Table 3 Major themes associated with pursuit of care based on qualitative patient interviews, associated Health Belief model constructs, and suggested interventions to improve care
Major themes | Associated Health Belief Model constructs | Proposed interventions to improve care |
|---|---|---|
Structural barriers: financial, scheduling, transportation, health-system level | Perceived barriers | Expand Medicaid; utilize pharmaceutical company drug assistance programs; educate patients on available resources and supportive care; aim for clinic responsiveness, ease of scheduling, and confidentiality |
Stigma | Perceived susceptibility Perceived barriers | Provide education on harm reduction strategies; co-locate treatment for substance use disorder and HCV; educate clinic staff on creating a welcoming atmosphere |
Ambivalence | Perceived susceptibility Perceived severity | Acknowledge and address the uncertainty related to having HCV; Focus patient education campaigns on ambivalence and the potential for treatment to relieve patients of the burden of uncertainty |
Prior experiences of HCV disease and treatment | Perceived susceptibility Perceived severity Perceived benefits Perceived barriers | Explore patients’ or others’ prior experiences with HCV treatment; address favorable changes in treatment since earlier therapies |
Patient-provider relationship | Perceived susceptibility Perceived severity Perceived barriers Perceived benefits Self-efficacy | Encourage expansion of HCV treatment to where patients are already receiving care and have established relationships |