{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:44:37Z","timestamp":1787676277661,"version":"build-2784847793"},"reference-count":58,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Public Health Nursing"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Getting and maintaining Hepatitis C Virus (HCV) cure is challenging among people experiencing homelessness (PEH) as a result of critical social determinants of health such as unstable housing, mental health disorders, and drug and alcohol use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The purpose of this exploratory pilot study was to compare a registered nurse\/community health worker (RN\/CHW)\u2010led HCV intervention tailored for PEH, \u201cI am HCV Free,\u201d with a clinic\u2010based standard of care (cbSOC) for treating HCV. Efficacy was measured by sustained virological response at 12 weeks after stopping antivirals (SVR12), and improvement in mental health, drug and alcohol use, and access to healthcare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>An exploratory randomized controlled trial design was used to assign PEH recruited from partner sites in the Skid Row Area of Los Angeles, California, to the RN\/CHW or cbSOC programs. All received direct\u2010acting antivirals. The RN\/CHW group received directly observed therapy in community\u2010based settings, incentives for taking HCV medications, and wrap\u2010around services, including connection to additional healthcare services, housing support, and referral to other community services. For all PEH, drug and alcohol use and mental health symptoms were measured at month 2 or 3 and 5 or 6 follow\u2010up, depending on HCV medication type, while SVR12 was measured at month 5 or 6 follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among PEH in the RN\/CHW group, 75% (3 of 4) completed SVR12 and all three attained undetectable viral load. This was compared with 66.7% (<jats:italic>n<\/jats:italic> = 4 of 6) of the cbSOC group who completed SVR12; all four attained undetectable viral load. The RN\/CHW group, as compared to the cbSOC, also showed greater improvements in mental health, and significant improvement in drug use, and access to healthcare services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>While this study shows significant improvements in drug use and health service access among the RN\/\u2010CHW group, the sample size of the study limits the validity and generalizability of the results. Further studies using larger sample sizes are necessitated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/phn.13204","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T06:23:33Z","timestamp":1683095013000},"page":"641-654","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exploratory assessment: Nurse\u2010led community health worker delivered HCV intervention for people experiencing homelessness"],"prefix":"10.1111","volume":"40","author":[{"given":"Adeline","family":"Nyamathi","sequence":"first","affiliation":[{"name":"University of California, Irvine, Sue &amp; Bill Gross School of Nursing  Irvine California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benissa E.","family":"Salem","sequence":"additional","affiliation":[{"name":"University of California, Los Angeles, School of Nursing  Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darlene","family":"Lee","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Susan Samueli Integrative Health Institute  Irvine California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxia","family":"Yu","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Department of Statistics, School of Information and Computer Sciences  Irvine California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Hudson","sequence":"additional","affiliation":[{"name":"Samuel Merritt University  Oakland California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sammy","family":"Saab","sequence":"additional","affiliation":[{"name":"Adult Liver Transplant Program University of California, Los Angeles, David Geffen School of Medicine at UCLA  Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanghyuk S.","family":"Shin","sequence":"additional","affiliation":[{"name":"University of California, Irvine, Sue &amp; 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