一项针对中国男男性行为人群的乙型肝炎和丙型肝炎检测的众包干预研究：一项全国性在线随机对照试验的研究方案。
A crowdsourced intervention to promote hepatitis B and C testing among men who have sex with men in China: study protocol for a nationwide online randomized controlled trial.
机构信息
School of Medicine, University of Washington, Seattle, WA, USA.
Department of Gastroenterology and Hepatology, University of California San Francisco, San Francisco, USA.
出版信息
BMC Infect Dis. 2018 Sep 29;18(1):489. doi: 10.1186/s12879-018-3403-3.
BACKGROUND
The World Health Organization recommends all men who have sex with men (MSM) receive Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) testing. MSM in China are a high-risk group for HBV and HCV infection, but test uptake is low. Crowdsourcing invites a large group to solve a problem and then shares the solution with the public. This nationwide online randomized controlled trial will evaluate the effectiveness of a crowdsourced intervention to increase HBV and HCV testing among MSM in China.
METHODS
Seven hundred MSM will be recruited through social media operated by MSM organizations in China. Eligible participants will be born biologically male, age 16 years or older, report previous anal sex with another man, and reside in China. After completing a baseline online survey, participants will be randomly assigned to intervention or control arms with a 1:1 allocation ratio. The intervention will include two components: (1) a multimedia component will deliver two videos and two images promoting HBV and HCV testing developed through a crowdsourcing contest in China; (2) a participatory component will invite men to submit suggestions for how to improve crowdsourced videos and images. The control arm will not view any images or videos and will not be invited to submit suggestions. All participants will be offered reimbursement for HBV and HCV testing costs. The primary outcome is HBV and HCV test uptake confirmed through electronic submission of test report photos within four weeks of enrolment. Secondary outcomes include self-reported HBV and HCV test uptake, HBV vaccination uptake, and change in stigma toward people living with HBV after four weeks. Primary and secondary outcomes will be calculated using intention to treat and as-exposed analyses and compared using two-sided 95% confidence intervals.
DISCUSSION
Few previous studies have evaluated interventions to increase HBV and HCV testing in middle-income countries with a high burden of hepatitis. Delivering a crowdsourced intervention using social media is a novel approach to increasing hepatitis testing rates. HBV and HCV test uptake will be confirmed through test report photos, avoiding the limitations of self-reported testing outcomes.
TRIAL REGISTRATION
NCT03482388 (29 March 2018).
背景
世界卫生组织建议所有男男性行为者（MSM）接受乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）检测。中国的 MSM 是 HBV 和 HCV 感染的高危人群，但检测率较低。众包邀请大量人群解决一个问题，然后将解决方案公之于众。这项全国范围内的在线随机对照试验将评估众包干预措施在中国 MSM 中增加 HBV 和 HCV 检测的有效性。
方法
通过中国 MSM 组织运营的社交媒体，将招募 700 名 MSM。符合条件的参与者将为生物学上的男性，年龄在 16 岁或以上，报告过去与另一名男性发生过肛门性行为，并居住在中国。在完成基线在线调查后，参与者将按照 1:1 的比例随机分配到干预组或对照组。干预措施将包括两个部分：（1）多媒体部分将提供两个视频和两个图片，通过中国的众包竞赛来推广 HBV 和 HCV 检测；（2）参与式部分将邀请男性提交如何改进众包视频和图片的建议。对照组将不会查看任何图像或视频，也不会被邀请提交建议。所有参与者将获得 HBV 和 HCV 检测费用的报销。主要结果是在登记后四周内通过电子提交检测报告照片确认 HBV 和 HCV 检测率。次要结果包括自我报告的 HBV 和 HCV 检测率、HBV 疫苗接种率以及四周后对 HBV 感染者的耻辱感变化。主要和次要结果将使用意向治疗和实际暴露分析进行计算，并使用双侧 95%置信区间进行比较。
讨论
很少有研究评估过在 HBV 和 HCV 负担较重的中等收入国家增加 HBV 和 HCV 检测的干预措施。使用社交媒体提供众包干预是一种增加肝炎检测率的新方法。HBV 和 HCV 检测率将通过检测报告照片确认，避免了自我报告检测结果的局限性。
试验注册
NCT03482388（2018 年 3 月 29 日）。
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