# Presentation: 299809

## 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