The Hepatitis C State Action Plan was finalized in December 2002. It
outlined strategies targeted to specific demographic groups, including those
with HIV, veterans, and racial and ethnic minorities who suffer a higher
incidence of hepatitis C, and persons who engage in high-risk behavior, such as
intravenous drug users.
Public education and awareness.
The Texas Department of Health (TDH) has ongoing public awareness and
educational projects. These efforts are guided by the Texas Hepatitis C State
Workgroup, a group comprised of various stakeholders from the public and private
The Hepatitis C State Workgroup.
The Hepatitis C State Workgroup is open to anyone
interested in attending. The workgroup meets two to three times per year,
depending on need, in Austin. Videoconferencing capability to remote locations
became available in March 2004. The workgroup offers guest speakers on various
hepatitis C-related topics, allows for networking opportunities, and provides a
forum for hepatitis C discussions. Meeting notices, agendas, and minutes are
transmitted through e-mail to all members. The workgroup has more than 150
members, including patients and their families, support group leaders, advocacy
group members, private physicians, nurses, medical research center staff, health
educators, counselors, local health department staff, legislative staff,
pharmaceutical company representatives, various associations, blood and tissue
center representatives, and state agency representatives.
Most of the state’s current public education efforts
are intended to raise the public’s overall awareness of hepatitis C, including
risk factors, modes of transmission, methods of prevention, and the value of
early detection. TDH has developed educational materials in English and Spanish.
Posters, brochures, exhibit handouts, Web pages, public service announcements,
and radio and TV advertisements have been developed for the general public and
targeted audiences, such as intravenous drug users, youths, at-risk adults, and
Campaigns to raise public awareness have been targeted at high-risk adult
Hispanic males and African-American youths. Campaigns have included local
collaborations and strategically placed TV and radio advertisements. Campaigns
have been supplemented by public service announcements, press releases, media
interviews, and the distribution of related posters and brochures in targeted
Plans are underway for a grassroots campaign
targeted at employers. Plans are also being developed to distribute educational
and prevention materials to students, K-12.
Conference exhibits and presentations.
Exhibits and presentations at public health fairs, school conferences, and
family fairs are being conducted year-round. The booth display, exhibit
materials, and handouts all include hepatitis C information about prevention,
risk factors, symptoms, and educational resources.
Web pages provide educational information and resources online for the general
public and targeted audiences, including intravenous drug users, youths,
employers, persons who have been incarcerated, veterans, and persons who are
co-infected with hepatitis B or HIV/AIDS. The Web pages offer frequently asked
questions, educational brochures, posters, and public service announcements. The
Web pages also include information on prevention, living with hepatitis C,
related social services, and links to other hepatitis C-related sites. All pages
can be viewed and downloaded.
The Web pages have information about the
development of the Texas Hepatitis C Initiative, including a historical timeline
of legislation passed, a flowchart of implementation, and descriptions of
projects and activities.
Hepatitis C video lending library.
Hepatitis C videos (and videos about all blood-borne pathogens) are available
for the public to borrow through TDH’s Audio/Visual Lending Library. Videos are
available that specifically target adults, youths, health-care professionals,
schools, and employers.
Hepatitis information line.
From May 2001 through August 2004, the Texas Hepatitis C Initiative developed
and maintained a toll-free hepatitis information line, 1-866-4HEPABC, in
collaboration with more than 35 local health departments across the state.
Callers were able to hear taped messages in English and Spanish about the most
frequently asked questions about hepatitis A, B, and C. An option key enabled
callers to speak directly to staff for more information on specific questions,
educational materials, health resources, and support group contacts statewide.
After September 1, 2004, when funding ends, the line will be discontinued.
Professional outreach is conducted year-round.
The Hepatitis C State Workgroup meetings offer guest speakers, including
physicians and medical research institute staff. Hepatitis C staff members also
are frequent guest speakers at professional health-care conferences, meetings,
and university and college medical and nursing program lectures.
Hepatitis C training.
Training also is conducted often, through videoconferencing, for local health
department staff and emergency personnel across the state.
Exhibits are held at professional health-care conferences.
Articles have been published in journals for physicians and other health-care
Web pages offer information about health-care professional training. Links to
training sites are listed for physicians, nurses, and licensed chemical
dependency counselors. The listing includes program descriptions, costs, and
methods of training. Other Web pages provide patient information that can be
viewed or downloaded.
From June 2000 through August 2003, when funding ended, more than 500
health-care professionals received training through biannual didactic courses.
TDH offered the professional training at the University of Texas Southwestern
Medical Center (UTSWMC) in Dallas, Texas. Trainings were conducted by Professors
of Internal Medicine at the Clinical Center for Liver Disease at UTSWMC. Primary
topics covered were hepatitis epidemiology, patient evaluation, and current
treatment options. The practicum consisted of observing patient visits and
discussions with UTSWMC clinicians of problems relating to the diagnosis and
treatment of viral hepatitis.
From October 2000 through August 2003, when funded ended, more than 850
counselors received training to develop skills and confidence in the integration
of hepatitis C intervention messages into existing HIV/STD intervention
settings. Since August 2003, HIV/STD staff members have integrated hepatitis C
information into existing HIV/STD training and manuals as chapters and
components of their trainings.
From March 2002 through August 2003, when funding ended, TDH provided training
to more than 400 licensed nurses statewide. This training was developed to help
licensed nurses receive required credits under state law, which required all
licensed nurses to participate in no less than two hours of continuing education
related to hepatitis C before their licensure renewals in June 2004.
Advocacy groups and pharmaceutical companies also
provided training to nurses statewide.
Counseling and testing.
From September 2000 through December 2003, when funded ended, more than 1,400
persons received counseling and testing per month. More than 46,000 persons
statewide received testing, with about 25 percent testing positive for hepatitis
C on the blood-screening test.
TDH was one of the first states to integrate
hepatitis C into HIV/STD settings. TDH had more than 20 contractors with
multiple counseling and testing sites statewide, which offered prevention
counseling and targeted testing services. Client-centered prevention counseling
helped individuals in making behavioral changes to reduce their risk of
acquiring or transmitting diseases. Prevention counseling helped clients improve
their perception of risk, develop a realistic risk reduction plan, and make
decisions about testing. If a client’s test was positive, counseling helped the
client to integrate the test result emotionally, behaviorally, and socially.
TDH conducted seroprevalence studies as mandated by state law. Recognizing that
resources for testing were limited and demand was high, staff members developed
a laboratory-testing algorithm, similar to the one used by the Centers for
Disease Control and Prevention, that ensured accurate results, but at the same
time limited the use of costly supplemental confirmatory assays to situations in
which the screening test was not clear.
Hepatitis C staff members monitor reported cases of
hepatitis C infections across the state to gauge demographic and geographic