Understanding hepatitis C intervention success—Qualitative findings from the HepCATT study. Issue 7 (27th February 2018)

• Record Type: Journal Article
• Authors: Harris, M.; Bonnington, O.; Harrison, G.; Hickman, M.; Irving, W.
• Other Names: Roberts Kirsty investigator.; Waldron Cherry Ann investigator.; Bevan Jo investigator.; Simpson Charlotte investigator.; Homan Coleen investigator.; Reeve Dave investigator.; Hathaway Clare investigator.; Purcell Stephen investigator.; Oelbaum Sandra investigator.; Whitfield Jo investigator.; Jennings Stephen investigator.; Dreha Robbie investigator.; Byrne Tara investigator.; Thomas Debbie investigator.; Fraser Elisabeth investigator.; Toyne Karen investigator.; Newton Paul investigator.; Hensley Fern investigator.; Hewish Steve investigator.; Rutkowski Rick investigator.; Christian Archie investigator.; Smith Stuart investigator.; Ward Emma investigator.; Rhodes Tim investigator.; Lattimore Sam investigator.; Mandal Sema investigator.; Simmons Ruth investigator.; Sreedharan Aravamuthan investigator.; Murray Karen investigator.; Richardson Paul investigator.; Caldwell Helen investigator.; Gore Roxanne investigator.; Hughes Amanda investigator.; Walters Claire investigator.; Orton Annette investigator.; Lee Penny investigator.; Ryder Steve investigator.; Thomson Brian investigator.; Montgomery Alan investigator.; Foster Graham investigator.;
• Is Part Of: Journal of viral hepatitis. Volume 25:Issue 7(2018)
• Page Start: 762
• Page End: 770
• Publication Date: 2018-02-27
• Subjects: hepatitis C -- intervention -- people who inject drugs -- qualitative -- treatment; Hepatitis, Viral -- Periodicals; Hepatitis, Viral, Animal; Hepatitis, Viral, Human; 616.3623
• DOI: 10.1111/jvh.12869
• Languages: English
• ISSNs: 1352-0504

Abstract

Summary: 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.