Tailoring viral hepatitis prevention training for urban American Indian and Alaska Native communities

Background: American Indians and Alaska Natives (AI/AN) experience high rates of Hepatitis C compared to other racial/ethnic populations. AI/AN experience high mortality rates due to chronic liver disease and are two times more likely to be diagnosed with chronic liver disease than non-Hispanic Whites. More than half of the AI/AN population in the United States lives in urban areas. Methods: Through a grant from the Centers for Disease Control and Prevention and Indian Health Services, the Urban Indian Health Institute provides free viral hepatitis prevention training to medical and behavioral health staff at 34 Title V urban Indian health organizations (UIHO). Curriculum was adapted from the New York State Department of Health's It's Time training to provide information specific to AI/AN populations and culturally relevant prevention materials. Training includes spectrum of illness for of hepatitis A, B, and C, risk factors for viral hepatitis, prevention and treatment options, and agency-specific prevention integration plans. Results: Trainings have been held at 15 UIHO. Staff participants reported that the training sessions were informational and useful for their agency. Participants identified funding, staff shortages, and the lack of culturally relevant viral hepatitis prevention materials as a barrier to prevention for urban AI/AN. Some agencies also reported distance to other health organizations as a barrier to prevention. Conclusion: On-site viral hepatitis trainings are beneficial to UIHO and need to continue. There is a strong need for culturally relevant viral hepatitis prevention and educational materials and training for urban AI/AN populations.