Hepatitis C clinical assessment form

Fibroscan assessment form


Self-medication risk assessment form

Discharge letter template

Testing results advice card

This was used to communicate hepatitis C negative results to prisoners. It was sealed and delivered to prisoner cells. This enabled scale-up through efficient return of large numbers of results, as prisoners did not have to be escorted to the clinic for face-to-face communication of results. All prisoners who tested positive to hepatitis C (or other blood borne viruses tested) were provided with their results in a face-to-face interaction with the nurse.

Posters

Posters with simple ‘Get tested’ and ‘You can get treated’ calls to action, and photos and quotes of current and former prisoners were displayed in the prison health clinic and wings. Posters focused on the three main messages.

Booklet

A booklet describing hepatitis C risk behaviours, testing and treatment was developed and distributed to prisoners by nurses. The booklet focused on simple, heavy use of icons and images, and personal stories of former prisoners.

Video

A video was developed to expand on the booklet content. A short (90 second) version and long (11 minute) version was broadcast at regular intervals on the prisoner channel, which could be viewed by prisoners with access to a television in his/her cell. Personal stories by both current and former prisoners were included to reinforce information on testing and treatment described by a doctor and graphics. Sample segments of the videos can be viewed here:

Hepatitis C testing.

Hepatitis C natural history and liver health.

Hepatitis C treatment.

Reducing risk of transmission in prison.

SToP C Fibroscan

Peer education booklet

The booklet was adapted for use by prisoner educators to distribute to peers.

Treatment leaflets


‘My hep C treatment’ trifold leaflet with simple messaging and prisoner-specific imagery was provided by nurses at initiation of therapy. The more detailed ‘SToP-C Treatment Instructions’ sheet was also provided.

Registration of interest form

A SToP-C study-specific form was made available in prison wings and at prisoner reception/arrival in the prison. Prisoners could complete the form to indicate interest in being tested. Forms were handed to the nurse and a clinic visit with the prisoner was scheduled (including informed consent).

Fibroscan result form


this was given to prisoners immediately after a fibroscan was performed by the nurse. It was used as a tool to explain fibroscan result during post-test counselling.

Family information booklet


These trifold pamphlets were placed in the prison visitor centre waiting rooms. The aim was to raise awareness of the study amongst prisoners’ visitors and to encourage conversation about testing and treatment during visits.

Branded Items

A number of SToP-C branded items were provided as incentives for prisoner visits, including: jellybeans, caps, decks of playing cards, and beanies.

Cash reimbursements


Since SToP-C was a research study, participants were reimbursed AUD $10 per clinic visit for testing or treatment monitoring. Cash was deposited into the participant’s bank account and could be accessed for purchase of discretionary personal items through the prison’s ‘buy-up’ system.

SToP-C-specific newsletters

Were distributed to communicate updates to stakeholders and the project team.

Articles

Articles were published in the Corrective Services staff newsletter to raise awareness about the study goals amongst correctional officers.

Articles

Articles were published in the Justice Health service staff newsletter to raise awareness about the study goals and progress amongst prison health workers.

Boelen, L., Teutsch, S., Wilson, D. P., Dolan, K., Dore, G. J., Lloyd, A. R., ... & HITS investigators. (2014). Per-event probability of hepatitis C infection during sharing of injecting equipment. PloS one, 9(7).

Brault, M. A., Spiegelman, D., Hargreaves, J., Nash, D., & Vermund, S. H. (2019). Treatment as prevention: concepts and challenges for reducing HIV incidence. Journal of acquired immune deficiency syndromes (1999), 82(2), S104.

Bretaña, N. A., Gray, R. R., Cunningham, E. B., Betz‐Stablein, B., Ribeiro, R., Graw, F., … & Lloyd, A. R. (2020). Combined treatment and prevention strategies for hepatitis C virus elimination in the prisons in New South Wales: a modelling study. Addiction, 115(5), 901-913.

Cunningham, E. B., Hajarizadeh, B., Bretana, N. A., Amin, J., Betz‐Stablein, B., Dore, G. J., ... & Grebely, J. (2017). Ongoing incident hepatitis C virus infection among people with a history of injecting drug use in an Australian prison setting, 2005‐2014: The HITS‐p study. Journal of viral hepatitis, 24(9), 733-741.

Justice Health and Forensic Mental health Network, Network Patient Health Survey 2015; ISBN (online) 978-1-76000-569-6; 2017.

Kronfli, N., Linthwaite, B., Kouyoumdjian, F., Klein, M. B., Lebouché, B., Sebastiani, G., & Cox, J. (2018). Interventions to increase testing, linkage to care and treatment of hepatitis C virus (HCV) infection among people in prisons: a systematic review. International Journal of Drug Policy, 57, 95-103.

Lafferty, L., Wild, T. C., Rance, J., & Treloar, C. (2018). A policy analysis exploring hepatitis C risk, prevention, testing, treatment and reinfection within Australia’s prisons. Harm reduction journal, 15(1), 39.

Mohamed, Z., Al-Kurdi, D., Nelson, M., Shimakawa, Y., Selvapatt, N., Lacey, J., ... & Brown, A. S. (2020). Time matters: Point of care screening and streamlined linkage to care dramatically improves hepatitis C treatment uptake in prisoners in England. International Journal of Drug Policy, 75, 102608.

Neuhaus, M., Langbecker, D., Caffery, L. J., Taylor, M., Garner, L., Williams, G., ... & Macdonald, G. A. (2018). Telementoring for hepatitis C treatment in correctional facilities. Journal of telemedicine and telecare, 24(10), 690-696.

Overton, K., Clegg, J., Pekin, F., Wood, J., McGrath, C., Lloyd, A., & Post, J. J. (2019). Outcomes of a nurse-led model of care for hepatitis C assessment and treatment with direct-acting antivirals in the custodial setting. International Journal of Drug Policy, 72, 123-128.

Papaluca, T., Hellard, M. E., Thompson, A. J., & Lloyd, A. R. (2019). Scale‐up of hepatitis C treatment in prisons is key to national elimination. The Medical Journal of Australia, 210(9), 391-393.

Papaluca, T., McDonald, L., Craigie, A., Gibson, A., Desmond, P., Wong, D., ... & Pedrana, A. (2019). Outcomes of treatment for hepatitis C in prisoners using a nurse-led, statewide model of care. Journal of hepatology, 70(5), 839-846.

Cunningham, E. B., Hajarizadeh, B., Amin, J., Bretana, N., Dore, G. J., Degenhardt, L., ... & HITS-p Investigators. (2018). Longitudinal injecting risk behaviours among people with a history of injecting drug use in an Australian prison setting: the HITS-p study. International Journal of Drug Policy, 54, 18-25.

Hajarizadeh B, Grebely J, Byrne M, Marks P, Amin J, McManus H, Butler T, Cunningham EB, Vickerman P, Martin NK, McHutchison JG, Brainard DM, Treloar C, Chambers GM, Grant L, McGrath C, Lloyd AR, Dore GJ on behalf of the SToP-C study group. Evaluation of hepatitis C treatment-as-prevention within an Australian prison prospective cohort: The SToP-C study. Lancet Gastro Hepatology 2021 (in press)

Indig, D., Lee, K., Grunseit, A., Milat, A., & Bauman, A. (2018). Pathways for scaling up public health interventions. BMC public health, 18(1), 1-11.

Lafferty, L., Rance, J., Dore, G. J., Lloyd, A. R., & Treloar, C. (2020). The role of social capital in facilitating hepatitis C treatment scale‐up within a treatment‐as‐prevention trial in the male prison setting. Addiction.

Lafferty, L., Rance, J., Grebely, J., Dore, G. J., Lloyd, A. R., Treloar, C., & SToP-C Study Group. (2020). Perceptions and concerns of hepatitis C reinfection following prison-wide treatment scale-up: Counterpublic health amid hepatitis C treatment as prevention efforts in the prison setting. International Journal of Drug Policy, 77, 102693.

Lafferty, L., Rance, J., Treloar, C., & SToP-C Study Group. (2019). ‘Fighting a losing battle’: prisoners’ perspectives of treatment as prevention for hepatitis C with inadequate primary prevention measures. Drugs: Education, Prevention and Policy, 26(6), 502-507.

Lafferty, L., Wild, T. C., Rance, J., & Treloar, C. (2018). A policy analysis exploring hepatitis C risk, prevention, testing, treatment and reinfection within Australia’s prisons. Harm reduction journal, 15(1), 1-9.

Lafferty, L., Rance, J., & Treloar, C. (2018). Who goes first? Understanding hepatitis C risk among injecting networks in the prison setting. Drug and alcohol dependence, 183, 96-101.

Lafferty, L., Rance, J., Grebely, J., Lloyd, A. R., Dore, G. J., Treloar, C., & SToP‐C Study Group. (2018). Understanding facilitators and barriers of direct‐acting antiviral therapy for hepatitis C virus infection in prison. Journal of viral hepatitis, 25(12), 1526-1532.

Rance, J., Lafferty, L., Treloar, C., & SToP‐C Study Group. (2021). Expert stakeholder perspectives on the acceptability of treatment‐as‐prevention in prison: A qualitative sub‐study of the ‘Surveillance and Treatment of Prisoners with Hepatitis C’ project (SToP‐C). Addiction.

Rance, J., Lafferty, L., & Treloar, C. (2020). ‘Behind closed doors, no one sees, no one knows’: hepatitis C, stigma and treatment-as-prevention in prison. Critical Public Health, 30(2), 130-140.

General hepatitis C resources

General hepatitis C education materials for prison staff were not explicitly used in the SToP-C project (in lieu of study-specific training), but are recommended. Several examples can be here:

1. https://www.ashm.org.au/HCV/training/
2. https://www.hepatitisaustralia.com/education-tools
3. https://www.cdc.gov/hepatitis/resources/index.htm
4. https://www.hepatitisc.uw.edu/

Planning phase checklist

The steps and issues which should be considered during the process of planning to scale-up hepatitis C testing and treatment are summarised in this checklist.

Implementation phase checklist

The steps and issues which should be considered in the implementation of hepatitis C testing and treatment scale-up are summarised in this checklist.