4-28-2016 Hep C Prevention in Youth Strategic Planning Meeting Highlights

Hep C Prevention in Youth Strategic Planning Meeting Highlights
April 28, 2016 (3-5 PM) at American Cancer Society, 132 West 32nd Street

Purpose of the Meeting

To addresses the increase of prescription medication misuse as well as intranasal and injection drug use, that has contributed to increased rates of Hepatitis B and C nationally.

 Background

• In NYC in 2014, there were 839 cases of Hepatitis C newly reported* to the health department among people 0 to 29 years of age.
• Bronx – 184 cases
• Brooklyn – 223
• Manhattan – 204
• Queens – 141
• Staten Island – 63
• Unknown – 24
• Rates were similar for males and females.
• Among all boroughs, Staten Island had the highest rate (34.7 per 100,000) of newly reported Hepatitis C in people 0 to 29 years of age.

For more information, check out the Hepatitis B and C 2014 Annual Report

*By law, all Hepatitis C antibody and RNA tests conducted in a lab in NYC are automatically reported to the NYC Department of Health. The NYC Department of Health routinely sends a letter to all newly reported cases, informing of their infection status and recommended medical follow up.

NYC Health Department potential projects focusing on Hep C prevention in youth
The group was asked for feedback on the following planned NYC Health Dept projects:

1. Youth surveillance based project
2. Hep C Prevention Training focused on Youth

Youth Surveillance Based Project

• The NYC Health Dept proposes to reach out to people under the age of 30 reported with a positive Hep C test to learn about the circumstance of infection and provide a Hep C linkage to care and prevention intervention that the young person could pass along to their social networks.
• This intervention could be provided online, or on an app, so youth can pass on with their friends.

Feedback from Group

• It is imperative to respect the confidentiality of youth diagnosed with Hepatitis C.
• The DOH should reassess its policy of sending test results to guardians of youth. This can place young people in dangerous situations.
• This project should entail a good amount of outreach and education to ensure young people are being tested and delivered interventions. Peer navigators should do a lot of this outreach.
• Ask organizations in areas with high prevalence of Hepatitis to help with outreach.
• Young people can be trained as health advocates to educate peers about Hepatitis and testing. They can help deliver interventions to young people diagnosed with hepatitis.
• Organizations can hold “Community Health Meetings” at schools to educate young people and their family about Hepatitis. This can remove the stigma surrounding Hepatitis, and motivate young people to get tested and seek care.
• Many young people who are injecting and/or have Hepatitis may not be motivated to participate in an intervention and pass along to their peers. We need to think hard on how to engage this population.  It is not helpful for the Health Dept to perform outreach in this population; peers should be doing the outreach and education.
• We currently do not know where young people are being tested for Hep C, Health Department can review reports to see if there is a pattern.
• There is a risk that if a youth receives a phone call from the NYC Health Department, they will tell their friends and no one will get tested.
• Best to ask for consent to be contacted at the time of the test.

Youth Substance Abuse Prevention Training

• The Health Department will develop a “Hep C Prevention Training” with a focus on youth to be provided by for free to interested community organizations approximately quarterly.
• These trainings will provide recommendations for standard screening and evidenced based intervention – with a focus on early identification of risk and harm reduction to prevent Hep C.

Feedback from Group

• These trainings should have a focus on youth, but not exclude organizations that work with older adults.
• Overall, the DOH should provide more community trainings on Hepatitis at organizations and schools.
• It may be possible to include Hep C Prevention messaging at existing naloxone trainings. However, we don’t want to include too much information in one training.
• Consider non-traditional community health education opportunities, such as at Barbershops and salons. See: arthurasheinstitute.org/arthurashe/community_outreach_programs/

Coalition Based  Hep C Youth Projects

The following projects are planned as part of NYC Hep C Task Force and NYC Hep B Coalition Activities

1. Hep C Prevention in Youth Video PSA
2. Youth Advisory Board

Hep C Prevention in Youth Video PSA

In collaboration with the NYC Health Department, as an NYC Hep C Task Force Activity, Tackling Youth Substance Abuse (TYSA)  applied for and received funding from the Birds Nest Foundation to create a video focused on Hep C Prevention in Youth.

Feedback from Group

• Two videos can be created: one video on Hepatitis prevention; second video for youth already injecting, with information on how to get help and tested.
• The video can show the story of someone being diagnosed with hepatitis, and what they did to receive help.
• The video should include text and exciting graphics.
• Video can show progression of addiction – abusing pain killers can lead to injecting heroin, which can lead to hepatitis.
• Consider a series of 3 or 4 short video clips that can be used as a series or alone, each covering one part of the timeline of risk to infection, and overdose:
  1. Prescription med use for fun/recreation/party
  2. Prescription med addiction
  3. Intranasal administration
  4. Injection
  5. Transition to heroin or other
  6. Hep C acquisition
  7. Overdose
• Include a Social Media integration at the end of each video clip.
• Video should auto direct viewer to a website to learn more.
• Get buy in from youth by involving them in development of video.
• Buzz feed
• Consider “word pop-up” type of video (like subtitles) can be watched without sound on phones (at school, elsewhere)

Youth Advisory Board

As part of the Hep Free NYC, Hep C Prevention in Youth Initiative, we hope to convene a Youth Advisory Board, comprised of people under the age of 30.  This advisory board will help us create and implement activities that raise awareness about opioid drug misuse, and the associated risk for Hepatitis B and C.

Feedback from Group

• Facilitators of the Advisory Board should be enthusiastic and invested in the group.
• We need to decide on how much commitment the youth should have to the group.
• We should hold regional meetings, particularly for young people in Staten Island. It will be hard for youth from Staten Island to make it to Manhattan.
• As we seek more funding from City Hall for our Check Hep B and Check Hep C Patient Navigation program, we should try to commit funding for youth to serve as patient navigators.
• Each organization in our committee can help recruit youth for the advisory board.
• There are some high schools with Community Health Worker and Nursing prep tracks. Could reach out to these schools for students seeking internships or experience.
• Teens need to learn while having fun. Integrate health education into social/recreational activities.
• Consider CDC DEBI: Community Promise intervention.
• Develop an environment for teens that feels safe, where they can make meaningful connections.
• Consider Teen Peer testers/navigators.
• Consider internship model.
• Need to cover transportation cost.

In Attendance

1. Betty Kolod, SUNY Downstate, Medical Student Leader, bettykolod@gmail.com
2. Brian Crozier, Safe Horizon – Streetwork Project,   Crozier@safehorizon.org
3. Brian Tang, Charles B. Wang Teen Resource Center, Program Corodinator btang@cbwchc.org
4. Daniel Calder, NYC Health Department, Community Outreach and Education Coordinator, dcalder@health.nyc.gov
5. Henrich Boahene, Bronxworks
6. Ivana Portes, St Ann’s Corner of Harm Reduction,    iportes@sachr.org
7. Leanne Demery, Bronxworks, Program Specialist, Targeted Prevention and Supportive Services, ldemery@bronxworks.org
8. Melissa Osborne, Center for Community Alternatives, Project Coordinator, New Roads To Health,  mosborne@communityalternatives.org
9. Mike Selick, Harm Reduction Coalition,  Hepatitis C Coordinator,  selick@harmreduction.org
10. Natalie DiRocco, Tackling Youth Substance Abuse – CHASI, Program Manager, natalie@sipcw.org
11. Nirah Johnson, NYC Health Department, Director of Program Implementation & Capacity Building, njohnso2@health.nyc.gov
12. Paula Wong, Project H+AL, Program Coordinator, w.wong@gmail.com
13. Vivienne Felix, Health Education & Research Occupations High School (H.E.R.O.),  Employer Partnerships Developer, Felix@cuny.edu
14. Wendy Ledesma,BOOM Health, Prevention Program Coordinator,  wledesma@boomhealth.org