Refugee Viral Hepatitis Coalition of Georgia: An Assessment of Capacity Building

Purpose: The purpose of this project was to examine the process of capacity building through the formation of a coalition in Georgia to reduce the hepatitis burden in the refugee community. The project sought to identify obstacles in the building of the Refugee Viral Hepatitis Coalition to improve the effectiveness of the initiative. Observations were made in order to inform recommendations for future action. Background: There has been a significant decline in the number of hepatitis cases nationally and internationally due to the routine use of vaccines. However, there exists a significant number of cases each year, most of which have been identified in newly arrived refugees in the community. In the past five years, the majority of cases screened for hepatitis B have been identified among this population during screening exams at the local board of health. Public health officials in the state and county have identified many of the major gaps that lead to the persistence and transmission of infection in the community and have begun the process of building a coalition to address those needs. Methods: A mixed-methodological approach combining participant observations and semi-structured interviews was used to assess the formation of the coalition. Observations of the quarterly meetings took place from August 2013 to March 2014. Semi-structured interviews were conducted of coalition members within a four day period in order to gain insights about the progress of the coalition. Interviews were conducted in person and over the telephone after an e-mail was sent to coalition members requesting their participation in a study to examine progress of the coalition. Results: Observations of the meetings showed that the coalition included community members, public health officials and members from a number of organizations that play a role in the health of refugees. Discussion topics included hepatitis B trends due to public health interventions, the Affordable Care Act and its impact on the refugee population in addition to the value of a support group for those living with hepatitis B. Seventeen members of the coalition were interviewed with a combination of in-person and telephone interviews. Answers were grouped into four themes which highlighted the motivation for the coalition, progress observed and recommendations for improvement of the coalition. Responses indicated that members were interested in improving awareness and treatment in the community, increasing formalization to promote growth of the coalition, increasing civic engagement and continuing to build on the strengths of the coalition. Conclusion: This study examined the process of coalition building to respond to the challenge of hepatitis B. Results indicated that members of the coalition play a role in the development of the coalition and influence the direction which it follows. The desire to continue on its current trajectory while improving formalization and recruitment efforts was expressed by members