Novel Models to Identify Census Tracts for Hepatitis C Screening Interventions.


Journal

Journal of the American Board of Family Medicine : JABFM
ISSN: 1558-7118
Titre abrégé: J Am Board Fam Med
Pays: United States
ID NLM: 101256526

Informations de publication

Date de publication:
Historique:
received: 30 08 2019
revised: 12 12 2019
accepted: 03 01 2020
entrez: 21 5 2020
pubmed: 21 5 2020
medline: 30 7 2021
Statut: ppublish

Résumé

Increased screening efforts and the development of effective antiviral treatments have led to marked improvement in hepatitis C (HCV) patient outcomes. However, many people in the United States are still believed to have undiagnosed HCV. Geospatial modeling using variables representing at-risk populations in need of screening for HCV and social determinants of health (SDOH) provide opportunities to identify populations at risk of HCV. A literature review was conducted to identify variables associated with patients at risk for HCV infection. Two sets of variables were collected: HCV Transmission Risk and SDOH Level of Need. The variables were combined into indices for each group and then mapped at the census tract level (n = 233). Multiple linear regression analysis and the Pearson correlation coefficient were used to validate the models. A total of 4 HCV Transmission Risk variables and 12 SDOH Level of Need variables were identified. Between the 2 indexes, 21 high-risk census tracts were identified that scored at least 2 standard deviations above the mean. The regression analysis showed a significant relationship with HCV infection rate and prevalence of drug use (B = 0.78, Geospatial models identified high-priority census tracts that can be used to map high-risk HCV populations that may otherwise be unrecognized. This will allow future targeted screening and linkage-to-care interventions for patients at high risk of HCV.

Sections du résumé

BACKGROUND
Increased screening efforts and the development of effective antiviral treatments have led to marked improvement in hepatitis C (HCV) patient outcomes. However, many people in the United States are still believed to have undiagnosed HCV. Geospatial modeling using variables representing at-risk populations in need of screening for HCV and social determinants of health (SDOH) provide opportunities to identify populations at risk of HCV.
METHODS
A literature review was conducted to identify variables associated with patients at risk for HCV infection. Two sets of variables were collected: HCV Transmission Risk and SDOH Level of Need. The variables were combined into indices for each group and then mapped at the census tract level (n = 233). Multiple linear regression analysis and the Pearson correlation coefficient were used to validate the models.
RESULTS
A total of 4 HCV Transmission Risk variables and 12 SDOH Level of Need variables were identified. Between the 2 indexes, 21 high-risk census tracts were identified that scored at least 2 standard deviations above the mean. The regression analysis showed a significant relationship with HCV infection rate and prevalence of drug use (B = 0.78,
CONCLUSIONS
Geospatial models identified high-priority census tracts that can be used to map high-risk HCV populations that may otherwise be unrecognized. This will allow future targeted screening and linkage-to-care interventions for patients at high risk of HCV.

Identifiants

pubmed: 32430372
pii: 33/3/407
doi: 10.3122/jabfm.2020.03.190305
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

407-416

Informations de copyright

© Copyright 2020 by the American Board of Family Medicine.

Déclaration de conflit d'intérêts

Conflicting and Competing Interests: None

Auteurs

Thomas Ludden (T)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP). Tom.Ludden@atriumhealth.org.

Lindsay Shade (L)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Jeremy Thomas (J)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Brisa Urquieta de Hernandez (BU)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Sveta Mohanan (S)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Mark W Russo (MW)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Michael Leonard (M)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Philippe J Zamor (PJ)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Charity G Patterson (CG)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

Hazel Tapp (H)

From Department of Family Medicine, Atrium Health, Charlotte, NC (TL, LS, JT, SM, HT); Department of Hepatology, Atrium Health, Charlotte, NC (MWR, PJZ); Department of Infectious Diseases, Atrium Health, Charlotte, NC (ML); Community Health, Atrium Health, Charlotte, NC (BUH); School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA (CGP).

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