Development and Feasibility Testing of a Multilevel Intervention to Increase Hepatitis C Virus Screening in Primary Care
Kasting, Monica, Purdue University; Susan M. Rawl, Indiana University School of Nursing
Background/Significance/Rationale: Chronic infection with hepatitis C virus (HCV) results in an increased risk of cirrhosis and hepatocellular carcinoma (HCC). Only 15% of baby boomers (born 1945-1965) have ever been screened. We aimed to develop a multilevel intervention to increase HCV screening for baby boomers in a primary care setting.
Methods: This study included two phases: intervention development (Phase 1), and feasibility testing (Phase 2). In Phase 1 we partnered with a CAB and a PAB, to develop a multilevel intervention to increase HCV screening to be delivered to both providers and patients in primary care. Phase 2 assessed intervention feasibility, acceptability, and usability by conducting Concurrent Think Aloud (CTA) interviews and surveys using previously validated scales with patients (n=8) and providers (n=7).
Results/Findings: Phase 1 results: The patient-level intervention included a mailed reminder letter and CDC pamphlet and a 7-minute in-clinic educational video. The provider-level intervention included a 30-minute educational session and monthly performance feedback e-mails. Phase 2 results: Qualitatively, both the patient and provider-level intervention were feasible, acceptable, and usable by the target audiences. Quantitatively, on a 1-4 scale, the range of patient-level score was 2.88-3.48 and provider-level was 3.46-3.71 for feasibility, acceptability, and usability.
Conclusions/Discussion: This project developed a feasible, acceptable, and usable multilevel intervention aimed at increasing HCV screening in primary care. Both patients and providers expressed positive attitudes towards the intervention and conveyed an appreciation that the information was clear, concise, and informative. Future research includes an R03 application to modify the intervention for all adults ages 18-79 and estimate effect sizes.
Translational/Human Health Impact: Translational/Human Health Impact: Once this intervention has been tested and implemented more broadly, it will have the potential to improve community health by increasing completion of HCV screening among a high-risk population and therefore reduce HCV-related morbidity and mortality.