In a fast-changing world, people need to be aware of their health conditions to prevent any repercussions on them and those around them. A crucial part of health promotion and disease prevention is screening because it can identify health problems and evade the spread of diseases. Screening is necessary for ensuring safe community environments and eliminating health disparities in current and future generations. A way of assuring health promotion for future generations is the screening for hepatitis B virus infection in pregnant women and identifying its outcomes.
Theory or Conceptual Model
Health promotion program theories and conceptual models are important in planning and implementing interventions. A conceptual model that can be applied to the initiative of screening for hepatitis B virus infection in pregnant women is the health belief model. The health belief model is one of the most commonly used models that be applied for short- and long-term interventions (“Health promotion and disease prevention”, 2018). The model is based on five key components that need to be analyzed to identify the state of health or risk of disease. The first components include identifying the population at risk and determining the consequences of the disease (“Health promotion and disease prevention”, 2018). The last components are based on the benefits of health action and its barriers, along with the performance of the action (“Health promotion and disease prevention”, 2018). The health belief model can be applied to screening for hepatitis B virus infection in pregnant women by utilizing the model’s components.
Population Screening Purpose
The first step in utilizing the health belief model components is gathering information regarding the disease and the population at risk. US Preventive Services Task Force (USPSTF) identifies screening for hepatitis B virus infection (HBV) in pregnant women as A preventive screening with high certainty that the net benefit will be substantial (Owens, 2019). Statistics show that there were 3,322 reported acute cases of HBV infection in the US in 2018 and 1,649 cases with HBV infection listed as a cause of death (Viral hepatitis surveillance, 2018). The target population is pregnant women who have to be screened at their first prenatal visit and their infants at risk of perinatal transmission (Owens, 2019). According to the World Health Organization (WHO) guideline, risk factors for perinatal transmission of HBV infection are related to sex workers, people who inject drugs, and people in prisons (2017). For the screening purposes, the population at risk are all pregnant women, especially those who use drugs or have multiple sex partners and their future children.
For the purposes of the screening were chosen New Hampshire and its counties. Women being the target population for the screening, account for 49.53% of people in New Hampshire (New Hampshire Population). Most cases of HBV infection in the country are among people aged 30–49 years, with the median age of the female population of New Hampshire being 44 years old (Viral hepatitis surveillance, 2018; New Hampshire Population). People affected by HBV infection based on racial diversity in the country are mostly non-Hispanic Black and White, with 92.88% of residents in New Hampshire being White (Viral hepatitis surveillance, 2018; New Hampshire Population). Statistics show that New Hampshire is one of the states that, from the period between 2015 and 2017, did not submit any cases of HBV infection or perinatal hepatitis B in 2018 (Viral hepatitis surveillance, 2018). With that being said, there is no up-to-date information regarding the state of HBV infection among the population, which shows a need for screening and possible preventive actions.
The location’ setting of the screening will be in New Hampshire. The screening will be taking place at The Event Center at Hampshire Hills from 9 a.m. to 12 a.m. 5/24/2021. The Event Center at Hampshire Hills is located at 50 Emerson Rd, Milford, NH, and provides indoor and outdoor venues (“The Event Center”). The location’ setting is appropriate according to WHO guideline, which recommends community-based screening in workplaces, parks, bars, educational establishments, and other venues (2017). Such community-based testing can increase the acceptance of testing by first-time testers and those who do not often use clinical services (World Health Organization, 2017). A venue such as The Event Center at Hampshire Hills should be comfortable for both the target population and the staff.
The screening activity plan should include the main points of the screening process and its outcomes. Education component describes information regarding the disease, its consequences, and prevention (Blackstock & Evans, 2019). Measures tested during the screening for hepatitis B virus infection in pregnant women include the serologic identification of hepatitis B surface antigen (HBsAg) (Owens, 2019). Testing for HBsAg is recommended by the WHO guideline as routine testing for pregnant women (World Health Organization, 2017). HBsAg is also recommended by USPSTF for pregnant women due to its positive accuracy of 98% (Owens, 2019). If a mother is tested positive for HBsAg further actions include HBV DNA viral load testing and medical management of the infection (Owens, 2019). The screening process has to show people the importance of detecting the disease and analyze preventive measures.
It is important to provide post-test counseling with an organized referral process. The health workers have to explain the test results and diagnosis making a referral for further clinical care (World Health Organization, 2017). The staff should also provide information regarding the prevention of transmission of HBV infection, such as HBV vaccination and counseling on lifestyles such as alcohol reduction and diet (World Health Organization, 2017). The outcomes of the screening include an identification of the infection, vaccination, and reducing the transmission of the disease. Identification of the infection should be measured by the number of people tested and is expected to give more information regarding the prevalence of HBV infection. Vaccination should be measured by the number of HBV-positive and negative women and their children who would need vaccination. Reduction of the transmission of HBV infection is expected to be measured in the long term by additional screenings.
The cost analysis to perform screening includes expenses for 100 people. The testing for HBsAg and simple supply costs can be covered by purchasing a Rapid test kit which costs around 40$ and does not require lab (“Hepatitis B”). The average salary of a health care specialist per hour is about 44$ with the estimated staff being five people (“How much”). The rental cost for the event starts from 150$ at The Event Center (“The Event Center”). Any attendee cost is not included to make the screening more affordable. Cost analysis for feasibility depends on the total cost and available budget. The total cost is estimated presented in Table 1 and may be decreased by attracting sponsors.
Table 1. Cost to perform screening
Screening for hepatitis B virus infection in pregnant women is important for detecting women with HBV infection and preventing perinatal transmission. The screening should take place in New Hampshire because, in recent years, the state has not provided information regarding the prevalence of HBV infection that could be used for the prevention of the disease. Screening for hepatitis B virus infection in pregnant women has to be consistent across the nation to prevent the disease and provide a better life for future generations.
Blackstock, F. C., & Evans, R. A. (2019). Rehabilitation in lung diseases: Education component of pulmonary rehabilitation. Respirology, 24(9), 863-870.
Health promotion and disease prevention theories and models: The health belief model. (2018). Rural Health Information Hub.
Hepatitis B Rapid Test Kit. (n.d.). STD Testing.
How much does a Care Specialist make in the United States? (n.d.) Indeed.
New Hampshire Population 2021. (n.d.). World Population Review.
Owens, D. K. (2019). Screening for hepatitis B virus infection in pregnant women: US Preventive Services Task Force reaffirmation recommendation statement. American Medical Association, 322(4), 349-354.
The Event Center at Hampshire Hills and The Hampshire Dome. (n.d.). Eventective.
Viral hepatitis surveillance report 2018 — hepatitis B. (2020). Centers for Disease Control and Prevention.
World Health Organization. (2017). Guidelines on hepatitis B and C testing.