Table 3.

Major themes associated with pursuit of care based on qualitative patient interviews, associated Health Belief model constructs, and suggested interventions to improve care

Major themes	Associated Health Belief Model constructs	Proposed interventions to improve care
Structural barriers: financial, scheduling, transportation, health-system level	Perceived barriers	Expand Medicaid; utilize pharmaceutical company drug assistance programs; educate patients on available resources and supportive care; aim for clinic responsiveness, ease of scheduling, and confidentiality
Stigma	Perceived susceptibility Perceived barriers	Provide education on harm reduction strategies; co-locate treatment for substance use disorder and HCV; educate clinic staff on creating a welcoming atmosphere
Ambivalence	Perceived susceptibility Perceived severity	Acknowledge and address the uncertainty related to having HCV; Focus patient education campaigns on ambivalence and the potential for treatment to relieve patients of the burden of uncertainty
Prior experiences of HCV disease and treatment	Perceived susceptibility Perceived severity Perceived benefits Perceived barriers	Explore patients’ or others’ prior experiences with HCV treatment; address favorable changes in treatment since earlier therapies
Patient-provider relationship	Perceived susceptibility Perceived severity Perceived barriers Perceived benefits Self-efficacy	Encourage expansion of HCV treatment to where patients are already receiving care and have established relationships

HCV hepatitis C virus