caa a22 4500 445794593 CHVBK 20180317145120.0 cr unu---uuuuu 170323e20111201xx s 000 0 eng 10.1007/s10620-011-1928-z doi (NATIONALLICENCE)springer-10.1007/s10620-011-1928-z Screening High Risk Individuals for Hepatitis B: Physician Knowledge, Attitudes, and Beliefs [Elektronische Daten] [Temitope Foster, Huiming Hon, Fasiha Kanwal, Steven Han, Brennan Spiegel] Background: Although the overall incidence of hepatitis B virus (HBV) has declined since the introduction of universal vaccine guidelines, the incidence remains elevated in high risk groups. Recent guidelines from the Centers for Disease Control (CDC) have underscored the importance of vaccination against HBV in high risk individuals. However, the incidence of HBV in this group remains elevated, suggesting underuse of vaccinations by healthcare providers. Aim: The purpose of this study was to measure practice patterns of HBV vaccination, and identify predictors of vaccination underuse. Methods: We created a survey with four vignettes describing patients at high risk for contracting HBV, followed by questions regarding knowledge, attitudes, and beliefs (KAB) of HBV screening and vaccination. A random sample of 1,000 physicians, including internists, family medicine, OB/GYN, gastroenterologists, and experts in HBV epidemiology were surveyed. Regression analysis on composite guideline adherence scores identified KAB profiles that predict scores. Results: On average, responders endorsed 71% of the CDC HBV vaccination guidelines. There were three predictors of diminished screening proclivity: (1) younger provider age (P=0.028), (2) lower awareness that adult HBV is contracted primarily through heterosexual sex (P=0.023), and (3) being a provider other than a gastroenterologist (P=0.009). Conclusions: Respondents endorsed most—but not all—CDC supported HBV screening practices. Lower adherence was predicted by specific and modifiable KAB profiles, and by younger age. Future efforts to improve adherence should target trainees, emphasize the importance of obtaining sexual histories in high risk patients, and inform that HBV is predominantly a heterosexually transmitted infection. Springer Science+Business Media, LLC, 2011 Hepatitis B nationallicence Vaccines nationallicence Screening nationallicence Guideline adherence nationallicence Foster Temitope Division of Digestive Diseases, Emory University School of Medicine, 49 Jesse Hill Jr. Dr. S.E. Rm 437, 30303, Atlanta, GA, USA aut Hon Huiming Division of Digestive Diseases, Emory University School of Medicine, 49 Jesse Hill Jr. Dr. S.E. Rm 437, 30303, Atlanta, GA, USA aut Kanwal Fasiha St. Louis University, St. Louis, MO, USA aut Han Steven University of California, Los Angeles, Los Angeles, CA, USA aut Spiegel Brennan University of California, Los Angeles, Los Angeles, CA, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3471-3487 0163-2116 56:12<3471 2011 56 10620 https://doi.org/10.1007/s10620-011-1928-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1928-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Foster Temitope Division of Digestive Diseases, Emory University School of Medicine, 49 Jesse Hill Jr. Dr. S.E. Rm 437, 30303, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Hon Huiming Division of Digestive Diseases, Emory University School of Medicine, 49 Jesse Hill Jr. Dr. S.E. Rm 437, 30303, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Kanwal Fasiha St. Louis University, St. Louis, MO, USA aut NATIONALLICENCE 700 1- Han Steven University of California, Los Angeles, Los Angeles, CA, USA aut NATIONALLICENCE 700 1- Spiegel Brennan University of California, Los Angeles, Los Angeles, CA, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/12(2011-12-01), 3471-3487 0163-2116 56:12<3471 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer