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Optimizing Community-Based Hepatitis B and C Care for Engaging Housing-Insecure Individuals
Vanessa Schick1, Abigail Grace1, F Tiffany Quan1
1School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
Insights
Community outreach effectively reached nearly 2000 individuals at high risk for Hepatitis B and C (HBV/HCV) infections. Different engagement sites best served specific needs, like HCV treatment or HBV vaccination, in this vulnerable population.
Area of Science:
- Public Health
- Infectious Diseases
- Health Equity
Background:
- Hepatitis B and C (HBV/HCV) disproportionately affect individuals with substance use histories and homelessness.
- Engaging these high-risk populations for HBV/HCV testing and treatment presents significant challenges.
Purpose of the Study:
- To describe a community-based approach (GRASSROOTS HEALTH) for HBV/HCV prevention and treatment.
- To compare the effectiveness of various engagement site types in reaching and engaging this high-need population.
Main Methods:
- A retrospective observational study analyzing data from GRASSROOTS HEALTH, launched in 2018.
- Services included on-site testing, HBV vaccination, treatment navigation, and adherence support across diverse housing and drop-in centers.
- Outcomes were tracked via REDCap and analyzed by engagement site.
Main Results:
- Nearly 2000 clients were reached through the GRASSROOTS HEALTH program.
- Drop-in centers showed the greatest need for HCV treatment, while low-income/supportive housing sites had the highest demand for HBV vaccination.
- All engagement sites demonstrated a high return on effort regarding participant needs for HBV vaccination and HCV/HBV treatment.
Conclusions:
- Community-based engagement through housing and service centers is effective in reaching high-need populations for HBV/HCV services.
- Tailoring engagement strategies to specific site types may optimize outreach for distinct needs, such as HCV treatment versus HBV vaccination.
Abstract:
IntroductionHepatitis B and C (HBV/HCV) are bloodborne infections, with individuals who have histories of substance use and homelessness bearing a disproportionate risk. Long-standing difficulties in engaging these populations have made testing and treatment challenging. This retrospective observational study describes a community-based approach to HBV/HCV prevention and treatment, comparing the effectiveness of different engagement site types in reaching and engaging this high-need population.MethodsGRASSROOTS HEALTH was launched in 2018 to improve HBV/HCV care by providing on-site testing, HBV vaccination, treatment navigation, and adherence support across various housing and drop-in centers. Outcomes were tracked through REDCap and analyzed by engagement site.ResultsGRASSROOTS HEALTH reached nearly 2000 clients, with the greatest needs for HCV treatment in drop-in centers and HBV vaccination in low-income/permanent supportive housing. All sites demonstrated a relatively high return on effort, as evidenced by the percentage of participants needing HBV vaccination or HCV/HBV treatment.ConclusionEngaging individuals through housing and service centers effectively reached a high-need community, with findings suggesting that different engagement points may enhance outreach based on the primary focus (HCV treatment vs HBV vaccination).
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