Enhanced self-efficacy in HCV management: educating a multidisciplinary drug and alcohol workforce in Europe and Canada

Background:

Education programs are crucial for training a multidisciplinary addictions health workforce in HCV management, but few have been developed and evaluated. The aim of this study was to evaluate changes in self-reported confidence (self-efficacy) for HCV management among attendees participating in an HCV education program, tailored to each of the 10 countries in which it was delivered, focused on primary care and drug and alcohol settings. 

Methods:

The “Hepatitis C in Primary Care and Drug and Alcohol Settings Education Program” consists of 1) Online learning modules (www.inhsu.org/education-program); 2) An interactive face-face or virtual workshop; 3) Tailored capacity strengthening toolkit. The program was contextualized for delivery in 10 countries, including translation, between 2017-2023. Participants completed self-administered surveys pre-course, immediately post-course, and 6 months post-course using a 5-point Likert scale to assess changes in confidence (scores >3) across 6 core competencies related to HCV testing, management, and treatment.

Results: Overall, 1,509 participants attended one of 80 HCV education sessions across Canada (38%), France (15%), Switzerland (10%), the United Kingdom (9%), Italy (7%), Portugal (6%), Sweden (5%), Spain (4%), Belgium (3%), and Germany (3%). 

Participants included Addiction Physicians (10%), General Practitioners / Family Physicians (10%), Nurses (37%), Pharmacists (8%), and others (33%) from Non-Hospital Based Drug and Alcohol Services (33%), Primary Healthcare Centres (15%), Hospital-Based Drug and Alcohol Services (10%), Needle and Syringe Programs (3%), Correctional Facilities (3%), and various other locations (34%).

Among participants who completed pre- and post-workshop surveys (n=545), there was an increase in the proportion of people who reported confidence with respect to regular screening (44% vs. 80%, P<0.001), interpretation of HCV test results (19% vs. 74%, P<0.001), advising patients about new HCV therapies (9% vs. 74%, P<0.001), and HCV treatment/management (4% vs. 65%, P<0.001).

Among the subset of participants who completed both pre and 6-month follow-up post-evaluation surveys (n=109), there was a noticeable sustained increase in the proportion of individuals reporting enhanced confidence in their ability to interpret test results and diagnose Hepatitis C (34.6% vs 75.2%, p<0.05) and educate clinic staff about HCV while serving as a contact point for related issues (19.3% vs 65.4%, p<0.05).

Conclusion:

Across all 10 countries, self-efficacy related to HCV management and treatment improved immediately following participation in this HCV education program. Changes in confidence were sustained, although further work is needed to evaluate the impact of this education, including enhanced HCV testing and treatment in drug and alcohol settings.