Post on 16-Dec-2015
Core Concepts for Hepatitis Education
Authors: Lisa K. Gilbert, PhD Kathy Ford, MSSW David Bergmire-Sweat, MPH
Funded by the Centers for Disease Control and Prevention (CDC), CA # U50/CCU418796 to
“Test, Disseminate and Evaluate Education Materials and Messages, and Training Programs Concerning Prevention
and Control of Viral Hepatitis”
Background
Few, if any, published studies have identified essential (core) concepts to include in hepatitis prevention educational materials (brochures, Web sites, etc.)
Few, if any, published studies have systematically analyzed the content of hepatitis prevention educational materials
Study Goals
To develop consensus core concepts To evaluate individual hepatitis prevention
educational materials based on inclusion of the identified core concepts
To assess the degree to which each core concept is covered across all relevant educational materials
Methods: Developing Core Concepts
ASHA-identified 79 hepatitis experts 26 were selected by the CDC for inclusion in
the Delphi Technique First round survey (n=11) elicited 197
concepts which were categorized and summarized
Second round survey (n=12) experts rank ordered concepts
Results: Core Concepts
Within the following six categories, concepts which:– ranked below the mean were excluded– ranked above the mean were included
Core concepts, by category:HAV HBV HCV
Patients 13 17 20
Providers 16 19 18
Methods: Evaluating Materials
Developed a data collection tool Collected hepatitis materials (n=405) Systematically scored each based on core
concept inclusion: Not mentioned = “0” Mentioned = “1” or Explained = “2”
Tallied total score for each material and computed percent out of total
Scoring Educational Materials
For example:– 13 core concepts for patients re: HAV– Each educational material scored based on
coverage of each of 13 concepts– Percent of core concept coverage calculated =
score/26 (score/total score possible) Range was 0 to 71% coverage
Hepatitis A materials
Patients:– 49 brochures & 2 Web sites
– Core concept coverage: 15% - 70%
Providers:– No materials specifically for
HAV!
Hepatitis B materials
Patients:– 132 brochures, 7 Web sites & 7
videos
– Core concept coverage: 3% - 71%
Providers:– 5 brochures & 1 Web site
– Core concept coverage: 11% - 45%
Hepatitis C materials
Patients:– 60 brochures & 59 Web sites
– Core concept coverage: 0 - 58%
Providers:– 3 brochures
– 5 Web sites
– Core concept coverage: 1% - 67%
Methods: Core Concept Coverage
For each core concept, the degree to which it was mentioned or explained was recorded
Frequencies revealed which were covered– For example, this HAV core concept for
patients: “Hepatitis A is highly contagious”:» was not mentioned in 33 (67%) of the materials
» was mentioned in 14 (29%) of the materials
» was explained in 2 (4%) of the materials
Patient Concepts Well Covered
Hepatitis A, B or C concepts mentioned or explained in half or more of the materials evaluated:– Transmission (70% - 100%)– Risk factors (50% - 76%)– Potential for chronic infection w/B or C (74% -
79%)
Patient Concepts Not Well Covered
Hepatitis A, B or C concepts mentioned or explained in less than half of the materials evaluated: :– How A, B and C differ (4% - 14%)– How they can become major health problems
(14% - 32%)
Patient Concepts Not Well Covered
Hepatitis A core concepts mentioned or explained in less than half of the materials evaluated: – Safety/efficacy of the HAV vaccine 47%– Testing information
26%– HAV is highly contagious
23%
Patient Concepts Not Well Covered
Hepatitis B core concepts mentioned or explained in less than half of the materials evaluated:– HBV prevention 46%– Testing information
36%– The vaccine prevents liver cancer 4%
Patient Concepts Not Well Covered
Hepatitis C core concepts mentioned or explained in less than half of the materials evaluated: – Preventing transmission 41-50%– Specific risks 30-50%– Follow-up healthcare
information 1-35%
Implications for Public Health Educators
Design, select and/or tailor educational materials to include these core concepts:– risk & transmission– signs/symptoms & testing– chronic infection– prevention (including vaccines)– type differences– referral options
Research Recommendations
Survey patients and providers to assess their core concept recommendations
Compile “comprehensive core concepts” recommendations from three samples (patients, providers and experts)
Re-score currently available materials
Acknowledgements
Cindy Weinbaum, MD - Project Officer Kelli Scanlon - Project Manager Delphi participants