Understanding hepatitis C intervention success-Qualitative findings from the HepCATT study

Area of Science:

• Public Health
• Hepatology
• Health Services Research

Background:

• The UK aims to eliminate viral hepatitis, necessitating innovative strategies for marginalized groups.
• Hepatitis C (HCV) remains a significant public health concern, particularly among populations facing barriers to treatment.

Purpose of the Study:

• To qualitatively explore the success and transferability of a complex HCV intervention in English drug treatment services.
• To identify barriers and facilitators to HCV treatment engagement among marginalized populations.

Main Methods:

• A qualitative study using in-depth interviews, focus groups, and observations at two intervention sites.
• Data collected at baseline (2014) and post-intervention (2016) from 96 participants (providers and clients).
• Thematic analysis of triangulated qualitative data.

Main Results:

• Client engagement with HCV treatment services increased from 16 at baseline to 147 post-intervention at intervention sites.
• Barriers to treatment included limited knowledge, fear, precarious circumstances, and service obstacles.
• Facilitators included timely intervention, improved communication, personalized care, streamlined pathways, and peer support, with nurse facilitators being crucial.

Conclusions:

• A multifaceted intervention, particularly the role of nurse facilitators and peer support, significantly increased HCV treatment engagement.
• Biomedical innovation alone is insufficient; sustainable resourcing of community services is vital for engaging marginalized populations.
• Identified barriers align with international findings, suggesting potential for intervention transferability.