{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:26:30Z","timestamp":1778567190892,"version":"3.51.4"},"reference-count":22,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":5119,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,4,13]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The complexity of the hepatitis B natural history and its prevalence in specific populations in Australia challenges the capacity of the health system to deliver health care effectively to affected people. This study explores the challenges in delivering health care to people with chronic hepatitis B (CHB) in Australia. Methods: We conducted a grounded theory based qualitative study in which data were gathered from 70 in-depth interviews with government program officers, clinicians and health and community workers across Australia, and four focus group discussions with 40 health and community workers from the communities most at risk of CHB. Results: A systematic approach to screening populations at risk, including people born in countries with intermediate or high prevalence of CHB; consensus on clinical guidelines; development of a shared care framework for CHB involving general practitioners; and effective communication between patients and health professionals were identified as essential. Workforce development, particularly for primary health care professionals, and developing the knowledge and capacity of health professionals to communicate effectively with people with HBV were described as other major factors in reducing the barriers to CHB treatment in Australia. Conclusion: To improve the clinical management of people with CHB in Australia, the health system needs to encourage the screening of people at risk, improve access to clinical services, and the knowledge and communication skills of primary health care and community health service providers. This study supported developing a shared care model and related infrastructures including training programs, referral pathways and clinical guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/sh10137","type":"journal-article","created":{"date-parts":[[2012,1,29]],"date-time":"2012-01-29T19:18:41Z","timestamp":1327864721000},"page":"131-137","source":"Crossref","is-referenced-by-count":20,"title":["Challenges to the effective delivery of health care to people with chronic hepatitis B in Australia"],"prefix":"10.1071","volume":"9","author":[{"given":"Jack","family":"Wallace","sequence":"first","affiliation":[{"name":"AAustralian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia."},{"name":"CCorresponding author. Email: j.wallace@latrobe.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"McNally","sequence":"additional","affiliation":[{"name":"AAustralian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqui","family":"Richmond","sequence":"additional","affiliation":[{"name":"BSt. Vincent\u2019s Hospital, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Behzad","family":"Hajarizadeh","sequence":"additional","affiliation":[{"name":"AAustralian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Pitts","sequence":"additional","affiliation":[{"name":"AAustralian Research Centre in Sex, Health and Society, La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2011,8,24]]},"reference":[{"key":"2025102616594780800_R1","unstructured":"World Health Organization (WHO). Disease and injury regional estimates for 2004. Geneva: WHO; 2004. Available online at: http:\/\/www.who.int\/healthinfo\/global_burden_disease\/estimates_regional\/en\/index.html [verified August 2010]."},{"key":"2025102616594780800_R2"},{"key":"2025102616594780800_R3","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1016\/S0140-6736(06)69374-4","article-title":"Causes of death after diagnosis of hepatitis B or hepatitis C infection: a large community-based linkage study.","volume":"368","author":"Amin","year":"2006","journal-title":"Lancet"},{"key":"2025102616594780800_R4","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/S0168-8278(03)00141-7","article-title":"Epidemiology of hepatitis B in Europe and worldwide.","volume":"39","author":"Alter","year":"2003","journal-title":"J Hepatology"},{"key":"2025102616594780800_R5","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.jcv.2003.09.016","article-title":"Incidence and routes of transmission of hepatitis B virus in England and Wales, 1995\u20132000: implications for immunisation policy.","volume":"29","author":"Hahn\u00e9","year":"2004","journal-title":"J Clin Virol"},{"key":"2025102616594780800_R6","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1002\/hep.21784","article-title":"Why we should routinely screen Asian American adults for hepatitis B: a cross-sectional study of Asians in California.","volume":"46","author":"Lin","year":"2007","journal-title":"Hepatology"},{"key":"2025102616594780800_R7","first-page":"125","article-title":"Chronic hepatitis B and hepatitis C in Asian Americans.","volume":"3","author":"Nguyen","year":"2003","journal-title":"Rev Gastroenterol Disord"},{"key":"2025102616594780800_R8","doi-asserted-by":"publisher","first-page":"922","DOI":"10.1111\/j.1440-1746.2007.05065.x","article-title":"Estimates and projections of hepatitis B-related hepatocellular carcinoma in Australia among people born in Asia-Pacific countries.","volume":"23","author":"Nguyen","year":"2008","journal-title":"J Gastroenterol Hepatol"},{"key":"2025102616594780800_R9","doi-asserted-by":"crossref","first-page":"670","DOI":"10.5694\/j.1326-5377.2009.tb02633.x","article-title":"Chronic hepatitis B and C infection in children in New South Wales.","volume":"190","author":"Nightingale","year":"2009","journal-title":"Med J Aust"},{"key":"2025102616594780800_R10","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1111\/j.1440-1746.2009.05841.x","article-title":"Chronic hepatitis B infection in an Australian antenatal population: seroprevalence and opportunities for better outcomes.","volume":"24","author":"Guirgis","year":"2009","journal-title":"J Gastroenterol Hepatol"},{"key":"2025102616594780800_R11"},{"key":"2025102616594780800_R12"},{"key":"2025102616594780800_R13"},{"key":"2025102616594780800_R14","first-page":"1","article-title":"Recommendations for identification and public health management of persons with chronic hepatitis B virus infection.","volume":"57","author":"Centers for Disease Control and Prevention.","year":"2008","journal-title":"MMWR Morb Mortal Wkly Report"},{"key":"2025102616594780800_R15","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1111\/j.1572-0241.2007.01060.x","article-title":"Virus infection in 6,130 unvaccinated Korean-Americans surveyed between 1988 and 1990.","volume":"102","author":"Hann","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"2025102616594780800_R16","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/1756-0500-4-45","article-title":"Managing chronic hepatitis B: a qualitative study exploring the perspective of people living with chronic hepatitis B in Australia.","volume":"4","author":"Wallace","year":"2011","journal-title":"BMC Public Health"},{"key":"2025102616594780800_R17","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1002\/hep.23190","article-title":"AASLD practice guidelines; chronic hepatitis B: update 2009.","volume":"50","author":"Lok","year":"2009","journal-title":"Hepatology"},{"key":"2025102616594780800_R18","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.jhep.2008.10.001","article-title":"EASL clinical practice guidelines: management of chronic hepatitis B.","volume":"50","author":"European Association for the Study of the Liver","year":"2009","journal-title":"J Hepatol"},{"key":"2025102616594780800_R19","unstructured":"Digestive Health Foundation. Australian and New Zealand chronic hepatitis B (CHB) recommendations, 2nd edition 2009\/10. Melbourne: Digestive Health Foundation, Gastroenterological Society of Australia; 2008. Available online at: http:\/\/www.gesa.org.au\/professional\/guidelines\/ChronicHepatitisB.cfm [verified July 2010]."},{"key":"2025102616594780800_R20","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1111\/j.1467-842X.2005.tb00751.x","article-title":"Knowledge about hepatitis and previous exposure to hepatitis viruses in immigrants and refugees from the Mekong region.","volume":"29","author":"Caruana","year":"2005","journal-title":"Aust N Z J Public Health"},{"key":"2025102616594780800_R21","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.3949\/ccjm.76.s3.03","article-title":"Understanding cultural barriers in hepatitis B virus infection.","volume":"76","author":"Tran","year":"2009","journal-title":"Cleve Clin J Med"},{"key":"2025102616594780800_R22","first-page":"333","article-title":"What barriers do primary care physicians face in the management of patients with chronic hepatitis B infection in primary care?","volume":"46","author":"Tan","year":"2005","journal-title":"Singapore Med J"}],"container-title":["Sexual Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/9\/2\/131\/1253677\/sh10137.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/connectsci.au\/sh\/article-pdf\/9\/2\/131\/1253677\/sh10137.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T20:59:54Z","timestamp":1761512394000},"score":1,"resource":{"primary":{"URL":"https:\/\/connectsci.au\/sh\/article\/9\/2\/131\/184698\/Challenges-to-the-effective-delivery-of-health"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,8,24]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2012,4,13]]}},"URL":"https:\/\/doi.org\/10.1071\/sh10137","relation":{},"ISSN":["1448-5028","1449-8987"],"issn-type":[{"value":"1448-5028","type":"print"},{"value":"1449-8987","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,24]]}}}