Nursing health technologies in the prevention and control of hepatitis A: a scoping review

Souza, Leonardo Cassimiro Fonseca e; Gomes, Camila Stela; Tavares, Laís Oliveira de Moraes; Paolinelli, João Pedro Vasconcelos; Melo, João Marcos Alves; Oliveira, Valéria Conceição de; Silva, Brener Santos; Amaral, Gabriela Gonçalves

doi:10.1590/1980-220X-REEUSP-2025-0051en

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REVIEW • Rev. esc. enferm. USP 59 • 2025 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0051en linkcopy

Nursing health technologies in the prevention and control of hepatitis A: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To map scientific evidence on nursing health technologies in the prevention and control of Hepatitis A.

Method: Scoping review conducted in 2024 according to JBI recommendations and reported following PRISMA-ScR criteria. The search was carried out (10/06/2024) in databases and gray literature. The technologies found were classified as: soft, soft-hard, and hard. The results were analyzed descriptively and synthesized.

Results: Ten studies were selected, all from the USA. Technologies include vaccination; serological testing; health education; reminders in health information systems; peer coaching training; case management; consultations; notification of diseases and injuries; clinical screening; and monitoring and tracking. Hard technologies prevailed.

Conclusion: Primary Health Care stood out as the main focus, mainly addressing vaccination and health education. Secondary and Tertiary Care, in turn, focused on clinical screening and continuity of care. The concentration of studies of American origin reinforces the perception of literary insipience and possible negligence and lack of technical preparation in the prevention and control of Hepatitis A.

DESCRIPTORS
Hepatitis; Viral; Human; Hepatitis A; Disease Prevention; Communicable Disease Control; Nursing

Title – author(s) – year – city/country of origin		Objectives:	Design	Participants	Scenario - Level of health care	Technologies for prevention and control of Hepatitis A	Technology classification	Contributions to practice
E1	Nurses’ use of the media to provide public health information during a hepatitis A outbreak Davidson and George(¹⁷) Moon Township, Pennsylvania, USA 2004	Report the experience carried out	Experience Report	TV Viewers	Media: television	- Health education carried out on television by three nurses on HEP A: transmission, incubation period, hand washing, signs and symptoms, action in case of symptoms, differences between vaccine and immunoglobulin.	Soft-hard	- The opportunity not only highlighted the university and the professionals involved, but demonstrated the scientific-informative nature of nurses on aspects of public health
E2	Viral hepatitis prevention education: What do people and providers need to know? Gilbert et al.(¹⁸) Atlanta, Georgia, USA. 2005	- Develop a consensus list of key concepts for educational materials on HEP A, B and C for patients and healthcare professionals; - Check what the general population should know about viral hepatitis; - Check what healthcare professionals should know about viral hepatitis; - Produce a list of essential concepts for the general population and health professionals; - Compare recommendations for the general population and healthcare professionals.	Qualitative study, conducted with three populations: experts in viral hepatitis, health professionals and the general population	11 experts in viral hepatitis; 10 health professionals, of which only one was a nurse; and 158 individuals outside the aforementioned groups, aged between 18-49, mostly women	Primary Health Care Tertiary Health Care	- Preparation of questions about viral HEP, from the perspective of experts, health professionals and the general population, with the purpose of verifying essential key concepts in the knowledge related to each group observed; - Formulation of a checklist to guide health education on viral HEP.	Soft-hard	- The study promoted the information that key concepts for the production of informative material must come from different sources, including the target audience;- For future studies, it is suggested that different topics related to health communication be included, such as the scope and reliability of sources, and that sociodemographic criteria, such as ethnicity/race and sexual orientation, be considered when providing health education.
E3	Hepatitis in primary care: what NPs can do to save lives Stonsifer et al.(¹⁹) Pennsylvania, USA 2006	Report the care practice carried out	Experience Report	3 experts: a nurse, a professor of medicine, and a researcher in epidemiology	Primary Health Care	- Testing of patients during history taking, especially those with liver enzyme abnormalities; history of injecting drug use; patients transfused before 1992; people deprived of liberty; individuals from Africa, Asia, or Eastern Europe; history of risky sexual contact or with men who have sex with men; - Vaccination against HEP A and B for people with chronic liver disease; increased sexual risk; drug use and injection drugs; travelers to or workers from countries at risk of contracting it; health and public safety workers; daycare workers and sewage workers.	Hard	- Need for vaccination against hepatitis A and B in at-risk populations. - Collaboration of the nurse regarding the initial diagnosis and primary care, health education in relation to hepatitis A and B and patient examinations during the collection of information about their clinical history.
E4	Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults Nyamathi et al.(²⁰) Los Angeles, California, USA 2009	- Evaluate the effectiveness of a nurse-led case intervention compared to two standard programs to complete the HEP A and B vaccine schedule (combined - Twinrix vaccine) in homeless adults - Access sociodemographic factors and behavioral risk factors related to the completeness of the vaccination schedule	Prospective, quasi-experimental, randomized study conducted with three groups of homeless adults	865 homeless adults, aged 18-65, able and willing to receive immunization against HEP A and B, in an initial immunization program and follow-up after six months	Primary Health Care	- Health education on HEP A; B, C and HIV: means of transmission; diagnosis; prevention; notions about the vaccine against HEP A and B; vaccination schedule; possible reactions and side effects; in addition to its importance; - Health education on topics such as self-esteem, communication, behavior, drug use, sexual behavior and influences on the completeness of the vaccination schedule against HEP A and B; - Monitoring/tracking; - Testing for HEP A; B, C and HIV. - Vaccination against HEP A and B.	Soft-hard, hard	The program demonstrated significant improvement over a six-month schedule (0, 180 days) of vaccinations against HEP A and B relative to standard control The nursing strategy was fundamental to this increase
E5	Integrating Health and Prevention Services in Syringe Access Programs: A Strategy to Address Unmet Needs in a High-Risk Population Burr et al.(²¹) New Jersey, USA 2014	Describe the implementation of a nurse-led project for health promotion and disease prevention, initially designed with the aim of approaching women enrolled in syringe exchange programs for prenatal care and HIV care.	Cross-sectional study	3,488 injecting drug users, of whom 38% were women, visited the needle exchange program facility	Primary Health Care	- Nurse-led program for STI prevention and control, as well as maternal-fetal health promotion for carriers and individuals at risk of HIV; - STI testing; - Immunization against HEP A and B (Twinrix).	Soft-hard, hard	- The study demonstrated that the inclusion of nurse-led prevention and health promotion services in syringe exchange services reaches a large number of injecting drug users and pregnant women; - In addition to promoting health through needle exchange, the inclusion of other services such as HIV and hepatitis testing and treatment has expanded the reach, particularly reaching marginalized populations such as injecting drug users.
E6	Nursing case management, peer coaching, and Hepatitis A and B vaccine completion among homeless men recently released on parole: randomized clinical trial Nyamathi et al.(²²) Los Angeles, California, USA 2015	- Identify which intervention (intensive peer coaching and nurse-guided case intervention; intensive peer coaching; and usual care) is more assertive in completing the HEP A and B vaccination schedule; - Identify predictors of completeness of the HEP A and B vaccination schedule	Randomized controlled clinical trial.	345 individuals on probation, included in drug treatment residences	Secondary Health Care	- Formation of pairs (Peer coaching); - Case management, in sessions with a nurse, for 45 minutes/week, for 8 weeks, based on vaccination completion, adherence to the drug rehabilitation program, health promotion and reduction of sexual risk and substance abuse; - Vaccination against HEP A and B (Twinrix) following the 0, 7 and 21-30 day schedule.	Soft, soft-hard, hard	- Completeness of the vaccination schedule against HEP A and B - Assessment of the effectiveness of three interventions carried out by nurses, with similarity between the proposed assistance modalities being checked; - Development of multi-level peer and nurse-led programs to improve receptivity to HEP A and B vaccine - Inclusion of nurses in drug treatment residences
E7	Viral Hepatitis: New US Screening Recommendations, Assessment Tools, and Treatments Dan et al.(²³) Washington, USA 2015	- Analyze the epidemiology and diagnosis of HEP A, HEP B and HEP C; - Discuss the natural history of chronic HEP B and HEP C; - Describe the US Department of Health and Human Services’ action plan, focusing on the role of nurses in prevention, treatment, and, in the case of HCV, cure	Experience Report	- People with HIV infection; - Anyone who has ever used injectable drugs (even once); - Healthcare professionals, emergency physicians and public safety after needlestick injuries or mucosal exposure to blood contaminated with HEP C; - Children born to mothers who tested positive for HEP C;	Primary Health Care	- Serological screening; - Two-step screening process (antibody test and nucleic acid test).	Hard	- Promotion of health education; - Review of action plans against viral hepatitis; - Emphasis on the importance of the nurse’s role in infection control, development and practices related to the aforementioned action plans.
E8	Hepatitis A takes hold in the community Heavey(²⁴) Brockport, New York, USA. 2020	To describe HEP A virus infections in at-risk individuals, such as homeless people, in the United States.	Experience Report	General population	Primary Health Care	- Health education on hand washing, hygiene of chlorinated surfaces, adequate consumption of food and water; - Vaccination against HEP A (Havrix and Vaqta) and against HEP A and B (Twinrix); - Notification to epidemiological surveillance and public health systems; - Consultation for travelers; - Testing for travelers.	Soft-hard, hard	The nurse has an educational and assistance role, especially with immunization, in addition to acting in the prevention and diagnosis of HEP A.
E9	Emergency Department-based Hepatitis A Vaccination Program in Response to an Outbreak Kaigh et al.(²⁵) Philadelphia, USA 2020	To assess the incidence of new cases of HEP A after the implementation of a vaccination program guided by best practice advisory (BPA)	Retrospective descriptive cross-sectional study	Data from 5009 individuals visiting an emergency department, perceived as at-risk population (homeless people, drug users, men who have sex with men, recently incarcerated people)	Primary Health Care Secondary Health Care	- Vaccination against HEP A; - Use of BPA, a tool that triggers a reminder, based on each patient’s medical records and history, aiming at checking their vaccination status and eligibility.	Hard	The use of the technologies employed, as well as the association between the public health and emergency departments contributed to the immunization of 669 individuals, and a decrease in the occurrence of HEP A was also observed.
E10	An electronic medical record-based intervention to improve hepatitis A vaccination rates in the emergency department during a regional outbreak Bukhsh et al.(²⁶) Michigan, USA 2022	To determine the success of implementing BPA to increase the HEP A vaccination rate in a hospital emergency department, as well as to quantitatively evaluate the use and barriers of the implementation.	Retrospective cohort study and survey analysis.	11,016 patients who presented to an emergency department, screened and verified as individuals at risk for HEP A (homeless people, drug users, incarcerated people, patients with liver disease and MSM)	Secondary Health Care	- BPA encouraging vaccination of individuals at risk for HEP A; - Vaccination against HEP A; - Serological testing.	Hard	The tool used is effective for reminders of HEP A vaccination, but lacks feedback from users (doctors, caregivers and nurses) for future improvements. A massive increase in the number of vaccine requests was observed during the period in which the tool was used.

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
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[T1FN1] Note: USA United States of America; HEP: Hepatitis; HIV: human immunodeficiency virus; STI: sexually transmitted infections; BPA: best practice advisory.