Implementing Promising Strategies to Reduce the Risk for Viral Hepatitis and Liver Cancer Among People Who Inject Drugs

Abstract

Purpose

To describe a 3-year demonstration project with selected Centers for Disease Control and Prevention National Comprehensive Cancer Control Program (NCCCP) award recipients to build partnerships with local organizations to improve knowledge and awareness of the association between injecting drugs and the risk for viral hepatitis and liver cancer, improve delivery of viral hepatitis services, and implement comprehensive syringe services programs.

Design

A mixed-methods descriptive evaluation of selected evidence-based interventions or promising strategies that each award recipient implemented based on the needs of their population.

Setting

Selected provider and patient populations served by NCCCP award recipients in Iowa, Minnesota (American Indian Cancer Foundation), Mississippi, and West Virginia.

Subjects

Four award recipients that implemented individually-tailored strategies and activities.

Measures

Processes were assessed through monitoring and tracking tools. Challenges, lessons learned, and recommendations were collected via qualitative interviews.

Analysis

We used descriptive statistics to analyze quantitative data. We analyzed award recipient interviews using thematic analysis.

Results

Activities were implemented across four strategies. Strong public-private partnerships, ongoing technical assistance, a deep understanding of individual populations, and a shared commitment to remaining flexible were main factors.

Conclusion

While challenges existed, award recipients implemented key strategies and activities in their populations. Findings contribute to the scaling of best practices to the larger cancer control community especially those whose populations are at higher risk for viral hepatitis.

Keywords

awareness strategies,specific populations underserved populations specific populations,clinical specific settings,community specific settings

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References

Centers for Disease Control and Prevention . Liver cancer. Liver cancer | CDC. Accessed November 16, 2022.

Cronin

Scott

Firth

, et al. Annual report to the nation on the status of cancer, part 1: National cancer statistics. Cancer. 2022;128:1-34. DOI: 10.1002/cncr.34479

Centers for Disease Control and Prevention . Hepatitis B surveillance in the United States. https://www.cdc.gov/hepatitis/statistics/2019surveillance/HepB.htm. Accessed October 17, 2022.

Centers for Disease Control and Prevention . Hepatitis C surveillance in the United States. https://www.cdc.gov/hepatitis/statistics/2019surveillance/HepC.htm. Accessed October 17, 2022.

National Academies of Sciences , Engineering, and medicine; health and medicine division; board on population health and public health practice; committee on a national strategy for the elimination of hepatitis B and C. In: Strom

Buckley

, eds. A National Strategy for the Elimination of Hepatitis B and C: Phase Two Report. Washington DC: National Academies Press (US); 2017.

Zibbell

Asher

Patel

, et al. Increases in acute hepatitis C virus infection related to a growing opioid epidemic and associated injection drug use, United States, 2004 to 2014. Am J Publ Health. 2018;108(2):175-181. doi:10.2105/AJPH.2017.304132

Centers for Disease Control and Prevention . National comprehensive cancer control program. https://www.cdc.gov/cancer/ncccp/index.htm. Accessed July 28, 2022.

U.S. Cancer Statistics Working GroupU.S. Cancer . Statistics Data Visualizations Tool, Based on 2021 Submission Data (1999-2019). U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute www.cdc.gov/cancer/dataviz. released in June 2022.

Centers for Disease Control and Prevention . Evidence-based strategies for preventing opioid overdose: What’s working in the United States. Available at: https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf. Accessed October 4, 2022.

10.

Project ECHO, The university of New Mexico. A revolution in medical education and care delivery: https://hsc.unm.edu/echo/. Accessed October 27, 2022.

11.

Momin

Mera

Essex

, et al. Implementation of liver cancer education among health care providers and community coalitions in the cherokee nation. Prev Chronic Dis. 2019;16:E112. doi:10.5888/pcd16.180671

12.

Momin

Nielsen

Schaff

Mezzo

Cariou

. Promising interventions to prevent liver cancer in Idaho. Health Promot Pract. 2023;24(0):373-379. doi:10.1177/15248399211057154

13.

Frieden

. Six components necessary for effective public health program implementation. Am J Publ Health. 2014;104(January 1):17-22.