Understanding hepatitis C intervention success: qualitative findings from the HepCATT study

The United Kingdom has committed to eliminating viral hepatitis as a public health threat. Innovative interventions for marginalized populations are required to realize this goal. In 2016, the HepCATT study team implemented a complex hepatitis C (HCV) intervention in three English drug treatment ser...

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Main Authors: Harris, Magdalena, Bonnington, Oliver, Harrison, Graham, Hickman, Matthew, Irving, William L.
Format: Article
Language:English
English
Published: Wiley 2018
Online Access:https://eprints.nottingham.ac.uk/50094/
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author Harris, Magdalena
Bonnington, Oliver
Harrison, Graham
Hickman, Matthew
Irving, William L.
author_facet Harris, Magdalena
Bonnington, Oliver
Harrison, Graham
Hickman, Matthew
Irving, William L.
author_sort Harris, Magdalena
building Nottingham Research Data Repository
collection Online Access
description The United Kingdom has committed to eliminating viral hepatitis as a public health threat. Innovative interventions for marginalized populations are required to realize this goal. In 2016, the HepCATT study team implemented a complex hepatitis C (HCV) intervention in three English drug treatment services, with five controls. We report qualitative study findings from two intervention sites to explore intervention success and transferability potential. The intervention comprised multiple components, including a nurse facilitator, peer support and education initiatives. Qualitative data were generated at baseline (2014) and post-intervention (2016) at two sites through in-depth interviews, focus groups and observations. The 96 participants comprised drug service and intervention providers and clients with an injecting history. Data were triangulated and thematically analysed. Client engagement with a HCV treatment service rose from 16 at baseline to 147 in 2016. There was no comparable increase at the five control sites. Baseline testing and treatment barriers included the following: limited HCV knowledge; fear of diagnosis and treatment; precarious living circumstances and service-specific obstacles. Treatment engagement was aided by intervention timeliness; improved communication structures; personalized care; streamlined testing and treatment pathways; peer support. Multiple interrelated components influenced the increased levels of treatment engagement documented in HepCATT. The nurse facilitator, involved in implementation and innovation, was key to intervention success. Baseline barriers correspond with international literature—indicating transferability potential. Control data indicate that biomedical innovation alone is not sufficient to increase engagement among the most marginalized. Sustainable resourcing of community services is crucial to effect change.
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spelling nottingham-500942019-02-27T04:30:13Z https://eprints.nottingham.ac.uk/50094/ Understanding hepatitis C intervention success: qualitative findings from the HepCATT study Harris, Magdalena Bonnington, Oliver Harrison, Graham Hickman, Matthew Irving, William L. The United Kingdom has committed to eliminating viral hepatitis as a public health threat. Innovative interventions for marginalized populations are required to realize this goal. In 2016, the HepCATT study team implemented a complex hepatitis C (HCV) intervention in three English drug treatment services, with five controls. We report qualitative study findings from two intervention sites to explore intervention success and transferability potential. The intervention comprised multiple components, including a nurse facilitator, peer support and education initiatives. Qualitative data were generated at baseline (2014) and post-intervention (2016) at two sites through in-depth interviews, focus groups and observations. The 96 participants comprised drug service and intervention providers and clients with an injecting history. Data were triangulated and thematically analysed. Client engagement with a HCV treatment service rose from 16 at baseline to 147 in 2016. There was no comparable increase at the five control sites. Baseline testing and treatment barriers included the following: limited HCV knowledge; fear of diagnosis and treatment; precarious living circumstances and service-specific obstacles. Treatment engagement was aided by intervention timeliness; improved communication structures; personalized care; streamlined testing and treatment pathways; peer support. Multiple interrelated components influenced the increased levels of treatment engagement documented in HepCATT. The nurse facilitator, involved in implementation and innovation, was key to intervention success. Baseline barriers correspond with international literature—indicating transferability potential. Control data indicate that biomedical innovation alone is not sufficient to increase engagement among the most marginalized. Sustainable resourcing of community services is crucial to effect change. Wiley 2018-02-27 Article PeerReviewed application/pdf en https://eprints.nottingham.ac.uk/50094/7/Qual%20overview_revision_251017.pdf application/pdf en https://eprints.nottingham.ac.uk/50094/1/HepCatt%20submitted%20qual.pdf Harris, Magdalena, Bonnington, Oliver, Harrison, Graham, Hickman, Matthew and Irving, William L. (2018) Understanding hepatitis C intervention success: qualitative findings from the HepCATT study. Journal of Viral Hepatitis . ISSN 1365-2893 http://onlinelibrary.wiley.com/doi/10.1111/jvh.12869/full doi:10.1111/jvh.12869 doi:10.1111/jvh.12869
spellingShingle Harris, Magdalena
Bonnington, Oliver
Harrison, Graham
Hickman, Matthew
Irving, William L.
Understanding hepatitis C intervention success: qualitative findings from the HepCATT study
title Understanding hepatitis C intervention success: qualitative findings from the HepCATT study
title_full Understanding hepatitis C intervention success: qualitative findings from the HepCATT study
title_fullStr Understanding hepatitis C intervention success: qualitative findings from the HepCATT study
title_full_unstemmed Understanding hepatitis C intervention success: qualitative findings from the HepCATT study
title_short Understanding hepatitis C intervention success: qualitative findings from the HepCATT study
title_sort understanding hepatitis c intervention success: qualitative findings from the hepcatt study
url https://eprints.nottingham.ac.uk/50094/
https://eprints.nottingham.ac.uk/50094/
https://eprints.nottingham.ac.uk/50094/