Qualitative Evaluation of the Decisions and Experiences of People Who Inject Drugs Who Received a Liver Disease Assessment as Part of a Liver Health Promotion Campaign: The Liverlife Study


Author: Marshall AD, Treloar C, Dore GJ and Grebely J

Theme: Social Science & Policy Research Year: 2016

QUALITATIVE EVALUATION OF THE DECISIONS AND EXPERIENCES OF PEOPLE
WHO INJECT DRUGS WHO RECEIVED A LIVER DISEASE ASSESSMENT AS PART
OF A LIVER HEALTH PROMOTION CAMPAIGN: THE LIVERLIFE STUDY
Marshall AD1
, Treloar C2
, Dore GJ1
and Grebely J1
1
The Kirby Institute, UNSW Australia, NSW Australia; 2Centre for Social Research in Health,
UNSW Australia, NSW Australia
Background: A liver health promotional campaign took place in New South Wales,
Australia (May to October 2014), with 235 people who inject drugs (PWID) receiving
FibroScan®
-based disease assessment. Participant follow-up occurred 2-16 weeks postenrolment. The aim of this qualitative sub-study was to evaluate the decisions and
experiences of participants who received a liver disease assessment, including
interpretation of FibroScan®
score and subsequent health behaviours.
Methods: Participants were recruited from two opioid substitution treatment clinics and one
medically supervised injecting centre between November 2015 and February 2016. The
four recruitment categories were: a) high FibroScan®
score (≥9.5 kPa)/ attended LiveRLife
follow-up; b) high score/did not attend follow-up; c) low score (≤9.4 kPa)/attended follow-up;
and d) low score/did not attend follow-up. Participants were not reminded of their category
during recruitment. Inclusion criteria were: participation in the LiveRLife campaign, received
a FibroScan®
score, and informed written consent. Interviews were audio-taped and
transcribed verbatim. Data was analysed using thematic analysis.
Results: Of 33 semi-structured interviews [category a (12 participants); category b (2);
category c (11); category d (8); 21% female], reasons for wanting to receive a FibroScan®
were varied. Most participants interpreted their level of liver disease correctly based on their
recalled FibroScan®
score. Persons with higher scores frequently recalled feeling shocked
by their score (e.g. ‘wake-up call’) whereas participants with lower scores were typically
pleasantly surprised (e.g. incentive to keep liver healthy). Some positive health changes
were stated with several relating their score to hepatitis C treatment. Additionally, some
confusion regarding causes of increased liver disease persisted despite this information
being provided in the campaign. Further analyses will explore health-seeking behaviours (or
lack thereof) by category.
Conclusion: Results provide greater insight into strategies to enhance knowledge and
‘linkage to care’ for PWID with, and at-risk of, advanced liver disease.
Disclosure of Interest Statement: The study was funded from MSD, Australia. The Kirby
Institute is funded by the Australian Government Department of Health and Ageing. The
Centre for Social Research in Health is supported by a grant from the Australian
Government Department of Health. The views expressed in this abstract do not necessarily
represent the position of the Australian Government. GJD is supported by a National
Health and Medical Research Council Practitioner Research Fellowships. JG is supported
by a National Health and Medical Research Council Career Development Fellowship. ADM
holds a University International Postgraduate Award (UIPA), UNSW Australia, and is also
supported by the CanHepC Trainee Program, Canada. The study authors have no conflict
of interest.

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