BMC Medicine
Volume 16, Issue 1, 2018

Hepatitis B in Moroccan-Dutch: A quantitative study into determinants of screening participation (Article) (Open Access)

Hamdiui N.* , Stein M.L. , Timen A. , Timmermans D. , Wong A. , van den Muijsenbergh M.E.T.C. , van Steenbergen J.E.
  • a National Institute for Public Health and the Environment, National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, Bilthoven, Netherlands, Radboud University Medical Center, Department for Health Evidence, Nijmegen, Netherlands
  • b National Institute for Public Health and the Environment, National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, Bilthoven, Netherlands
  • c National Institute for Public Health and the Environment, National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, Bilthoven, Netherlands
  • d VU University Medical Center, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, Netherlands, National Institute for Public Health and the Environment, Bilthoven, Netherlands
  • e National Institute for Public Health and the Environment, Department of Statistics, Informatics and Mathematical Modelling, Bilthoven, Netherlands
  • f Pharos: Dutch Centre of Expertise on Health Disparities, Program Prevention and Care, Utrecht, Netherlands, Radboud University Medical Center, Department of Primary and Community Care, Nijmegen, Netherlands
  • g National Institute for Public Health and the Environment, National Coordination Centre for Communicable Disease Control, Centre for Infectious Disease Control, Bilthoven, Netherlands, Leiden University Medical Centre, Centre for Infectious Diseases, Leiden, Netherlands

Abstract

Background: In November 2016, the Dutch Health Council recommended hepatitis B (HBV) screening for first-generation immigrants from HBV endemic countries. However, these communities show relatively low attendance rates for screening programmes, and our knowledge on their participation behaviour is limited. We identified determinants associated with the intention to request an HBV screening test in first-generation Moroccan-Dutch immigrants. We also investigated the influence of non-refundable costs for HBV screening on their intention. Methods: Offline and online questionnaires were distributed among first- and second/third-generation Moroccan-Dutch immigrants using respondent-driven sampling. Random forest analyses were conducted to determine which determinants had the greatest impact on (1) the intention to request an HBV screening test on one's own initiative, and (2) the intention to participate in non-refundable HBV screening at €70,-. Results: Of the 379 Moroccan-Dutch respondents, 49.3% intended to request a test on their own initiative, and 44.1% were willing to attend non-refundable screening for €70,-. Clarity regarding infection status, not having symptoms, fatalism, perceived self-efficacy, and perceived risk of having HBV were the strongest predictors to request a test. Shame and stigma, fatalism, perceived burden of screening participation, and social influence of Islamic religious leaders had the greatest predictive value for not intending to participate in screening at €70,- non-refundable costs. Perceived severity and possible health benefit were facilitators for this intention measure. These predictions were satisfyingly accurate, as the random forest method retrieved area under the curve scores of 0.72 for intention to request a test and 0.67 for intention to participate in screening at €70,- non-refundable costs. Conclusions: By the use of respondent-driven sampling, we succeeded in studying screening behaviour among a hard-to-reach minority population. Despite the limitations associated with correlated data and the sampling method, we recommend to (1) incorporate clarity regarding HBV status, (2) stress the risk of an asymptomatic infection, (3) emphasise mother-to-child transmission as the main transmission route, and (4) team up with Islamic religious leaders to help decrease elements of fatalism, shame, and stigma to enhance screening uptake of Moroccan immigrants in the Netherlands. © 2018 The Author(s).

Author Keywords

Screening Determinants Netherlands Intention Random forest Moroccans Hepatitis B

Index Keywords

Netherlands Dutchman mass screening quantitative study predictive value human epidemiology middle aged controlled study social determinants of health pathology Aged ethnology procedures Surveys and Questionnaires Young Adult health care cost Humans Adolescent male female prediction evaluation study questionnaire self concept population research Article disease transmission random forest Evaluation Studies as Topic adult chronic hepatitis B disease severity hepatitis B Moroccan area under the curve
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85044763773&doi=10.1186%2fs12916-018-1034-6&partnerID=40&md5=9f07c93db46b51ba2bc34644edbac10e
DOI: 10.1186/s12916-018-1034-6
ISSN: 17417015
Cited by: 3
Original Language: English