Evaluation of the Deadly Liver Mob program: insights for roll-out and scale-up of a pilot program to engage Aboriginal Australians in hepatitis C and sexual health education, screening, and care

Carla Treloar; Max Hopwood; Elena Cama; Veronica Saunders; L Clair Jackson; Melinda Walker; Catriona Ooi; Ashley Ubrihien; James Ward

doi:10.1186/s12954-018-0209-y

Evaluation of the Deadly Liver Mob program: insights for roll-out and scale-up of a pilot program to engage Aboriginal Australians in hepatitis C and sexual health education, screening, and care

Harm Reduct J. 2018 Feb 1;15(1):5. doi: 10.1186/s12954-018-0209-y.

Authors

Carla Treloar¹, Max Hopwood², Elena Cama², Veronica Saunders², L Clair Jackson², Melinda Walker², Catriona Ooi³, Ashley Ubrihien⁴, James Ward⁵

Affiliations

¹ Centre for Social Research in Health, UNSW Sydney, Sydney, Australia. c.treloar@unsw.edu.au.
² Centre for Social Research in Health, UNSW Sydney, Sydney, Australia.
³ Western Sydney Sexual Health Centre, Western Sydney Local Health District, Sydney, Australia.
⁴ Western Sydney HIV and Related Programs Unit, Western Sydney Local Health District, Sydney, Australia.
⁵ South Australian Health and Medical Research Institute, Adelaide, Australia.

Abstract

Background: Deadly Liver Mob (DLM) is a peer-driven, incentivised health promotion program aimed at increasing understanding of hepatitis C, promoting harm reduction in relation to injecting drug use, and linking participants to screening for hepatitis C, other blood borne viruses and sexually transmissible infections among Aboriginal people in Western Sydney, NSW. This paper presents the evaluation of a pilot study examining the acceptability of the program as a first step of a scalability assessment.

Methods: Deadly Liver Mob operated in co-located needle and syringe programs and sexual health clinics in two sites: (Site 1: two and a half years for 2 days/week; Site 2: 1 year for 1 day per week). Comparisons were made of the proportion of Aboriginal clients (Site 1) and occasions of service provided to Aboriginal clients (Site 2) in the 12 months prior and post-introduction of DLM. Interviews were conducted with 13 staff involved in delivery of DLM and with 19 clients.

Results: A total of 655 and 55 Aboriginal clients, respectively, attended Site 1 and Site 2 for health education. The proportion of Aboriginal clients attending both sites was significantly higher during the DLM compared with prior to its implementation. Of those attending for health education, 79 and 73%, respectively, attended screening following education. DLM clients strongly endorsed the program. Some staff were concerned about workforce capacity to effectively engage Aboriginal clients with multiple and complex needs, managing the differing aims of the participating services involved, and about offering of incentives for attendance at health services.

Conclusion: While acceptability was high among staff and clients and preliminary results show high engagement with Aboriginal communities, this evaluation of a pilot program raises some issues to consider in scale up of DLM to other sites. The initiation of additional DLM sites should address issues of alignment with governing strategies and workforce capacity.

Keywords: Aboriginal Australians; Hepatitis C; Implementation; Incentives; STIs.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Female
Harm Reduction
Health Education / methods*
Health Promotion / methods*
Health Services, Indigenous*
Hepatitis C / diagnosis*
Hepatitis C / prevention & control
Hepatitis C / therapy*
Humans
Male
Middle Aged
Native Hawaiian or Other Pacific Islander
New South Wales
Pilot Projects
Program Evaluation / methods*
Young Adult