Assessment of a pilot intervention to increase knowledge and testing for hepatitis C in high risk populations

Background: More than 3 million Americans are infected with hepatitis C virus (HCV) and many more are unaware of their HCV status. Because there is disagreement about the utility of routine testing for high-risk individuals, patients may benefit from additional information when deciding to test. Methods: Patients from a family medicine practice were screened for eligibility and invited to participate if they self-reported at least one HCV risk factor. Participants completed a baseline survey, met with a health educator to review a study-specific HCV pamphlet, determined their testing preference and completed a post-intervention survey. Survey results and a medical chart review were used to evaluate the intervention and determine HCV testing status. Results: Seventy-one participants with at least one HCV risk factor were enrolled (76% female; 67% African American; mean age 31; 61% completed some post high school education). The most common risk factors were having a tattoo/piercing (75%) and having been in prison or jail (18%). Participants with lower educational attainment were more likely to report multiple risk factors (p=.001); African Americans had higher perceptions of risk (p=.058). To date, 22 participants (31%) have tested, a three-fold increase from historical baseline rates. On 10 different knowledge items, participants scored an average of 4.45 correct answers at baseline and 6.38 correct answers post-intervention (p=<.001) Conclusions: Exposure to this brief intervention appears to have increased knowledge and testing for HCV. Interventions utilizing decision aids are valuable in primary care settings as tools for complex decisions such as testing and screening.