The Effect of Low-Cost Educational Interventions for Reducing the Spread of Hepatitis - Literature review Example

?A Systematic Review to Access the Effect of Low Cost Educational Interventions for Reducing the Spread of Hepatitis Background Hepatitis isa highly spreadable virus and is a common phenomenon among individuals with low knowledge about how to deal with it. The infection of hepatitis virus leads to severe illness and ultimately can cause death to human beings. Proper educational intervention is necessary in order to teach individuals about the detrimental impact of hepatitis and also to provide measures to reduce its spread. Objectives The objective of the review is to evaluate whether low cost educational interventions could possibly minimise the spread of hepatitis among people. The paper also attempts to analyse several aspects which are associated with spread of hepatitis among individuals. Search Methods In order to undertake the review several electronic papers, articles and books are studied. Observational journals are included in the paper in order to obtain information about the subject. Selection Criteria The major selection criteria for the systematic review are randomised controlled trials, interview, questionnaire study, data abstraction and analyses of databases. Table of Contents Abstract 2 Background 2 Objectives 2 Search Methods 2 Selection Criteria 2 Background 4 Objectives 5 Selection Criteria 5 Types of Studies 5 Type of Participants 6 Type of Interventions 6 Type of Outcome Measures 6 Search Strategy for Identification of Studies 7 Methods of the Review 8 Assessment and Selection of Studies 8 Assessment of Quality 9 Data Extraction 9 Data Analysis 10 Description of Studies 10 Methodical Quality of Included Studies 11 Results 11 Discussion 13 Conclusion 14 References 15 Bibliography 18 Background Recent decades have witnessed rapid spread of hepatitis virus which is a highly transmittable blood related pathogen characterised by extensive illness and at times death. Hepatitis virus can be spread in several ways such as blood transfusion, organ replacement, colonoscopies, use of low purified medicinal, clinical and dental tools, birth from sick mother, vaccination drug use, intranasal cocaine consumption, ear-splitting, tattooing, earrings, sexual interaction with infected person, sharing of certain tools such as shaving blades and contact with blood for professional reasons. Among the above factors, organ replacement is the basic cause for hepatitis diffusion. Sexual interaction is the second most risk creating aspect for hepatitis acquirement. Apart from these, considerable number of hepatitis infections in developed nations is also diffused through vaccination needles (Rauner & et. al., 2005). The spread of hepatitis is avoidable. Efficient deterrence intervention can decrease the spread and succeeding influence of infection on people as well as society. Reduction of spread of hepatitis encompasses variety of tactics, including supply of germ-free vaccinating tools, peer education, and primary care facilities. Involving people and providing support and education are essential parts for reducing the spread of hepatitis. With appropriate education, risks of hepatitis can be addressed and inhibited effectively (Hunt & et. al., 2010). The major activities for reduction of hepatitis transmission could be: Increased access to germ-free vaccinating tools, especially in population with high requirement Strengthen the capability of educators to make sure that they have complete access to hepatitis reduction understanding and skill Strengthen association with drug and medical divisions Create innovative health education system Enhance training and support for community oriented hepatitis educationalists including drug consumers Recognise and perform through regulatory obstacles to evidence oriented prevention policies Conduct a systematic review to recognise the impact of educational interventions on lessening of hepatitis (Commonwealth of Australia, 2010) Objectives The objective of the systematic review is to recognise the importance of low cost educational interventions for reducing the diffusion of hepatitis among people. The review will help to understand how educational support can be beneficial for people to minimise the occurrence of hepatitis spread incidents. Selection Criteria Types of Studies In order to undertake the research, systematic review of major internet healthcare databases, ‘randomised controlled trials’ and personal interviews had been considered. Systematic review helps in understanding the fundamental aspects of the subject under study. On the other hand, randomised controlled trails are very significant experimental tool for research. Randomised controlled trials are useful for the study as the paper is related with developing relationship between providing education and its impact on minimisation of hepatitis. In this study, people were selected at random in order to obtain medical interventions. Intervention in this sense is education which can have an impact on the prevention strategies of hepatitis. Randomised controlled trials are also used for assessment of the impact of intervention on specific consequences such as recurrence of hepatitis transmission to people. Thus, it is considered as one of the strongest tools in modern medical research studies (Stolberg & et. al., 2004). Furthermore, personal interview also is suitable for assessing the cost effectiveness of the subject. Type of Participants The participants for the study were people of different age groups (such as teenagers and aged persons) of different nations such as the United States, Korean immigrants and Cambodian refugees. The study was intended to promote education to them in order reduce hepatitis spread. Type of Interventions The intervention for the study encompasses learning, motivation and interactive abilities. The intervention is focussed on providing knowledge regarding hepatitis spread reduction. Through inspiring the participants, the study intended to influence them for changing the activities towards several aspects which can result in infection (Lauver & et. al., 2004). Type of Outcome Measures In this paper, four kinds of outcome measures have been considered. The first measurement was to recognise the level of decline of risk which is related with vaccination drug. Moreover, changes in the greater-risk sexual activities of people are one of the most significant reasons for spread of hepatitis among individuals. The third measurement was the awareness and attitudes of individuals about hepatitis infection and inhibition. It helped to recognise the risk level after low cost educational interventions to the individuals. Overall, hepatitis infection occurrence among people and hepatitis conversions are also measured in the study review. Search Strategy for Identification of Studies Two strategies are used in order to gather research materials for systematic review. The first strategy was to search from various internet records. The research undertakes searching of articles and records which can provide significant information about the research subject. The research also attempted to download complete reports in order to conduct systematic review. In order to minimise the biasness, different journals have been selected. The other strategy which has been used for searching materials for studies is scanning of internal components of journals. The issues of numerous periodicals have been covered through searching. This strategy helped to avoid selecting inadequate journals for the research and to classify those journals which are pertinent for the study. Internet searching is used for the study as it is a valuable technique for collecting writings such as unpublished documents, reports and papers (University of York, 2009). In order to search for appropriate documents and journals, the following keywords have been used: Hepatitis infection Injection drug Spreading of hepatitis infection Health education Educational interventions Reduction of spread of hepatitis Minimisation of virus transmission Prevention of hepatitis spread The procedure of searching appropriate paper was quite iterative. Thus, in order to avoid missing useful terms for searching appropriate materials, the searching process has been repeated and developed (Commonwealth of Australia, 2000). Methods of the Review Finding appropriate studies is quite a difficult task as there are numerous journals in the field of medical research. Thus, scanning through mass amount of writings can result in duplicate publications and insignificant journals. Therefore, systematic approach has been followed in order to identify the best journals which can appropriately address the research subject. Numerous journals have been selected by using different keywords relevant to the subject topic. The date, quality and publications of journals were considered while searching them for conducting the study. Assessment and Selection of Studies After searching certain journals for the study, they are apprised for selection. Only relevant articles are chosen from the large pool of articles found online. In order to select suitable journals, the components are appraised to match the research subject criteria. There must not be any kind of measurement bias in assessing the components of different papers. Thus, in order to reduce the biasness, opinions of two reviewers are used. Each reviewer independently read and scored the journals which can possibly be encompassed in the study. Any differences between reviewers are resolved through open conversation regarding the justification of selection for any particular journal. This conversation was a useful instructive procedure which possibly facilitated to raise the reliability and truthfulness of selected journals. In response to directing the systematic review, both the reviewers had selected randomised controlled trials method. Assessment of Quality Assessment of quality of journals is a vital part for any systematic review. The journals had been assessed by developing summaries about them. The generic and specific quality components are tabulated with the subject under study. The similarities and the dissimilarities of the journals are also assessed for synthesising the studies (Commonwealth of Australia, 2000). Data Extraction The data from the journals are extracted through standardised digital form by using MS Word. Three factors are considered while extracting data which are: appropriateness of research related information (such as hepatitis spread, educational intervention and number of participants), method of analysis of information and research design type. The extracted information was studied for accurateness and truthfulness by two reviewers and was presented in an expressive format (Brown & Lilford, 2006). Data Analysis In order to analyse the data various journals have been studied. The journals are exclusively based on hepatitis infection and educational impact on the reduction of spreading of hepatitis virus (Howard-Anderson & et. al., 2011). Description of Studies Approximately five articles have satisfied the research subject criteria. Concerning the data review, no discordance had occurred between reviewers. In the first journal, the systematic review of hepatitis had recognised 98 studies about vaccination drug users. The occurrence of hepatitis ranged from 30% to 95% for men, 48% to 94% among women and 33% to 98% among indeterminate genders (Wright & Tompkins, 2006). In the second journal, participants within age group of 15-30 years have been measured. Approximately 10 to 20 eligible respondents who meet the age criteria and who were ready to involve themselves in the research were randomly allocated for trials (Garfein & et. al., 2007). The third journal considers focus group interview to 18 respondents from cathedrals and community oriented organisations. The respondents were all Korean immigrants within age group of 18 to 64 (Choe & et. al., 2005). In the fourth journal, group study was conducted with 248 teenagers inside the age group of 10-19 years. The information about demographics and heath opinions regarding hepatitis has been obtained and analysed. The respondents were observed about development in hepatitis vaccination (Rourke & et. al., 2001). The fifth journal involves a study of Cambodian females within the age group of above 18. The numbers of respondents were 320 who had been provided with questionnaires in order to evaluate the impact of intervention on hepatitis. The study considered refugees with baseline survey (Taylor & et. al., 2002). Methodical Quality of Included Studies One of the major limitations which can generate a doubt about the conclusion of the research is type of data. The paper only considers the secondary information from several journals which can provide subjective results about the research topic due to lack of in-field-comprehensive research. Furthermore, the research considers only one criterion i.e. education and its impact on reduction of hepatitis transmission. However, there are other aspects which are similarly significant for eliminating the effect of hepatitis among individuals. Results Reducing the incidence of hepatitis is a considerable challenge for any nation. The aspect of exchange of needles was observed for encouraging insecure vaccinating drug use actions of individuals. Thus, it can cause spread of hepatitis. It has been observed that after the educational ‘needle exchange program’ there was considerable reduction in the trends of hepatitis spread. The reduction rate was greatest among the individuals aged below 25 (Wright & Tompkins, 2006). In the second journal, it can be observed that negative vaccination consequence and multiple index measure had decreased considerably among participants who were provided with education. The educational intervention on lessening of hepatitis spread was statistically significant. The intervention had generated 29% decline in the overall injection related risk in 6 months. Improvement has also been perceived in the sexual based risk activities among individuals (Garfein & et. al., 2007). In case of third journal, it has been witnessed that Korean immigrants have high propensity of getting infected by hepatitis. It has been discovered that lack of information about hepatitis infection is the cause for such spread in the disease among individuals. Although they were aware about the existence of hepatitis but their understanding regarding the source of hepatitis transmission was very limited. Only few respondents were correctly capable of starting immunisation against hepatitis (Choe & et. al., 2005). The results of fourth journal indicate that hepatitis vaccination program can be improved by providing education to the people about several risk factors. It can be observed that teenagers who sensed that physicians and nurses did not elucidate about hepatitis were less likely to take the vaccination for prevention of hepatitis. Only teenagers who have significant knowledge about the risk of hepatitis are probable to take the vaccination for hepatitis at the first stage. Demographic factors are not associated with spread of hepatitis rather it is the education which can help to reduce the spread of hepatitis (Rourke & et. al., 2001). The result of fifth journal depicted that low level of education is related with low level of acquaintance about the spread of hepatitis. About 56% of Cambodian respondents had depicted that they had never heard about hepatitis and the percentage of respondents who knew that hepatitis can spread was about 23%. The average score of knowledge about hepatitis among respondents were 4.8. Thus, the recurrently infected family members with hepatitis were high among Cambodian immigrants (Taylor & et. al., 2002). Discussion From the above results, it can be depicted that educational intervention is necessary for reduction of hepatitis spread related incidents. The incidence of hepatitis is quite high among people who have less knowledge about reduction techniques of hepatitis infection. Interventions by delivering appropriate education can inevitably enhance the risk reduction abilities of people about hepatitis spread. Besides, education is also necessary for people to change the unhealthy behaviours such as sharing of blades/needles, using hygienic medical tools and unprotected sexual activities among other aspects which can significantly help to prevent the spread of hepatitis. Low level of understanding is one of the crucial reasons for causing hepatitis to be generated and spread. In this context, it can be said that focused educational interventions intended for hepatitis related activities and knowledge can decrease its transmission. Conclusion The study provides valuable descriptive information about hepatitis virus and beliefs of people about its transmission and infection. This study could be used for future survey results intended for number of people for enhancing protection from hepatitis. Today, the hepatitis virus is considered as one of the most dangerous viruses due to its widespread characteristics. Hepatitis infection is common among people of several developed and developing nations and poor access to sanitation and knowledge about its prevention can enhance its vulnerability (Hunt & et. al., 2010). Education of people regarding the management and the deterrence of hepatitis along with treatment are central, basic and protective activity for minimisation of spread of hepatitis. Educational programs can encourage healthy practices among people. Information is necessary for fighting with the problem of hepatitis infection. With efficient educational programs, the objective of hepatitis prevention can be accomplished. References Brown, C. A. & Lilford, R. J., 2006. The Stepped Wedge Trial Design: A Systematic Review. BMC Medical Research Methodology, Vol. 6, No. 54, pp. 1-9. Commonwealth of Australia, 2010. Third National Hepatitis C Strategy 2010–2013. Department of Health and Ageing. [Online] Available at: http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-national-strategies-2010-hcv/$File/hcv.pdf [Accessed July 26, 2012]. Commonwealth of Australia, 2000. How to Review the Evidence: Systematic Identification and Review of the Scientific Literature. National Health and Medical Research Council. [Online] Available at: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/cp65.pdf?q=publications/synopses/_files/cp65.pdf [Accessed July 26, 2012]. Choe, J. H. & et. al., 2005. Hepatitis B and Liver Cancer Beliefs among Korean Immigrants in Western Washington: Report of a Qualitative Study. Cancer, Vol. 15, No. 104, pp. 2955-2958. Garfein, R. S. & et. al., 2007. A Peer-Education Intervention to Reduce Injection Risk Behaviors for HIV and Hepatitis C Virus Infection in Young Injection Drug Users. AIDS, Vol. 21, No. 4, pp. 1923-1932. Hunt, N. & et. al., 2010. A Review of the Evidence-Base for Harm Reduction Approaches to Drug Use. Forward Thinking on Drugs: A Release Initiative. [Online] Available at: http://www.ihra.net/files/2010/05/31/HIVTop50Documents11.pdf [Accessed July 26, 2012]. Howard-Anderson, J. & et. al., 2011. Quality of Life, Fertility Concerns, and Behavioral Health Outcomes in Younger Breast Cancer Survivors: A Systematic Review. Journal of National Cancer Institute. Lauver, D. R. & et. al., 2004. Patient-Centered Interventions. Nursing Research, Vol. 53, No. 6, pp. 30-35. Rauner, M. S. & et. al., 2005. Modelling the Spread of Hepatitis C via Commercial Tattoo Parlours: Implications for Public Health Interventions. Carnegie Mellon University. [Online] Available at: http://repository.cmu.edu/cgi/viewcontent.cgi?article=1022&context=heinzworks [Accessed July 26, 2012]. Rourke, K. M. O. & et. al., 2001. Improving Hepatitis B Immunization among High-Risk Adolescents: A Low-Cost Intervention on the Mexico-United States Border. Rev Panam Salud Publica/Pan Am J Public Health, Vol. 9, No. 4, pp. 228-233. Stolberg, H. O. & et. al., 2004. Randomized Controlled Trials. American Journal of Roentgenology, Vol. 183, No. 6, pp. 1539-1544. Taylor, V. M. & et. al., 2002. Hepatitis B Knowledge and Practices among Cambodian American Women in Seattle, Washington. J Community Health, Vol. 27, No. 3, pp. 151-163. University of York, 2009. Undertaking the Review. Systematic Reviews. [Online] Available at: http://www.york.ac.uk/inst/crd/SysRev/!SSL!/WebHelp/1_3_UNDERTAKING_THE_REVIEW.htm [Accessed July 26, 2012]. Wright, N. M. & Tompkins, C. N., 2006. A Review of the Evidence for the Effectiveness of Primary Prevention Interventions for Hepatitis C among Injecting Drug Users. Harm Reduction Journal, Vol. 3, No. 27, pp. 1-9. Bibliography Everitt, B. & Howell, D. C., 2005. Encyclopedia of Statistics in Behavioral Science. John Wiley & Sons. Jamison, D. T., 2006. Disease Control Priorities in Developing Countries. World Bank Publications. World Health Organization, 2005. What is The Evidence for the Effectiveness of Interventions to Reduce Hepatitis C Infection and the Associated Morbidity? Europe. [Online] Available at: http://www.euro.who.int/__data/assets/pdf_file/0005/74678/E86159.pdf [Accessed July 26, 2012]. Wodak, A., 2011. Demand Reduction and Harm Reduction. Global Commission on Drug Policies. [Online] Available at: http://www.globalcommissionondrugs.org/wp-content/themes/gcdp_v1/pdf/Global_Com_Alex_Wodak.pdf [Accessed July 26, 2012]. Read More