Screening for Hepatitis C Among Community Health Center Patients by Ethnicity and Language Preference.
Screening for Hepatitis C Among Community Health Center Patients by Ethnicity and Language Preference.
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DOI：
10.1016/j.focus.2023.100077
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发表时间：
2023-06
期刊：
影响因子：
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通讯作者：
Heintzman, John
中科院分区：
文献类型：
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作者：
Chan, Brian L;Ezekiel-Herrera, David;Bailey, Steffani R;Marino, Miguel;Lucas, Jennifer A;Giebultowicz, Sophia;Cottrell, Erika;Carroll, Joe;Heintzman, John
丙型肝炎病毒相关的肝病是拉丁美洲人死亡的主要原因。社区卫生中心为大量拉丁裔提供服务，是一个重要的场所。喜欢英语的拉丁裔患者的丙型肝炎病毒筛查率低于其他群体。需要了解语言偏好如何影响筛选差异。丙型肝炎病毒与高发病率和死亡率相关——慢性肝病是美国拉美裔人死亡的主要原因。社区卫生中心为拉美裔人群提供服务的丙型肝炎病毒筛查对于根除丙型肝炎病毒感染至关重要。我们根据种族和语言偏好评估了社区卫生中心服务的成年人中丙型肝炎病毒筛查的差异。这是一项观察性队列研究（跨越 2013 年至 2017 年），对象是 1945 年至 1965 年出生的成年人，在国家社区健康中心网络电子健康记录数据集中加速数据价值。我们感兴趣的是种族/民族和语言偏好（非西班牙裔白人、拉丁裔英语首选、拉丁裔西班牙语首选）。我们的主要结果是丙型肝炎病毒筛查的相对风险，使用多变量 Cox 比例风险回归进行估计。共有 182,002 名患者符合研究标准，其中 60% 为非西班牙裔白人，29% 为首选拉丁裔西班牙裔，11% 为首选拉丁裔英语。总共有9%的人接受了丙型肝炎病毒筛查，2.4%的人被诊断出患有丙型肝炎病毒。喜欢英语的拉丁裔患者的筛查率低于喜欢非西班牙裔白人和喜欢拉丁裔西班牙语的患者（分别为 5.5% 和 9.4% 和 9.6%）。首选拉丁裔英语的人的丙型肝炎病毒筛查风险低于非西班牙裔白人（调整后的风险比=0.56，95% CI=0.44，0.72），首选拉丁裔西班牙语的丙型肝炎病毒筛查的风险相似（调整后的风险比=1.11，95% CI=0.88，1.41）。我们发现，在大型社区卫生中心网络中，喜欢英语的成年拉美裔人的丙型肝炎病毒筛查风险低于非西班牙裔白人，而喜欢西班牙语的拉美裔人的筛查风险与非西班牙裔白人相似。丙型肝炎病毒筛查的总体患病率较低。需要进一步研究语言偏好在丙型肝炎病毒筛查中的作用，以便更好地使初级保健提供者能够以文化相关的方式提供这种推荐的预防服务。
Hepatitis C virus–related liver disease is a leading cause of death among Latinos. Community health centers serve a high proportion of Latinos and are an important setting. Latino English-preferred patients had lower hepatitis C virus screening rates than other groups. Understanding how language preference impacts screening disparities is needed. Hepatitis C virus is associated with high morbidity and mortality—chronic liver disease is a leading cause of death among Latinos in the U.S. Screening for hepatitis C virus in community health center settings, which serve a disproportionate percentage of Latinos, is essential to eradicating hepatitis C virus infection. We assessed hepatitis C virus screening disparities in adults served by community health centers by ethnicity and language preference. This was an observational cohort study (spanning 2013–2017) of adults born in 1945–1965 in the Accelerating Data Value Across a National Community Health Center Network electronic health record data set. Our exposure of interest was race/ethnicity and language preference (non-Hispanic White, Latino English preferred, Latino Spanish preferred). Our primary outcome was the relative hazard of hepatitis C virus screening, estimated using multivariate Cox proportional hazards regression. A total of 182,002 patients met the study criteria and included 60% non-Hispanic Whites, 29% Latino Spanish preferred, and 11% Latino English preferred. In total, 9% received hepatitis C virus screening, and 2.4% were diagnosed with hepatitis C virus. Latino English-preferred patients had lower rates of screening than both non-Hispanic Whites and Latino Spanish preferred (5.5% vs 9.4% vs 9.6%, respectively). Latino English preferred had lower hazards of hepatitis C virus screening than non-Hispanic Whites (adjusted hazard ratio=0.56, 95% CI=0.44, 0.72), and Latino Spanish preferred had similar hazards of hepatitis C virus screening (adjusted hazard ratio=1.11, 95% CI=0.88, 1.41). We found that in a large community health center network, adult Latinos who preferred English had lower hazards of hepatitis C virus screening than non-Hispanic Whites, whereas Latinos who preferred Spanish had hazards of screening similar to those of non-Hispanic Whites. The overall prevalence of hepatitis C virus screening was low. Further work on the role of language preference in hepatitis C virus screening is needed to better equip primary care providers to provide this recommended preventive service in culturally relevant ways.