around the globe, and provide initial recommendations for addressing discrimination using key informant interviews. Methods Purposive and snowball sampling were used to identify potential key informants for qualitative interview. Key informants identified as community health leaders, public health scientists, doctors, and researchers, many of whom were also living with hepatitis B. Using a semi-structured guide, participants were asked to describe their experience and any challenges for people living with hepatitis B including marginalization and its’ consequences. A codebook was used to guide the organization of data for analysis, and all transcripts N = 17 were double coded. Results The overarching themes identified from interviews demonstrate explicit experiences with discrimination of those directly affected, the psychological responses, and the negative health outcomes associated with the unvirtuous cycle of discrimination. All key informants reported on the substantial quality of life implications and often poorer health outcomes resulting from hepatitis B discrimination. Participants also identified the significant impact of hepatitis B discrimination occurring within a range of education-based services across several countries as well as military exclusion or removal if individuals are found to have hepatitis B. Conclusion Our data demonstrate that hepatitis B discrimination has a significant impact. Discrimination can occur at various points in life from education, to seeking employment, to marriage, to restrictions on entry, travel and stay in other countries. This study demonstrates the impact of discrimination and the need for future research that can lead to policy change and protections for people living with and impacted by hepatitis B.
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Affiliation(s)
| | - Lindsay Mendola
- Temple University, 1801 N Broad St, Philadelphia, PA, 19122, USA
| | - Vivian Cheng
- Arcadia University, 450 S Easton Rd, Glenside, PA, 19038, USA
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Rd, Doylestown, PA, 18902, USA
| | - Jack Wallace
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.,Center for Social Research in Health, UNSW, Sydney, NSW, 2052, Australia.,La Trobe University, Bundoora, VIC, 3086, Australia
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12
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Kheir OO, Freeland C, Abdo AE, Yousif MEM, Altayeb EO, Mekonnen HD. Assessment of Hepatitis B knowledge and awareness among the Sudanese population in Khartoum State. Pan Afr Med J 2022; 41:217. [PMID: 35721651 PMCID: PMC9167479 DOI: 10.11604/pamj.2022.41.217.30390] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 01/28/2022] [Indexed: 11/11/2022] Open
Abstract
Introduction globally it is estimated that majority of the burden of hepatitis B virus infection is in sub-Saharan African countries (SSA). Africa is also hit by a dreadful complication of hepatocellular carcinoma and sequalae of end-stage liver disease. Despite this, the knowledge and awareness of the population to this silent killer is largely unknown. The aim of this study was to assess the knowledge and awareness of hepatitis B virus among the general population within Sudan to understand the misconceptions and provide a better direction toward the disease elimination goals. Methods a community-based study was carried out in three locations in Khartoum state during a community hepatitis awareness campaign, where participants were provided education, screening, and vaccine. Data were collected after proper consent was obtained from the respective Institutional Review Board (IRB) office. Basic demographic characteristics, knowledge assessment questions, and awareness were used, which are derived from standard questionnaire. Finally, basic descriptive statistics were undergone to assess the knowledge and awareness of the participants. Results the study has shown that self-reported hepatitis B among the participants was 9.6%. There are areas of hepatitis B misconception in knowledge and awareness related to transmission, modes of prevention and disease state. We have also noticed that prior vaccine coverage was low among the groups, which is also another major concern. Conclusion the prevalence of hepatitis B from these randomly selected population groups is high. There is also lower vaccine coverage and many misconceptions in knowledge and awareness of hepatitis B. Policymakers should consider these issues seriously to improve the gaps in hepatitis B.
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Affiliation(s)
- Omer Osman Kheir
- Research Unit, National Center for Gastrointestinal and Liver Diseases (NCGLD), Khartoum, Sudan
- Corresponding author: Omer Osman Kheir, Research Unit, National Center for Gastrointestinal and Liver Diseases (NCGLD), Khartoum, Sudan.
| | | | | | | | - Eilaf Osama Altayeb
- Research Unit, National Center for Gastrointestinal and Liver Diseases (NCGLD), Khartoum, Sudan
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13
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Freeland C, Racho R, Kamischke M, Moraras K, Wang E, Cohen C, Kendrick S. Health-related quality of life for adults living with hepatitis B in the United States: a qualitative assessment. J Patient Rep Outcomes 2021; 5:121. [PMID: 34757456 PMCID: PMC8581088 DOI: 10.1186/s41687-021-00398-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 2019, an estimated 296 million people were living with chronic hepatitis B virus (HBV) globally with approximately 2.4 million living within the United States. Those living with HBV require years if not decades of regular monitoring to prevent liver complications from occurring. The aim of this study was to explore the working conceptual framework of health related quality of life (HRQL) for those living with chronic HBV through qualitative analysis. METHODS Data were collected by in-depth telephone interviews conducted in 2019 using purposeful sampling as part of a disease understanding assessment on the HBV patient experience within the United States. A directed content analysis approach was utilized by creation of a codebook to guide the organization of data, codes were developed by review of the literature (a priori) and through line-by-line reading of a subsample of queries. All transcripts were analyzed by at least two members of the study team and intercoder reliability was assessed using Dedoose software. FINDINGS A sample of 19 individuals living with chronic HBV were included within this study. Themes identified from transcripts noted the significant overlap between the reported experience of HBV and constructs within the HRQL model. The psychological impact of chronic HBV on study participants' HRQL overall was considerable and contributed to depression, anxiety, homelessness, drug use, and incarceration. CONCLUSION Our analysis supports the hypothesis that HBV impacts HRQL and often negatively affects emotional health. Our findings suggest that it would be beneficial to include HRQL assessment in the medical management of HBV, so that interventions can focus on reducing the burden of disease and improving quality of life for those living with HBV.
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Affiliation(s)
- Catherine Freeland
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA.
| | - Rhea Racho
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Maureen Kamischke
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Kate Moraras
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Evangeline Wang
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
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14
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Freeland C, Racho R, Kamischke M, Moraras K, Wang E, Cohen C. Cure everyone and vaccinate the rest: The patient perspective on future hepatitis B treatment. J Viral Hepat 2021; 28:1539-1544. [PMID: 34363715 DOI: 10.1111/jvh.13592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/29/2021] [Accepted: 07/24/2021] [Indexed: 12/13/2022]
Abstract
Those living with chronic hepatitis B virus (HBV) require years, if not decades, of regular monitoring to prevent liver complications from occurring. An estimated 292 million people were living with chronic HBV globally in 2018 with approximately 2.4 million of those residing within the United States (US). This study is one of the first of its kind that aims to explore the treatment preferences for those living with chronic HBV through qualitative interviews. Participant data were collected by in-depth telephone interviews using a semi-structured discussion guide. A codebook guided the organization of data, and codes were developed by review of the literature (a priori) and through line-by-line reading of a subsample of queries. All data transcripts (N = 19) were independently double coded. Overarching themes identified from the data specific to the treatment modalities and implications of a functional HBV cure included the concern about side effects, treatment modality, frequency, duration, cost-effectiveness and overall impact on their lives. Qualitative data analysis revealed the significant impact that an HBV functional cure would have on quality of life. Benefits of a cure were described as not having a finite course of treatment, improving overall vitality, and reducing the fear and anxiety associated with lifelong infection and potential development of liver cancer. Many individuals expressed the desire for a cure for HBV, stating it would be life-changing, and a 'miracle'. As new therapies are in development, more research should examine in detail the treatment preferences of those living with HBV.
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Affiliation(s)
| | - Rhea Racho
- Hepatitis B Foundation, Doylestown, PA, USA
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15
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Freeland C, Huynh T, Vu N, Nguyen T, Cohen C. Understanding Knowledge and Barriers Related to Hepatitis B for Vietnamese Nail Salon Workers in the City of Philadelphia and Some of Its Environs. J Community Health 2021; 46:502-508. [PMID: 32700174 PMCID: PMC7855392 DOI: 10.1007/s10900-020-00878-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In the United States (U.S.), up to 2.2 million individuals have been chronically infected with hepatitis B virus (HBV). Many nail salon workers are at risk for HBV as they are coming from high-risk and traditionally underserved communities. To understand barriers and knowledge associated with HBV in the Vietnamese nail salon community, the Health Belief Model (HBM) was used to qualitatively assess the health needs for the prevention of HBV among Vietnamese nail salon workers in Philadelphia through focus groups and interviews (N = 19). Results revealed several themes that highlight barriers within the Vietnamese nail community. Major themes were the lack of knowledge related to hepatitis B, including significant misconceptions related to symptoms, and how hepatitis B is transmitted and prevented. There were also several barriers to health care access within the Vietnamese nail community including the cost of health care, long work hours, lack of insurance and lack of understanding of current community resources. Additionally, discrimination and stigma related to those infected with hepatitis B emerged as a theme from this data. Those interviewed also noted that the nail training and licensing they received did not highlight hepatitis B and other infectious diseases that can be spread within the nail salon.
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Affiliation(s)
| | - Tran Huynh
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Nga Vu
- Vietlead, 320 W. Oregon Ave, Philadelphia, PA, 19148, USA
| | - Tracy Nguyen
- Vietlead, 320 W. Oregon Ave, Philadelphia, PA, 19148, USA
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA, 18902, USA
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16
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Kumar P, Freeland C, Bodor S, Farrell S, Cohen C, Frasso R. Needs of Individuals Living With Hepatitis Delta Virus and Their Caregivers, 2016-2019. Prev Chronic Dis 2020; 17:E159. [PMID: 33337297 PMCID: PMC7769086 DOI: 10.5888/pcd17.200324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Hepatitis delta virus (HDV) is a serious coinfection of the hepatitis B virus (HBV) that is estimated to affect between 48 to 72 million people worldwide. Data are limited on the informational needs of people living with HDV. The Hepatitis B Foundation, a US-based nonprofit organization that provides support to people living with HBV and HDV, receives emails (queries) as part of a helpline, a service to provide information, resources, and support to people affected by HBV and HDV. Methods Query content was analyzed to assess the impact of HDV at the individual level. A total of 65 HDV-related queries from 17 countries were received from October 2016 to January 2019, and all were analyzed for this study. Results Thematic analysis of queries indicated 4 dominant themes. Three were related to a need for information about 1) the disease and prevention of it, 2) disease symptoms and outcomes, and 3) treatment options. The fourth theme was related to barriers and quality of life. Individuals requested information on treatment options, medication access, diagnostic test interpretation, and clinical trials. Conclusion Our study highlights the needs and lived experience of patients with HDV and summarizes critical information gaps. Findings can inform health care providers, public health professionals, and the pharmaceutical and biotechnology industries about the informational needs and lived experiences of individuals living with HDV and help create future HDV-related educational resources, care, and clinical trials.
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Affiliation(s)
- Priyanka Kumar
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania.,Jefferson College of Population Health, Philadelphia, Pennsylvania.,101 The City Drive S, Suite 400, Orange, CA 92868.
| | - Catherine Freeland
- Jefferson College of Population Health, Philadelphia, Pennsylvania.,Hepatitis B Foundation, Doylestown, Pennsylvania
| | - Sierra Bodor
- Hepatitis B Foundation, Doylestown, Pennsylvania
| | - Sean Farrell
- Jefferson College of Population Health, Philadelphia, Pennsylvania.,Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, Pennsylvania
| | - Rosemary Frasso
- Jefferson College of Population Health, Philadelphia, Pennsylvania
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17
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Freeland C, Vader D, Cohen C, George B. A predictive model for hepatitis B infection among high-risk adults using a community-based sample in greater Philadelphia. J Viral Hepat 2020; 27:1319-1325. [PMID: 32702781 DOI: 10.1111/jvh.13365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/13/2022]
Abstract
Liver cancer is the 3rd deadliest cancer worldwide, with 5-year survival rates of only 15%. In the United States, liver cancer incidence and death rates are increasing at a faster rate than any other cancer and are projected to continue to rise through at least 2030. A significant proportion of these liver cancer cases are due to hepatitis B virus (HBV). Community-based screening is a public health practice working to identify individuals who are living with HBV in underserved communities, particularly Asian American, Pacific Islander and African immigrant populations. This data set includes a total of 3019 individuals considered high risk for HBV tested at community-based testing events between 2008 and 2019. Descriptive results revealed HBV infection rate was 7.9% (N = 229), and 59% (N = 1704) had protective antibodies against HBV. To account for missingness in the data, multiple imputation was preformed and followed by logistic regression to create a predictive model. The results support an association between insurance status and HBV infection in the predictive model. Participant region of origin was also significantly related to HBV infection, and participants who immigrated from the Western Pacific and African World Organization designated regions had higher odds of infection compared to participants from the Americas. Results emphasize the need to continue to expand testing in high-risk populations for HBV.
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Affiliation(s)
| | - Daniel Vader
- Drexel University, Philadelphia, Pennsylvania, USA
| | - Chari Cohen
- Hepatitis B Foundation, Doylestown, Pennsylvania, USA
| | - Brandon George
- Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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18
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Alber JM, Cohen C, Racho R, Freeland C, Ghazvini S, Tolentino B, Almeida R, Silliman M. Exploring the Impact of Storytelling on Storytellers in a Hepatitis B Health Communication Context. Patient Educ Couns 2020; 103:1760-1766. [PMID: 32331825 DOI: 10.1016/j.pec.2020.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/21/2020] [Accepted: 03/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In order to address the stigma associated with hepatitis B, increase awareness, encourage testing, and promote prevention through vaccination, a storytelling campaign featuring people living with hepatitis B and their family members was developed. Storytelling campaigns have been evaluated for their impact on the viewing audience; however, few studies have examined the impact of storytelling on storytellers themselves. This study seeks to examine the experiences of the individuals telling their stories. METHODS Trained researchers conducted semi-structured interviews (n = 23) with individuals who had participated in a hepatitis B storytelling campaign. RESULTS A thematic analysis of the interviews produced four overarching themes: 1) Outreach; 2) Emotion; 3) Education; and 4) Stigma. The interviews demonstrate that participants found storytelling to be a positive, comfortable, and emotional experience, and that it motivated them to educate others and increase awareness. Additionally, participants identified the need to increase outreach and address stigma related to hepatitis B. CONCLUSION While more research is needed, these study results can be used to enhance future engagement, training, and experiences of hepatitis B storytellers. PRACTICE IMPLICATIONS Findings provide insight into how storytelling can impact the sharing their story and provide important implications for future storytelling campaigns.
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Affiliation(s)
- Julia M Alber
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, USA.
| | | | - Rhea Racho
- Hepatitis B Foundation, Doylestown, USA.
| | | | - Sanam Ghazvini
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, USA.
| | - Brenda Tolentino
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, USA.
| | - Rebeca Almeida
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, USA.
| | - Miriam Silliman
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, USA.
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19
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Affiliation(s)
- Catherine Freeland
- Hepatitis B Foundation, Doylestown, Pennsylvania.,3805 Old Easton Rd, Doylestown, PA 18902.
| | - Daniel J Ventricelli
- Department of Pharmacy Practice and Administration, Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, Pennsylvania
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20
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Figgatt M, Hildick-Smith J, Addish E, Coleman J, Benitez J, Freeland C, Alles S, Viner K, Johnson C, Kuncio D. Susceptibility to Hepatitis A and B Virus Among Clients at a Syringe Services Program in Philadelphia, 2018. Public Health Rep 2020; 135:691-699. [PMID: 32791034 DOI: 10.1177/0033354920943528] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Although many people who use drugs meet criteria for vaccination against hepatitis A virus (HAV) and hepatitis B virus (HBV), estimates of susceptibility (ie, lack of immunity) are not well established. This study sought to identify the prevalence of and characteristics associated with HAV and HBV susceptibility among people who use drugs attending an urban syringe services program. METHODS We initiated this seroprevalence study in 2018 among 438 clients of a syringe services program who met study criteria, including provision of a blood specimen and a self-reported history of drug use. We assessed HAV and HBV susceptibility and infection via serological testing. We examined associations between participant characteristics and serology status by using descriptive statistics and multivariable logistic regression models. RESULTS Of the initial 438 clients identified, 353 (80.6%) met study criteria. Of 352 participants with conclusive HAV test results, 48.6% (n = 171) were HAV susceptible; of 337 participants with conclusive HBV test results, 32.6% (n = 110) were HBV susceptible, 24.3% (n = 82) showed evidence of past or present HBV infection, and 43.0% (n = 145) had vaccine-derived immunity. Compared with participants born before 1970, participants born during 1980-1989 had 5.90 (95% CI, 2.42-14.40) times the odds of HAV susceptibility and 0.18 (95% CI, 0.06-0.53) times the odds of HBV susceptibility, and participants born during 1990-1999 had 6.31 (95% CI, 2.34-17.00) times the odds of HAV susceptibility. Decreased odds of HAV susceptibility were associated with homelessness (adjusted odds ratio = 0.48; 95% CI, 0.28-0.82). CONCLUSION Despite applicable HAV and HBV vaccination recommendations, substantial gaps exist in HAV and HBV susceptibility among a population of people who use drugs. These findings highlight the need for increased HAV and HBV vaccination efforts among people who use drugs.
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Affiliation(s)
- Mary Figgatt
- 6542 Philadelphia Department of Public Health, Philadelphia, PA, USA
| | | | - Eman Addish
- 6542 Philadelphia Department of Public Health, Philadelphia, PA, USA
| | | | - José Benitez
- Prevention Point Philadelphia, Philadelphia, PA, USA
| | | | - Steven Alles
- 6542 Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - Kendra Viner
- 6542 Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - Caroline Johnson
- 6542 Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - Danica Kuncio
- 6542 Philadelphia Department of Public Health, Philadelphia, PA, USA
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21
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Freeland C, Bodor S, Perera U, Cohen C. Barriers to Hepatitis B Screening and Prevention for African Immigrant Populations in the United States: A Qualitative Study. Viruses 2020; 12:v12030305. [PMID: 32168926 PMCID: PMC7150884 DOI: 10.3390/v12030305] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/26/2020] [Accepted: 03/06/2020] [Indexed: 12/29/2022] Open
Abstract
Chronic hepatitis B infection (HBV) disproportionately affects African Immigrant (AI) communities in the U.S., with a reported infection rate of 15%. HBV screening rates within these communities are low. This study sought to better understand the socio-cultural determinants associated with low HBV screening among AI communities and identify potential strategies to help inform the development of effective HBV education and screening interventions. Seventeen in-depth interviews were conducted with community health experts working in AI communities throughout the U.S. Interviews explored the potential impact of culture, perception of health, awareness of HBV, religious practices, current screening practice, provider relationship, and behaviors towards general prevention. Interview data were analyzed using thematic analysis. Religious preferences and cultural norms affect health care access, perceptions towards prevention, awareness of HBV, and contribute to myths and stigma within this population. Participants reported a lack of HBV knowledge and awareness and barriers to health care access including, cost, language, racism, understanding of Western Medicine, and usage of traditional medicine. This study elucidates the role of religious and cultural beliefs as barriers to HBV screening and care. Results can contribute to public health efforts to increase awareness, screening and vaccination efforts within AI communities.
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Affiliation(s)
- Catherine Freeland
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA 18902, USA; (S.B.); (C.C.)
- Correspondence:
| | - Sierra Bodor
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA 18902, USA; (S.B.); (C.C.)
| | - Udara Perera
- Drexel University Dornsife School of Public Health, 3215 Market Street, Philadelphia, PA 19104, USA;
| | - Chari Cohen
- Hepatitis B Foundation, 3805 Old Easton Rd., Doylestown, PA 18902, USA; (S.B.); (C.C.)
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22
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Cohen C, Alber JM, Bleakley A, Grossman S, Freeland C, Alarcon K, Merchant RM. Social Media for Hepatitis B Awareness: Young Adult and Community Leader Perspectives. Health Promot Pract 2018; 20:573-584. [PMID: 29606039 DOI: 10.1177/1524839918765438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Screening for hepatitis B (HBV) among high-risk young adults can help prevent its transmission and lead to earlier treatment and better long-term health outcomes. Yet few interventions have focused on increasing HBV awareness among young adults. Social media (SM) may be an effective method for disseminating information and engaging young adults about HBV. In this pilot study, qualitative and quantitative methods were applied to collect information on current use and perceptions toward SM through semistructured interviews and focus groups with young Chinese and Vietnamese adults and community leaders from local organizations in Philadelphia. Additionally, survey items were collected during the interviews and focus groups to provide quantitative data. Results from the interviews provided evidence that young adults and local organizations are already using SM and are open to using it to share general health information that is specific to their community. The focus groups suggested that using group pages or chats could be most appropriate for reaching young adults and that credible sources should be used to deliver messages that are tailored to the audience. The findings from this study will support the development of an SM intervention aimed at increasing HBV awareness.
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Affiliation(s)
- Chari Cohen
- 1 Hepatitis B Foundation, Doylestown, PA, USA
| | - Julia M Alber
- 2 California Polytechnic State University, San Luis Obispo, CA, USA
| | - Amy Bleakley
- 3 University of Pennsylvania, Philadelphia, PA, USA
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Shaffer R, Freeland C, Jeevarathnam I, Pardon L. EP-1694: Radiotherapy for Ledderhose disease of the feet. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32003-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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24
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Horrow JC, Pharo GH, Levit LS, Freeland C. Neither skin tests nor serum enzyme-linked immunosorbent assay tests provide specificity for protamine allergy. Anesth Analg 1996; 82:386-9. [PMID: 8561347 DOI: 10.1097/00000539-199602000-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- J C Horrow
- Department of Anesthesiology, Medical College of Pennsylvania, Philadelphia, USA
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