Improving Compliance with ACIP Guidelines Using the Internet

Background:  There exists a widely-available safe and effective hepatitis B (HBV) vaccine, immunoprophylaxis, and suppressive anti-viral therapies. US immunization programs have also been successful in reducing new acute infections among adolescents and adults. However, despite these advances, approximately 1,000 to 1,500 infants annually – most of whom are Asian and Pacific Islander – still develop chronic HBV through vertical transmission at a rate 30 times greater than perinatal HIV transmission (for which there is no vaccine). Previous studies have demonstrated that major gaps in HBV knowledge exist in first-line perinatal health care providers who are key in implementing national strategies to eliminate perinatal HBV transmission. Most providers do not provide HBV education to their infected patients due to lack of time or resources. Patients are also increasingly relying on the internet as their source of health information, with the majority of women reporting turning to the internet as their first source of health information.  Thus improving compliance with ACIP guidelines may rely on the development of web-based educational resources.

Setting:  Various public health settings including the public health department, hospitals/clinics, and any educational settings (including patient residence).

Population:  Pregnant women with chronic hepatitis B infection, public health officials, and peri-partum health care providers.

Project Description:  A web-based platform (www.hepbmoms.org) was designed to bring together all the key stakeholders in reducing mother-to-child transmission of hepatitis B by improving adherence to ACIP guidelines. The site serves to meet different needs of each target population by providing: 1) comprehensive information for the public, 2) evidence-based practice guidelines for health care providers through an online module which confers continuing education units, 3) a password-protected platform that allows public health officials to discuss difficult cases and share resources through a secure portal inaccessible by the general public.  For all stakeholders, there are downloadable resources, interactive videos, and discussion forums.

Results/Lessons Learned:  Significant improvements are needed to bolster our nation's existing perinatal HBV prevention programs to reduce vertical transmission to zero. A web-based tool may help bring together key stakeholders to a central source of consistent, evidence-based information and created a shared community to improve prevention efforts.