Abstract
Introduction
CVH is a leading contributor to the UK’s liver disease epidemic, but is often undiagnosed. Guidance recommends case-finding in higher-risk groups in line with the World Health Organisations call for elimination of CVH as a public health problem. Migrants from high prevalence areas are one such higher-risk group. However, there
remains no consensus on the optimal case-finding strategy.
Methods
Focus groups (FG) were held with South Asian migrants to explore understanding of CVH. Analysis of FG data identified key themes, which were used to develop a targeted educational film. A feasibility study assessing recruitment of South Asian migrants to view this film, to promote case-finding for CVH, was completed in South-East England. Dried-blood spot testing for CVH was offered after the film. Statistical analysis was performed using Stata IC V15.
Results
Eight FGs representative across age, gender and education levels were held. Five key themes were identified: lack of awareness, access and attitude to healthcare, concerns around testing and stigma. These were used to develop a culturally tailored educational film shown in community settings to promote CVH testing.Of the n=219 recruited to view the film, 84% (n=) tested for CVH. Fourteen had exposure to CVH and all active cases were linked to care.
Discussion
This study showed it is feasible to recruit South Asian migrants to view an educational film on CVH in community settings. The effectiveness of this intervention in promoting testing for CVH (84% tested) has led to plans for a national randomised controlled trial, demonstrating the importance of targeted case-finding in line with the WHO plan for CVH elimination. Furthermore, its success means we can recommend this approach as a model for targeted community-based interventions.