Hepatitis A, B, and C Prevention Programs
Information and Programs for Adults and Adolescents at Risk
Presented by the Immunization Action Coalition with dedicated funding from the
Division of Viral Hepatitis at the Centers for Disease Control and Prevention
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Programs for other populations at risk
STD/HIV clinics

Texas Department of Health (TDH), Hepatitis C Initiative
Program name: Texas Department of Health (TDH), Hepatitis C Initiative
Population served: Educational resources and materials are provided to all requestors
Eligibility: Counseling and testing are available at some locations for a nominal fee. Until December 31, 2003, when funding ended, counseling and testing were provided at no cost to those persons at highest risk for hepatitis C who did not have financial resources.
Region served: Texas
Funding: State appropriations and grants
Program started: January 2000
Number of clients: More than 90 requests for information are received monthly (not including Web site hits or direct requests for educational materials from the department’s lending library or warehouse). Until December 31, 2003, when funding ended, the counseling and testing sites served 2,400 clients annually.
Contact: Gary Heseltine, MD, MPH
TDH IDEAS Division
1100 W. 49th Street
Austin, TX 78756
Phone: (512) 458-7111, ext. 6352
Fax: (512) 458-7616
Email: Gary.Heseltine@dshs.state.tx.us
Website: http://www.tdhideas.org
IAC is not responsible for content found on other websites.

State plan. 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 sector.

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.

Educational materials. 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 employers.

Campaigns. 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 communities.

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. 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 training. Professional outreach is conducted year-round.

Guest speakers. 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.

Conference exhibits. Exhibits are held at professional health-care conferences.

Journal articles. Articles have been published in journals for physicians and other health-care professionals.

Web pages. 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.

Didactic courses. 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.

Counselor training. 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.

Nurses training. 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.

Seroprevalance studies. 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.

Ongoing surveillance. Hepatitis C staff members monitor reported cases of hepatitis C infections across the state to gauge demographic and geographic trends.

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          Hepatitis Prevention Programs

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