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123NoMi. A 3-year project by Hep-C ALERT to increase and evaluate viral hepatitis screening, vaccination coverage and completion among underserved minority adults in No rth Mi ami-Dade County. Acronyms. HCV. Hepatitis C Virus. HIV. Human Immunodeficiency Virus. STD.

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123nomi

123NoMi

A 3-year project by Hep-C ALERT to increase and evaluate viral hepatitis screening, vaccination coverage and completion among underserved minority adults in North Miami-Dade County

acronyms
Acronyms

HCV

Hepatitis C Virus

HIV

Human Immunodeficiency Virus

STD

Sexually Transmitted Disease (or Infection)

OMH

Office of Minority Health

BOI

Bureau of Immunization

“09 Program” - Florida Hepatitis and Liver Failure Prevention and Control Program

09

CTL

Counseling, Testing and Linkage (referral)

Hep-C ALERT, Inc.

hep c alert background
Hep-C ALERT Background
  • 1997 – chronic HCV focused
    • National: Hep-C Hotline; Education, HCV CTL, Cause Advocacy
    • Local: Support Groups, Outreach, Education. Local HCV CTL in 1999
  • 2002 – added HIV CTL and hepatitis vaccination (vaccine in collaboration with Miami-Dade County Health Dept.)
  • 2006 – added Rapid HIV & STD CTL

Hep-C ALERT, Inc.

slide4

Area Description

Hep-C ALERT, Inc.

annual growth on site ctl
Annual Growth On-Site CTL

Hep-C ALERT, Inc.

baseline data
Baseline Data
  • Hep-C ALERT Hepatitis Risk Assessments reveal that 81% of minority adults self-reported not ever receiving hepatitis vaccination
  • Upon viral hepatitis testing, approximately 50% were not immune
  • Even with these compelling results, vaccine coverage and completion rates remained low

Hep-C ALERT, Inc.

barrier identified
Barrier Identified
  • Resources were needed to bridge the client’s gap between risk appraisal and action
  • Novel approaches to increasing adult vaccine coverage and completion for our community was necessary

Hep-C ALERT, Inc.

closing the gap grant
Closing The Gap Grant
  • Rationale
    • Community interest demonstrated through “Vaccine Interest Survey”
    • Prior experience with managing vaccination services off-site (ARHIP)
    • Already serving primarily at-risk young adult / adult minority population at the Hep-C ALERT office

Hep-C ALERT, Inc.

office race ethnicity
Office: Race/Ethnicity

Hep-C ALERT, Inc.

office age groups
Office: Age Groups

Hep-C ALERT, Inc.

123nomi objectives
123NoMi Objectives
  • Reduce barriers to viral hepatitis screening and vaccination
  • Identify susceptible at-risk persons and provide vaccination
  • Achieve target vaccine coverage and completion rates
  • Monitor, evaluate and disseminate 123NoMi project results

Hep-C ALERT, Inc.

1 reduce barriers
#1 - Reduce Barriers
  • Diversify project staff (Spanish/Creole speaking)
  • Offer 100% walk-in services, non-traditional hours (including Sat)
  • Implement vaccine reminder system
  • Utilize incentives for new client recruitment and vaccine completion

Hep-C ALERT, Inc.

2 screen
#2 - Screen
  • Test (one time) all adult clients to determine their serostatus using the State Lab chronic hepatitis panel
  • Counsel and refer acute/chronic HBV and HCV to medical care
  • Recall at-risk/susceptible adults to initiate vaccination

Hep-C ALERT, Inc.

3 vaccinate
#3 - Vaccinate
  • A and B vaccine administered per 09 program Memorandum of Agreement
  • Coverage
    • Year 1 thru 3 @ 60%
  • Completion
    • Year 1 =/> 20%
    • Year 2 =/> 30%
    • Year 3 =/> 40%

Hep-C ALERT, Inc.

4 evaluate
#4 - Evaluate
  • Coverage and completion rates
  • Client satisfaction with
      • Cultural responsiveness
      • Screening and vaccination services
  • Tools
    • VACTRAC 4.0 (SmithKlineBeecham)
    • IMM07 (OMH/BOI software)
    • HIMS (proprietary software)
    • QuestionPro.com (subscription survey creation/analysis site)

Hep-C ALERT, Inc.

struggles
Struggles
  • Reaching consensus on
    • 09 program vaccine distribution to non-governmental organization (NGO)
    • Type of nurse (RN or LPN) needed for vaccine administration at NGO
    • Agency liability insurance coverage
  • Contract vs. Finance & Accounting
    • Totally unanticipated issue w/finance
    • In process of resolution

Hep-C ALERT, Inc.

strengths
Strengths
  • Standing Orders
  • Project staff were incumbent or hired and trained before the contract start date
  • Existing infrastructure for data gathering and analysis
  • Pool of previously-screened clients to recruit from at project launch
  • Great Board and Medical Directors

Hep-C ALERT, Inc.

new era of collaboration
New Era Of Collaboration
  • Cooperation between the 09 program, and community-based (and private) organizations has resulted in several new projects in non-traditional settings
  • Success has wide implications for promoting other adult vaccinations

Hep-C ALERT, Inc.

summary to date
Summary To Date
  • 123NoMi data show substantial increase in susceptible persons initiating hepatitis vaccination
    • 0% baseline vs. 37% present
  • Need improvement in getting clients in for first dose to achieve 60% coverage
  • Client satisfaction is higher than expected in all domains during roll-out period and loyalty rating for vaccine service ranks all time high for agency

Hep-C ALERT, Inc.

acknowledgements
Acknowledgements
  • Office of Minority Health
  • Phil and Cheryl for opening 09 program vaccine access to NGOs
  • Rick Barrett, Bureau of Immunization Contract Manager for 123NoMi
  • Anita Martinez, RN, MDCHD for sharing vaccine inventory
  • Bob Griffin for years of unconditional support at the local level
  • Hep-C ALERT’s excellent staff

Hep-C ALERT, Inc.

contact information
Contact Information

Andi Thomas

Executive Director, Hep-C ALERT

[email protected]

www.hep-c-alert.org

Offc: 305-893-7992 x101

Cell: 954-931-8463

Hep-C ALERT, Inc.