Hepatitis B virus (HBV) is a leading cause of chronic liver disease among ethnic minorities, particularly individuals from African and Asia-Pacific regions. While there has been much research and outreach programs focused on improving HBV screening among these high risk populations, fewer studies have specifically focused on the gap between HBV diagnosis and receipt of treatment among eligible patients. This gap in linkage to treatment is affected by multiple factors including provider-specific factors (e.g. provider knowledge of updated HBV treatment guidelines for determination of eligibility) and patient-specific factors (e.g. adherence to clinic visits and medication prescribed, concurrent high risk behaviors including alcohol and drug use, medical co-morbidities).
Often overlooked is the concept of system barriers including delays in access to clinics that treat and monitor HBV and delays in receipt of treatment prescribed due to insurance factors, and these types of barriers are particularly prevalent among underserved safety-net populations and non-English speaking minorities, which make up the majority of the chronic HBV burden in the U.S. However, to adequately bridge this gap in initiating treatment among treatment-eligible HBV patients, we need to understand the burden of this problem and be able to identify factors that contribute to inappropriate delays in treatment so that interventions and education can be appropriately targeted to impact change. Furthermore, we hypothesize that the burden of this problem to be particularly high among safety-net systems, and thus our current proposal aims to focus on underserved safety-net populations.