Office of Minority Health

Grantee Information

Organization: Mississippi State Department of Health (MSDH), Office of Health Disparity Elimination (OHDE)

Organization Address: 570 East Woodrow Wilson Blvd., Jackson, MS, 39215

Phone Number: 601-206-1540

Fax Number: 601-957-6781

Organization website URL (if any): http://msdh.ms.gov/msdhsite/_static/44,0,236.html

[Brief Description of the Organization]: The Mississippi State Department of Health, the leading public health agency in the state, has an important mission to serve and protect the health of all citizens of Mississippi. MSDH is a centralized system with 102 clinics in 81 of 82 counties. The MSDH Office of Health Disparity Elimination (OHDE) is one of three offices in the MSDH’s Office of Health Promotion and Health Equity. The mission of the OHDE is to identify health inequities and their root causes and to promote evidence-based solutions to create a more equitable system. Established in 2003, OHDE has worked to expand disparity elimination efforts to underserved populations through evidence-based projects and strategies that increase awareness of health disparities, strengthen leadership for addressing health disparities, and improve cultural and linguistic competency in delivering health services. OHDE plans and organizes activities for several programs such as the Chronic Disease Self-Management Program, medical interpreter trainings, Community Research Fellows Training, and Affordable Care Act outreach and education.

Grant Project Information

Title of Grant Project: Test to Protect Family and Self: A Hepatitis B Project in the Vietnamese Communities of Harrison, Hancock, and Jackson Counties in Mississippi

Amount of OMH Award: $198,583

Name of Project Director: Dr. Tanya Funchess

Phone Number of Project Director: 601-206-1540

E-mail Address of Project Director: tanya.funchess@msdh.ms.gov

Abstract

Counties that make up the Mississippi Gulf Coast are home to a large portion of the Vietnamese population in Mississippi, and are geographic hot spots due to the high prevalence of hepatitis B among this population. Based on the prior screenings conducted by the Office of Health Disparity Elimination (OHDE), the estimated prevalence of chronic hepatitis B among the Vietnamese population on the Mississippi Gulf Coast is 11.2%. Most people living with hepatitis B do not know they are infected, placing them at greater risk for severe, even fatal, complications from the disease and increasing the likelihood they will spread the virus to others. Given the continued migration and transition of the Vietnamese American community on the Mississippi Gulf Coast, the need for additional hepatitis B awareness and education campaigns and screenings are implicit. Financial, language, and cultural barriers are causes of disparity in accessing health services among this population, as many of the local residents are immigrants and refugees from Vietnam who have been in the U.S. for less than 15 years and speak limited English. Limited English proficiency (LEP) prevents many Vietnamese individuals from understanding information and decreases their seeking help from healthcare service providers. To confront these issues, the OHDE and partners will implement theTest to Protect Family and Self: A Hepatitis B Project in the Vietnamese Communities of Harrison, Hancock, and Jackson Counties in Mississippi. The focus of this project is on increasing the proportion of persons who have been tested for the hepatitis B virus (HBV) within these minority communities experiencing health disparities. The project goal is to implement system-level, evidence-based strategies to address hepatitis B in the Vietnamese populations of the Mississippi Gulf Coast, targeting Harrison, Hancock, and Jackson counties.

OHDE plans to conduct this project in three phases, over the course of which they will create a health disparities profile, implement evidence-based interventions, and publish and disseminate results:

• Phase 1: During year one of the grant, OHDE will produce a health disparity profile and conduct capacity building in Harrison, Hancock, and Jackson counties. In order to build the health disparity profile, OHDE will utilize primary data from the Centers for Disease Control & Prevention, previous screenings conducted by OHDE, the US Census, and data from partner organizations. OHDE will also conduct several capacity-building efforts including:

o Focus groups within the Vietnamese population in the target counties in order to assess the current quality and distribution of hepatitis B educational materials.

o Resource mapping to determine what potential resources the Vietnamese community will need to assist with access to care as it relates to hepatitis B in this community.

o A Community Advisory Board (CAB) that will guide implementation of the intervention plan.

• Phase 2: Intervention implementation is the main focus of phase 2, which will be carried out in project years 2-4. Each quarter of years two and three, an awareness campaign will be conducted to educate the Vietnamese community about hepatitis B and the importance of knowing one’s status. Immediately following the awareness campaign, a screening session will be held in the community to test individuals to determine natural immunity, show vaccination status, or show positive serology for chronic hepatitis B. Two Vietnamese community health workers will provide follow-up to persons who test positive for chronic hepatitis B or need to be vaccinated by linking them to services and providing follow-up which includes: navigating the healthcare system, educating them on ACA and helping to enroll in the Marketplace, and providing further education to clients, family, gatekeepers, and the community. To complement these awareness campaigns and screening events, Chronic Disease Self-Management, cultural competency, Affordable Care Act education, and National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care trainings will be conducted to enhance the proficiency and capacity of the intervention.
• Phase 3: The final year of the grant will revolve around the publication and dissemination of results and lessons learned to the partners and the public. Working together with internal and external stakeholders, OHDE will produce reports to share with the local Vietnamese communities and providers of health services in Harrison, Hancock, and Jackson counties and other stakeholder organizations; produce press releases for local media; and, offer presentations and group discussions. Reports will be developed and posted on the MSDH website and in newsletters. To further inform the community at large, representatives from the MSDH and other stakeholders will be made available to newspapers, local television and radio stations to present and discuss the implications of the interventions and the results of the study.

The intended results of the Test to Protect Family and Self: A Hepatitis B Project in the Vietnamese

Communities of Harrison, Hancock, and Jackson Counties in Mississippi are:

• Increased awareness/knowledge about hepatitis B and the effects of undiagnosed infection on health among communities at risk;
• Increased public awareness about hepatitis B and importance of screening;
• Increased number of Vietnamese newly screened for hepatitis B, who receive their results and are linked to healthcare services, as appropriate;
• Increased healthcare provider skills in communicating with and counseling patients about hepatitis B vaccination and other chronic diseases such as diabetes and hypertension; and
• Increased system design to minimize barriers for racial/ethnic minority users, such as the development of the video remote medical interpretation, or bilingual healthcare providers to facilitate health care.

The grantee’s evaluation and performance measurement plan uses the Strategic Framework for Improving Racial and Ethnic Minority Health and Eliminating Racial and Health Disparities. OHDE’s multi-stage and multi-tier data collection plan is designed to assess the health impact of the project and conduct activities to measure changes in the target population’s knowledge and awareness related to hepatitis B. Assessment questions will be comparable to those used in the Behavioral Risk Factor Surveillance System and other surveillance systems and will provide a second level of data to compare changes from the baseline data. Assessments will be disseminated during project activities and evidence-based intervention programs when feasible. OHDE developed the following measures to track the success of their project:

• Number of Healthy People 2020 objectives addressed (e.g., Increase the proportion of persons who have been tested for hepatitis B virus within minority communities experiencing health disparities);
• Number of partnerships established to enhance the coordination and implementation of hepatitis B education, screening/results, and healthcare linkages;
• Number of training and technical assistance events;
• Number of educational materials and messaged developed and disseminated
• Number of communication campaign messages developed, and reach of messages;
• Number of individuals (unduplicated) participating in OMH-funded activities per year;
• Number and percent of individuals with increased awareness and knowledge of hepatitis B; and
• Number of supportive evidence-based interventions (e.g., Chronic Disease Self-Management Program) and care services.

NATIONAL PARTNERSHIP FOR ACTION TO END HEALTH DISPARITIES GOALS

None identified by the grantee

RELATED HEALTHY PEOPLE 2020 OBJECTIVES & SUBOBJECTIVES

• IID 28: Increase the proportion of persons who have been tested for hepatitis B virus