Florida Public Health Review


Hepatitis C virus (HCV) infection is a growing problem in the United States and most patients remain undiagnosed. CDC guidelines from 2012 recommend one-time screening of everyone born from 1945-1965. The penetration of this guideline is relatively unknown and the literature reveals that most efforts for improvement are poorly sustained. The purpose of this study was to compare a Florida county health department’s screening practices to national guidelines. In addition, provider-level barriers to screening were assessed in order to develop tailored recommendations for improvement. Using a serial cross-sectional design, data was examined to determine HCV screening prevalence for patients born from 1945-1965. Providers were also interviewed to identify barriers to screening. Results indicated HCV screening prevalence improved from 14.3% in 2011 to 25.9% in 2014 but remained well below the 100% birth cohort guideline. Notable barriers included provider confusion over and lack of familiarity with the guideline, an attitude that current practices were adequate, treatment cost concerns, and a perceived lack of referral sources. Other clinics likely have similar suboptimal screening. Health care clinics should assess their HCV screening rates, then evaluate provider-level knowledge, attitude, and external barriers in order to choose locally relevant strategies for sustainable improvement.