title: Improving support and education of low-income baby boomers diagnosed with chronic hepatitis C virus infection through universal screening.
abstract: OBJECTIVE
  To identify support needs of low-income baby boomers recently diagnosed with chronic hepatitis C virus infection.
  
  
  BACKGROUND
  The U.S. Preventive Services Task Force has endorsed one-time screening of all baby boomers (born 1945-1965) for hepatitis C because 75% of the estimated 2-3 million persons with chronic infection are in this age range. We hypothesised that persons diagnosed by routine screening would have significant psycho-emotional, cognitive and healthcare challenges that need to be met by collaborative care and services from nurses and other healthcare personnel.
  
  
  METHODS
  Qualitative descriptive study of data from three focus groups with predominantly minority participants (N = 16). Data were analysed using qualitative content analysis, and transcribed data were categorised by three domains in a previously developed model and a new domain identified in this study. Frequencies of unique participants' comments about each theme were calculated.
  
  
  RESULTS
  Elucidated domains were as follows: (i) psycho-emotional effects due to social stigma, shame, fear and dealing with risky behaviours; (ii) social effects due to concerns about infecting others; and (iii) cognitive deficits because of poor understanding about hepatitis C virus infection and its care. A new domain related to health care emerged reflecting the following themes: poor access to care, barriers to costly treatment, and navigating complex care for comorbidities. Despite these challenges, participants strongly endorsed universal baby boomer hepatitis C virus screening.
  
  
  CONCLUSIONS
  This study describes psycho-emotional and social challenges of people dealing with a hepatitis C diagnosis which are compounded by poor knowledge and barriers to supportive care.
  
  
  CONCLUSIONS
  Nursing and other allied health personnel require structured support programmes to assist older persons diagnosed with hepatitis C with addressing these common challenges with the ultimate goal of achieving a cure.
authors.affiliation: Department of Medicine, University of Texas Health San Antonio (UT Health San Antonio), San Antonio, TX, USA.|Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA.
authors.forename: Barbara J
authors.identifier: http://orcid.org/0000-0003-0736-1071
authors.initials: BJ
authors.lastname: Turner
authors.affiliation: School of Medicine, UT Health San Antonio, San Antonio, TX, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Craig
authors.affiliation: School of Medicine, UT Health San Antonio, San Antonio, TX, USA.
authors.forename: Vidhi S
authors.initials: VS
authors.lastname: Makanji
authors.affiliation: Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA.|School of Nursing, UT Health San Antonio, San Antonio, TX, USA.
authors.forename: Bertha E
authors.initials: BE
authors.lastname: Flores
authors.affiliation: Center for Research to Advance Community Health (ReACH), UT Health San Antonio, San Antonio, TX, USA.
authors.forename: Ludivina
authors.initials: L
authors.lastname: Hernandez
mesh_terms: D000368:Aged; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000451:nursing / Q000523:psychology*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D010353:Patient Education as Topic; D011203:Poverty; D036301:Qualitative Research; D014481:United States
keywords: hepatitis C virus; medically uninsured; patient education; patient navigation; qualitative research