ASPO Abstracts
Clinicians’ Perspectives on Barriers and Facilitators to Perinatal Hepatitis B Care as a Pathway to Preventing Liver Cancer Disparities
Category: Behavioral Science & Health Communication
Conference Year: 2019
Abstract Body:
Purpose: Hepatitis B virus (HBV) is the most common serious liver infection and leading cause of liver cancer worldwide. Chronic HBV infection and liver cancer in Asian and African immigrants are among the most serious, but frequently neglected racial health disparities in the U.S. Health care providers play a crucial role in preventing perinatal HBV transmission, by providing perinatal HBV testing, maternal education and care for both mothers and neonates. The objectives of this study were to determine provider-level knowledge, barriers, and facilitators to care for HBV positive women and determine what tools might be most helpful in providing HBV care to women who are diagnosed during pregnancy. Methods: Ten audio-transcribed 30-minute semi-structured interviews with obstetricians, gastroenterologists, neonatologists, pediatricians, family practitioners and nurses were conducted using open-ended questions. Inductive content analysis was used to identify emerging themes in the data. Results: Clinicians were most likely to report patient-related barriers, including a lack of hepatitis B knowledge, stigma and misconceptions surrounding the disease, low language skills and health literacy levels, phobia of frequent bloodwork, lack of health insurance coverage, and lack of compliance to medication. Most frequently mentioned provider barriers include not having necessary patient educational materials in various languages, and among general practitioners, not seeing the need to refer patients to specialty care. Facilitators to care that were identified include both patient and provider level education on hepatitis B and the creation of perinatal hepatitis B materials in languages other than English. Conclusion: The barriers reported by clinicians have been used to highlight new potential intervention targets and tools to improve patient outcomes, including developing strategies to better educate providers at health centers and creating and disseminating patient literature in various languages. Findings will be used to inform the development of a questionnaire to be administered to women who are hepatitis B positive in phase two of the study to assess HBV knowledge, attitudes, beliefs, and barriers and facilitators to care.
Keywords: Health disparities, liver cancer, hepatitis b, maternal and child health