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Abstract Details
Formal Hepatitis C Education Increases Willingness to Receive Therapy in an On-site Shelter-Based HCV Model of Care in Persons Experiencing Homelessness
Open Forum Infect Dis. 2022 Mar 1;9(4):ofac103. doi: 10.1093/ofid/ofac103.eCollection 2022 Apr.
1Department of Medicine, University of California San Francisco, San Francisco, California, USA.
2Hennepin Healthcare, Minneapolis, Minnesota, USA.
3Street Medicine and Shelter Health, San Francisco Department of Public Health, San Francisco, California, USA.
4Division of Gastroenterology and Hepatology, Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California, USA.
5Department of Psychiatry, University of California San Francisco, San Francisco, California, USA.
6University of California San Francisco Liver Center, San Francisco, California, USA.
7Division of Gastroenterology and Hepatology, Department of Medicine, University of California San Francisco, San Francisco, California, USA.
Abstract
Background: The objective of this study was to evaluate the effectiveness of formal hepatitis C virus (HCV) education on engagement in therapy in persons experiencing homelessness in an on-site shelter-based model of care. As policies to eliminate Medicaid access restrictions to HCV treatment are expanded, patient education is paramount to achieving HCV elimination targets in difficult-to-engage populations including persons experiencing homelessness.
Methods: This prospective study was conducted at 4 shelters in San Francisco and Minneapolis from August 2018 to January 2021. Of the 162 HCV Ab-positive participants, 150 participated in a 30-minute HCV education session. Posteducation changes in knowledge, beliefs, barriers to care, and willingness to accept therapy scores were assessed.
Results: Following education, knowledge scores (mean change, 4.4 ± 4.4; P < .001) and willingness to accept therapy (70% to 86%; P = .0002) increased. Perceived barriers to HCV care decreased (mean change, -0.8 ± 5.2; P = .001). Higher baseline knowledge was associated with lesser gain in knowledge following education (coef., -0.7; P < .001). Posteducation knowledge (odds ratio, 1.2; P = .008) was associated with willingness to accept therapy.
Conclusions: An HCV educational intervention successfully increased willingness to engage in HCV therapy in persons experiencing homelessness in an on-site shelter-based HCV model of care.