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Abstract Details
Liver health events: an indigenous community-led model to enhance HCV screening and linkage to care
Health Promot Int. 2021 Jun 13;daab074. doi: 10.1093/heapro/daab074. Online ahead of print.
1Research, Saskatchewan Health Authority, 2180-23 Ave, Wascana Rehabilitation Centre, Regina, SK, S4S 0A5, Canada.
2First Nations Inuit Health Branch-Sask Region, Indigenous Services Canada, Government of Canada, 1783 Hamilton Street, 6th Floor, Alvin Hamilton Building, Regina, SK, S4P 2B6, Canada.
3Ahtahkakoop Health Centre P.O. Box 64 Mont Nebo, SK, S0J 1X0, Canada.
4Saskatchewan Infectious Disease Care Network, 320 Ave F South, Saskatoon, SK, S7M 1T2, Canada.
5Wellness Wheel Regina General Hospital, 2nd Floor Medical Office Wing c/o Infectious Diseases Clinic 1440-14th Avenue, Regina, SK, S4P 0W5, Canada.
Despite high prevalence of hepatitis C virus (HCV), linkage to care and treatment for Indigenous people is low. In an Indigenous community in Saskatchewan, Canada a retrospective review identified 200 individuals (∼12% prevalence) had HCV antibodies though majority lacked ribonucleic acid (RNA) testing, and few received treatment despite availability of an effective cure. Following Indigenous oral traditions, focus group discussions were held with key community members and leadership. Participants emphasized the need for a community-based screening and treatment programme. A team of community members, peers and healthcare professionals developed a streamlined screening pathway termed 'liver health event' (LHE) to reduce stigma, reach undiagnosed, re-engage previously diagnosed, and ensure rapid linkage to care/treatment. LHEs began December 2016. Statistics were tracked for each event. As of July 2019, there were 10 LHEs with 540 participants, 227 hepatitis C tests and 346 FibroScans completed. This represented 294 unique individuals, of which 64.3% were tested, and of those, 40.8% were Ab positive. Among those positive for antibodies, 41.7% had active hepatitis C infections, and among these, 90% were linked to care, and 14 new positive individuals were identified. Following the success of LHEs, these were adapted and implemented in 10 other communities in this region, resulting in 17 additional LHEs. This intervention is reaching the undiagnosed and linking clients to care through a low-barrier and de-stigmatizing approach. It has facilitated collaboration, knowledge exchange and mentorship between Indigenous communities, significantly impacting health outcomes of Indigenous people in this region.