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This study identifies essential core concepts for hepatitis prevention education materials and evaluates their coverage in existing resources for patients and providers. Findings inform recommendations for designing tailored educational materials.
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Core Concepts for Hepatitis Education Authors: • Lisa K. Gilbert, PhD • Kathy Ford, MSSW • David Bergmire-Sweat, MPH Funded by the Centers for Disease Control and Prevention (CDC), CA # U50/CCU418796 to “Test, Disseminate and Evaluate Education Materials and Messages, and Training Programs Concerning Prevention and Control of Viral Hepatitis”
Background • Few, if any, published studies have identified essential (core) concepts to include in hepatitis prevention educational materials (brochures, Web sites, etc.) • Few, if any, published studies have systematically analyzed the content of hepatitis prevention educational materials
Study Goals • To develop consensus core concepts • To evaluate individual hepatitis prevention educational materials based on inclusion of the identified core concepts • To assess the degree to which each core concept is covered across all relevant educational materials
Methods: Developing Core Concepts • ASHA-identified 79 hepatitis experts • 26 were selected by the CDC for inclusion in the Delphi Technique • First round survey (n=11) elicited 197 concepts which were categorized and summarized • Second round survey (n=12) experts rank ordered concepts
Results: Core Concepts • Within the following six categories, concepts which: • ranked below the mean were excluded • ranked above the mean were included • Core concepts, by category: HAV HBV HCV Patients 13 17 20 Providers 16 19 18
Methods: Evaluating Materials • Developed a data collection tool • Collected hepatitis materials (n=405) • Systematically scored each based on core concept inclusion: Not mentioned = “0” Mentioned = “1” or Explained = “2” • Tallied total score for each material and computed percent out of total
Scoring Educational Materials • For example: • 13 core concepts for patients re: HAV • Each educational material scored based on coverage of each of 13 concepts • Percent of core concept coverage calculated = score/26 (score/total score possible) • Range was 0 to 71% coverage
Hepatitis A materials • Patients: • 49 brochures & 2 Web sites • Core concept coverage: 15% - 70% • Providers: • No materials specifically for HAV!
Hepatitis B materials • Patients: • 132 brochures, 7 Web sites & 7 videos • Core concept coverage: 3% - 71% • Providers: • 5 brochures & 1 Web site • Core concept coverage: 11% - 45%
Hepatitis C materials • Patients: • 60 brochures & 59 Web sites • Core concept coverage: 0 - 58% • Providers: • 3 brochures • 5 Web sites • Core concept coverage: 1% - 67%
Methods: Core Concept Coverage • For each core concept, the degree to which it was mentioned or explained was recorded • Frequencies revealed which were covered • For example, this HAV core concept for patients: “Hepatitis A is highly contagious”: • was not mentioned in 33 (67%) of the materials • was mentioned in 14 (29%) of the materials • was explained in 2 (4%) of the materials
Patient Concepts Well Covered Hepatitis A, B or C concepts mentioned or explained in half or more of the materials evaluated: • Transmission (70% - 100%) • Risk factors (50% - 76%) • Potential for chronic infection w/B or C (74% - 79%)
Patient Concepts Not Well Covered Hepatitis A, B or C concepts mentioned or explained in less than half of the materials evaluated: : • How A, B and C differ (4% - 14%) • How they can become major health problems (14% - 32%)
Patient Concepts Not Well Covered Hepatitis A core concepts mentioned or explained in less than half of the materials evaluated: • Safety/efficacy of the HAV vaccine 47% • Testing information 26% • HAV is highly contagious 23%
Patient Concepts Not Well Covered Hepatitis B core concepts mentioned or explained in less than half of the materials evaluated: • HBV prevention 46% • Testing information 36% • The vaccine prevents liver cancer 4%
Patient Concepts Not Well Covered Hepatitis C core concepts mentioned or explained in less than half of the materials evaluated: • Preventing transmission 41-50% • Specific risks 30-50% • Follow-up healthcare information 1-35%
Implications for Public Health Educators Design, select and/or tailor educational materials to include these core concepts: • risk & transmission • signs/symptoms & testing • chronic infection • prevention (including vaccines) • type differences • referral options
Research Recommendations • Survey patients and providers to assess their core concept recommendations • Compile “comprehensive core concepts” recommendations from three samples (patients, providers and experts) • Re-score currently available materials
Acknowledgements • Cindy Weinbaum, MD - Project Officer • Kelli Scanlon - Project Manager • Delphi participants