Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 3, 2020
Date Accepted: Jun 25, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Design and Implementation of a Multilevel Intervention to Reduce Hepatitis C Transmission Among Men who have Sex with Men in Amsterdam: a co-creation process
ABSTRACT
Background:
In the Netherlands transmission of hepatitis C virus (HCV) occurs primarily among men who have sex with men (MSM). Early HCV testing of MSM at risk and immediate initiation of treatment will prevent onward transmission, but this may not be sufficient to eliminate HCV in a population with ongoing risk behavior. Therefore, targeted socio-culturally accepted preventive measures, including behavioral interventions are urgently needed. Currently, little contextually appropriate information about HCV or risk reduction interventions are available.
Objective:
The objective of this project was to develop an intervention to reduce HCV transmission among MSM in Amsterdam, through a co-creation process, with the input of men from the targeted community directly impacting intervention content, design and implementation.
Methods:
We developed a multilevel intervention targeting six levels: the individual, community, professional, context, patient and network level. The intervention was developed in close cooperation between health professionals, gay community members and (commercial) stakeholders. The co-creation process had four phases: a needs assessment, stakeholder engagement, co-creation and implementation phase. The co-creation phase continued until consensus between the researchers and community members on the intervention content and design was reached. The final intervention, NoMoreC, was completed within 2 years and implementation started in February 2018.
Results:
NoMoreC includes web-based and face-to-face components as well as an anonymous HCV-testing service. The NoMoreC website provides information about hepatitis C, HCV transmission routes, risk reduction strategies, testing and treatment options and partner notification. The face-to-face component comprises a risk reduction toolbox, a training for health professionals and providing tailored advice to sex on premises venues. NoMoreC is promoted by an active voluntary campaign team.
Conclusions:
Involving the community and stakeholders in the creation of NoMoreC has been the main strength of this project. It has resulted in an intervention with various components that resonates with the gay community at risk of HCV infection. The uptake and acceptability of the described intervention will be evaluated in the future. The description of the co-creation process and implementation of the project may serve as a rich and useful source for others who want to develop culturally and context appropriate HCV interventions. Clinical Trial: Not applicableCo-creation, mHealth, intervention, hepatitis C, prevention, risk reduction, MSM, HCV
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