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. 2025 Apr;49(2):100229.
doi: 10.1016/j.anzjph.2025.100229. Epub 2025 Mar 12.

One size does not fit all: healthcare worker perspectives on hepatitis B models of care in a low-prevalence region in Australia

Jacqueline A Richmond  1 , Christine Roder  2 , Chris Hair  3 , Amanda J Wade  4 , Jack Wallace  5
Affiliations
Free article

One size does not fit all: healthcare worker perspectives on hepatitis B models of care in a low-prevalence region in Australia

Jacqueline A Richmond et al. Aust N Z J Public Health. 2025 Apr.
Free article

Abstract

Objective: Australia is not on track to achieve national hepatitis B elimination care targets. Many low hepatitis B prevalence Australian regions have disproportionately lower care uptake rates than higher-prevalence regions. This study aimed to determine enablers to providing care in a low hepatitis B prevalence region of Australia.

Methods: Semi-structured interviews were conducted with healthcare workers in the Barwon South West region of Victoria, Australia, to identify their perspectives on hepatitis B care and service delivery.

Results: Between August and November 2023, 20 participants were interviewed including nine general practitioners, four nurses, three specialists, three interpreters, and one refugee worker. Hepatitis B was understood as a rare, complex condition. The increasing pressure on general practitioners to manage specialist health conditions affected their willingness to manage hepatitis B. Enablers included specialist nurses providing case management and developing systematic links between specialist clinic staff and general practitioners. A localised community of practice would build general practitioner confidence.

Conclusions: Low-prevalence regions have unique hepatitis B care challenges. Disease prevalence needs to be considered when implementing decentralised models of care, with infrequent exposure challenging general practitioner confidence and skill maintenance.

Implications for public health: The model for community-based hepatitis B care should be guided by prevalence and regional population characteristics and supported by enabling infrastructure.

Keywords: hepatitis B; micro-elimination; patient care; primary health care.

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Conflict of interest statement

Conflicts of interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr Christine Roder reports financial support was provided by Gilead Sciences Inc. This study received ethics approval from the Barwon Health Research Ethics Committee (HREC/98114). Dr Christine Roder was awarded a Gilead Fellowship Grant in 2023, Deakin University, Institute for Mental and Physical Health and Clinical Transformation (IMPACT) Seed Grant and Centre for Innovation of Infectious Disease and Immunology research (CIIDIR) Seed Grant, which supported this project. The authors acknowledge the contribution to this work of the Victorian Operational Infrastructure Support Program received by the Burnet Institute. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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