178998 Hepatitis prevention activities in public health and primary care clinics that serve migrants

Monday, October 27, 2008

Claire Loe, MPH , Community Health Education Concepts, Austin, TX
Craig W. Johnson, PhD, MA , School of Health Information Sciences, University of Texas Health Science Center at Houston, Houston, TX
Edward Zuroweste, MD , Migrant Clinicians Network, State College, PA
Deliana Garcia, MA , Migrant Clinicians Network, Austin, TX
Carmen L. Retzlaff, MPH, CHES , Community Health Education Concepts, Austin, TX
Kathryn M. Anderson, MA , Community Health Education Concepts, Austin, TX
Jillian Hopewell, MPA, MA , Migrant Clinicians Network, Austin, TX

Chronic disease prevention among low income populations is an important role of local health departments and migrant and community health centers. This study compared clinic system factors that affect hepatitis prevention activities in clinics serving migrants.


Researchers completed a Physical and Social Environment Scale (PSES) at 27 clinics, 15 primary care and 12 public health, that serve migrants. The scale captures clinic environment factors hypothesized to affect prevention activities. Researchers rated clinics on nine factors grouped into general environment, clinic process, and hepatitis-related subscales.

Cronbach's alpha for the instrument was 0.78 indicating good reliability. Cronbach's alphas for the three subscales were 0.79, 0.30 and 0.72, respectively.


MANOVA revealed primary care and public health clinic environments differed significantly, F(3,21)=5.39, p = .007, in their PSES scores. Public health clinics received higher scores for two of the three subscales, content F(1,23)=11.62, p = .002, and process, F(1,23)=6.07, p = .02. The substantial difference in content (Cohen's d = 1.14 SD) and process (d = 0.90 SD) exceeded Cohen's 0.8 “large” standardized effect size criterion.


Local health departments are more likely than migrant and community health centers to include physical and social environment factors thought to promote hepatitis prevention activities. This suggests that the primary care centers may be able to address gaps in their delivery of preventive care services through changes in the physical and social environment as defined by this study.

Learning Objectives:
1. Identify components of the physical and social environment of a clinic. 2. Describe how the physical and social environment of a clinic can affect the provision of communicable disease prevention education in a clinic setting. 3. Consider differences between public health and primary care centers that may affect their physical and social environment.

Keywords: Clinical Prevention Services, Hepatitis B

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been integrally involved in the design, implementation, evaluation and analysis of this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.