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CASE STUDY: Test4HepC
Program Development, Implementation, Evaluation / 2015-2017

COLLABORATION: Sentient Research and UCLA

 

Challenge
Find innovative ways to encourage baby boomers in the United States—those born between 1945 and 1965—to test for hepatitis C virus (HCV). There are currently an estimated 3.4 to 6 million Americans with chronic hepatitis C, a disease that can lead to liver cancer, liver failure, and death, but which can now be effectively treated.

Impact
Sentient Research and UCLA demonstrated the potential for an online/social media platform (Test4HepC) to be an effective tool to promote testing for HCV to baby boomers, who account for three-quarters of people with HCV in the United States. By getting tested, people can get the care they need to stay healthy and greatly reduce their chances of suffering serious health consequences from untreated HCV.

Publication
Test4HepC: Promoting Hepatitis C Testing to Baby Boomers Using Social Media.
Plant A, Snow EG, Montoya JA, Young S, Javanbakht M, Klausner JD. Health Promot Pract. 2019 [Epub ahead of print].

Contact
Aaron Plant, MPH
info@sentientresearch.net

 

The Story
The majority of people with HCV will develop a chronic infection that can result in liver disease and is the leading cause of liver cancer. HCV-associated liver failure is the most common reason for liver transplantation in the U.S. and worldwide. Pharmaceutical advances have resulted in several highly effective HCV medications with cure rates ranging from 70% to 100%, however, many people (43-85%) are unaware of their HCV infection.

Baby boomers are disproportionately affected by HCV. Survey data from 1999-2008 found that 3.2% of baby boomers have HCV, compared to 1.3% of all adults. Interestingly, the same study showed that almost half (48%) of baby boomers reported no known exposure risks. Other studies have revealed that overall, baby boomers have low HCV knowledge, low risk perception, and low rates of testing for HCV.

Program Design and Implementation
In collaboration with the David Geffen School of Medicine at UCLA and UCLA Fielding School of Public Health, Sentient Research created a website and social media program (Test4HepC) designed to increase baby boomers’ risk perception for and ultimately testing for HCV. Test4HepC.org was launched in October 2015, and includes a field where users enter their zip code to find free or low-cost testing locations near them, and promotes various ways to test, including free testing at commercial laboratory locations paid for by the program. Test4HepC.org also includes detailed information about HCV transmission, risk factors, testing, and treatment.

This program was promoted solely using social media. Facebook ads specifically targeting baby boomers living in Los Angeles County directed people to the website with information and resources about HCV testing. In addition, we created a Test4HepC Facebook page where we posted information about the program and general HCV news. Twenty-five Facebook ads and boosted posts were run in several waves over 16 months, with varied images and messaging about HCV risk among baby boomers, negative outcomes of untreated HCV, and availability of free and low-cost HCV testing.

Evaluation
After the first 16 months of implementing the program, Sentient Research conducted a mixed-methods evaluation of Test4HepC that included website analytics, free laboratory testing usage data collected by program staff, an online survey of website users, and qualitative interviews with website users. To our knowledge, this is the first evaluation of a program that uses social media to specifically encourage baby boomers to test for HCV, even though baby boomers are extremely active Facebook users.

Test4HepC Facebook advertisements reached 204,657 individuals and resulted in 8,547 clicks to the website. There were 6,919 unique Test4HepC.org visitors. Of these, 2,020 (29.2%) used the testing site locator. Forty-eight people accessed free laboratory testing through the testing site locator and one of these results was HCV-positive.

Out of 302 total survey participants, most found Test4HepC.org to be very useful (60.3%) or somewhat useful (22.8%) and (70.5%) of participants used the testing site locator. Seventy-four (24.5%) tested for hepatitis C after using the website; two participants reported testing positive (2.7%; which is similar to the estimated positivity rate among baby boomers nationally). Over half of those testing (51.4%) used the free laboratory testing provided by the program.

Twenty individuals participated in a qualitative telephone interview. These interviews indicated that Test4HepC increased baby boomers' HCV risk perception and encouraged testing. Participants also offered valuable feedback on program refinements.

Next Steps
Our mixed methods evaluation of Test4HepC demonstrated the potential of using social media to promote HCV testing to baby boomers, provided useful information about which elements of the program worked best, and revealed feasible ways to improve the program. We plan to make further refinements to the program using the data from our evaluation, and currently are considering program expansion to other areas, and specifically targeting segments of baby boomers at highest risk for HCV.

 

 

 

 
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