C0504 - Acceptability and Feasibility of Hepatitis B Screening Using Dried Blood Spots in a Free Community Health Fair Setting

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Sirisha Gaddipati, MD

University of Miami/Jackson Health System
miami, FL

Sirisha Gaddipati, MD¹, Kristin Gmunder, MS², Joseph Deshan, BS², Osmay Cardoso, BS³, Amar R. Deshpande, MD, FACG², Patricia Jones, MD, MSCR²
¹University of Miami/Jackson Health System, Miami, FL; ²University of Miami Miller School of Medicine, Miami, FL; ³University of Miami, Miami, FL

Introduction: Chronic hepatitis B virus (HBV) infection is a major global health problem. Rates of HBV in Florida are higher than the national rate, reflecting immigration patterns. There are pervasive barriers to screening for HBV. In this study, we aimed to assess the feasibility of using dried blood spot (DBS) tests to screen for HBV at medical-student run, free community health fairs and to understand factors influencing acceptability of such testing.

Methods: Participants attended two of the University of Miami’s Mitchell Wolfson Sr. Department of Community Service (DOCS) health fairs in December 2021 and April 2022. At these USPSTF-based screening health fairs, patients were invited to participate and complete a questionnaire assessing HBV screening acceptability. Those who agreed to screening had fingerstick performed and DBS testing; DBS cards were shipped to Molecular Testing Labs (Vancouver, WA). Samples were processed for hepatitis B surface antigen and results were returned to DOCS student personnel, who then provided results via letter and/or telephone call according to a pre-specified schema over 3 to 4 weeks.

Results: There were 82 participants in this pilot study. While all participants agreed to receive DBS testing, 28.0% reported that aspects made them feel uncomfortable, citing the long turnaround time for results, 78.2%, and lack of financial resources should treatment be necessary, 69.9%. The majority, 72.0%, found the proposed screening acceptable, but proposed that other community members might be uncomfortable with screening due to the lack of immediate results, 33.9%, and lack of resources for treatment, 30.5%. In total, 73 patients had negative tests, 8 patients had insufficient samples for adequate screening; 1 patient received preliminary positive findings for HBV infection.

Discussion: In a community health fair setting, we found that using DBS to screen for HBV was acceptable among most participants receiving similar health screenings. Offering screening tests with faster turnaround time for results could improve acceptability. The finding of insufficient samples highlights the need for quality improvement training to obtain adequate blood samples. Participant concern regarding lack of financial resources if treatment is needed has been reported in other studies. Future studies will examine acceptability at other health fairs with different demographics and a cost-benefit analysis of routine screening for HBV amongst vulnerable patients.

Figure: Figure 1A shows the geographic distribution of the countries of origin of patients seen at the community health fairs. Figure 1B displays proportion of patients who have been vaccinated for HBV as well as those who have not been vaccinated and those who are unaware of their vaccination status. Figure 1C shows testing results and the schema utilized to return results to participants and patients.

Table 1: Demographics of patients who underwent HBV Screening
Median age (years)	49.5
Female sex (%)	50
Race/Ethnicity (%)
Black (African American)	2.4
Black (Hispanic)	4.9
White (Hispanic)	85.4
White (Non-Hispanic)	3.7
Prefer not to answer	3.7
Language Preferences (%)
Spanish	78
English	22
Country of Origin: United States (%)	12.2
Insurance Type (%)
Uninsured	58.5
Private	28
Medicare/Medicaid	6.1
Other/Do not know/Refused	7.3

Table: Table 1: Demographics of patients who underwent screening for HBV at one of two medical-student run, free community health fairs.

Disclosures:

Sirisha Gaddipati indicated no relevant financial relationships.

Kristin Gmunder indicated no relevant financial relationships.

Joseph Deshan indicated no relevant financial relationships.

Osmay Cardoso indicated no relevant financial relationships.

Amar Deshpande: American Board of Internal Medicine – Advisory Committee/Board Member. GI Health Foundation – Advisory Committee/Board Member. Takeda – Grant/Research Support.

Patricia Jones indicated no relevant financial relationships.

Sirisha Gaddipati, MD¹, Kristin Gmunder, MS², Joseph Deshan, BS², Osmay Cardoso, BS³, Amar R. Deshpande, MD, FACG², Patricia Jones, MD, MSCR². C0504 - Acceptability and Feasibility of Hepatitis B Screening Using Dried Blood Spots in a Free Community Health Fair Setting, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.