1. Core Concepts for Hepatitis Education Authors: n Lisa K. Gilbert, PhD n Kathy Ford, MSSW n 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”

2. Background n Few, if any, published studies have identified essential (core) concepts to include in hepatitis prevention educational materials (brochures, Web sites, etc.) n Few, if any, published studies have systematically analyzed the content of hepatitis prevention educational materials

3. Study Goals n To develop consensus core concepts n To evaluate individual hepatitis prevention educational materials based on inclusion of the identified core concepts n To assess the degree to which each core concept is covered across all relevant educational materials

4. Methods: Developing Core Concepts n ASHA-identified 79 hepatitis experts n 26 were selected by the CDC for inclusion in the Delphi Technique n First round survey (n=11) elicited 197 concepts which were categorized and summarized n Second round survey (n=12) experts rank ordered concepts

5. Results: Core Concepts n Within the following six categories, concepts which: –ranked below the mean were excluded – ranked above the mean were included n Core concepts, by category: HAVHBVHCV Patients131720 Providers161918

6. Methods: Evaluating Materials n Developed a data collection tool n Collected hepatitis materials (n=405) n Systematically scored each based on core concept inclusion: Not mentioned = “0” Mentioned = “1” or Explained = “2” n Tallied total score for each material and computed percent out of total

7. Scoring Educational Materials n 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) n Range was 0 to 71% coverage

8. Hepatitis A materials n Patients: –49 brochures & 2 Web sites –Core concept coverage: 15% - 70% n Providers: –No materials specifically for HAV!

9. Hepatitis B materials n Patients: –132 brochures, 7 Web sites & 7 videos –Core concept coverage: 3% - 71% n Providers: –5 brochures & 1 Web site –Core concept coverage: 11% - 45%

10. Hepatitis C materials n Patients: –60 brochures & 59 Web sites –Core concept coverage: 0 - 58% n Providers: –3 brochures –5 Web sites –Core concept coverage: 1% - 67%

11. Methods: Core Concept Coverage n For each core concept, the degree to which it was mentioned or explained was recorded n 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

12. 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%)

13. 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%)

14. 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 information26% –HAV is highly contagious 23%

15. Patient Concepts Not Well Covered Hepatitis B core concepts mentioned or explained in less than half of the materials evaluated: –HBV prevention46% –Testing information36% –The vaccine prevents liver cancer4%

16. 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 information1-35%

17. 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

18. Research Recommendations n Survey patients and providers to assess their core concept recommendations n Compile “comprehensive core concepts” recommendations from three samples (patients, providers and experts) n Re-score currently available materials

19. Acknowledgements n Cindy Weinbaum, MD - Project Officer n Kelli Scanlon - Project Manager n Delphi participants