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Screening for hepatitis B in the Bronx West African community with a blood pressure cuff: a cohort study
Julie Nguyen1, Mandira Shashank1, Jessie A Birnbaum1
1Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA.
Insights
Hypertension screening programs in the Bronx facilitated hepatitis B screening among West African immigrants. This initiative also helped integrate individuals into the US healthcare system, addressing common health challenges.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Cardiovascular Health
Background:
- Hepatitis B (HBV) and hypertension (HTN) are significant health concerns in West African (WA) communities, particularly in the US.
- Immigrants face challenges in accessing and navigating the US healthcare system for managing these conditions.
- HBV carries a stigma, while HTN is more widely recognized, presenting unique management hurdles.
Purpose of the Study:
- To assess the effectiveness of a hypertension screening program in promoting hepatitis B screening among West African immigrants.
- To evaluate the program's role in facilitating integration into the United States healthcare system.
Main Methods:
- Educational programs on hypertension were delivered through faith-based organizations and community gatherings.
- Participants interested in a clinic visit underwent blood pressure measurement, received a free blood pressure cuff, and were offered hepatitis B testing.
- Assistance with insurance and linkage to care was provided for uninsured individuals.
Main Results:
- Hypertension was identified in 48.4% of participants, with a significant number unaware of their condition.
- Hepatitis B screening was accepted by nearly all participants, revealing a 7.5% positivity rate for hepatitis B surface antigen.
- Over a third of participants with hypertension were successfully linked to ongoing care within the US healthcare system.
Conclusions:
- Integrating hypertension screening into community outreach programs effectively increases hepatitis B screening rates.
- Providing resources like free blood pressure cuffs and assistance with healthcare navigation can improve health outcomes and system integration for immigrant populations.
Background:
Hepatitis B (HBV) and hypertension (HTN) are prevalent in West Africa (WA). Inadequate control is common, and evaluation and management are challenging among immigrants due to unfamiliarity with the United States (US) healthcare system. While HBV is stigmatised, HTN is recognised as an important condition. We describe how a HTN screening program can facilitate HBV screening in the Bronx WA community.
Methods:
Thirty-minute HTN educational programs were delivered in collaboration with faith-based organisations, and 5-min presentations were presented upon request at community gatherings. Arrangements were made for those interested in a clinic visit where a questionnaire was completed, blood pressure (BP) measured, a free BP cuff provided, HBV testing performed, and referrals made. For those without ongoing care, insurance was arranged, and linkage to care provided.
Findings:
Seven 30-min and five 5-min presentations were conducted. After the 30-min presentation, 204 of 445 attendees (45.8%) requested a visit, and 68 (33.3%) attended the visit. After the 5-min presentation, 80 requested a visit and 51 (63.8%) attended the visit. A BP >140/90 mmHg was present in 122 individuals (48.4%), including 43 (17.1%) without a history of HTN and 39 (15.5%) with BP >160/90 mmHg. All except two who reported previous testing agreed to HBV testing. 19 (7.5%) were hepatitis B surface antigen positive. Transition into ongoing care was provided for 60 (33.9%) with HTN who were not integrated into the US healthcare system.
Interpretation:
HTN screening with a free BP cuff promotes HBV screening and US healthcare integration.
Funding:
No funding.
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