“HEPARJOC-ACTÚA”: educational tool created through a process of participatory action research with vulnerable immigrant groups to improve accessibility to diagnosis of hepatitis B

Abstract

Background: The World Health Organization estimates that 257 million people suffer from chronic infection by the hepatitis B (HB) virus. It is common for diagnosis to be delayed or never given at all. In Spain, immigrants that come from endemic areas present a prevalence of infection of around 8%. In the year 2015, this study was begun with the aiml of improving accessibility to hepatitis B diagnoses in immigrant communities. Methods: A descriptive qualitative study was carried out, based on participatory action research (IAP). It was di- vided into two cycles: in the first cycle, after forming a motor group (GIAP), a participatory community assessment (DCP) was performed with the population, through a descriptiveinterpretative qualitative study (ECDI) with 3 focal groups (n=17). A narrative analysis was then performed of thema- tic content. In the second cycle, two collaborative work- shops (coworking) were held to create an educational tool (HEPARJOC) and to co-create an action plan (PDA). As a pilot test, the PDA was put into practice through eight work- shops (n=56). A knowledge questionnaire was used to compare the median number of correct responses before and after the workshop, using the t of Student for paired data. Results: A GIAP was formed with 8 members of different sectors and community spaces. In the DCP it was observed that there was a lack of knowledge about different aspects of hepatitis B. Visual, interactive materials were proposed as educational tools, and “HEPARJOC” was created as the final product. In the pilot test of the PDA, the median of correct responses to the knowledge questionnaire about HB was 7.7 (DE=3) before the workshop, and 10.6 (DE=0.2) afterward. The improvement of the median was 2.9 points (IC 95% 2.2- 3.6), which is statistically significant (p<0.001). 30 people sought screening (53.6% of participants), and 23 of those people were screened (41% of participants). Conclusions: “HEPARJOC-ACTUA” is a strategy that could contribute to transforming knowledge and improving accessibility to hepatitis B diagnosis in immigrant communities. Key words: Infectious diseases, hepatitis B, community health, community health agents, health education, participatory action research, immigration.