Accurate HCV knowledge is lacking among high-risk groups, including people with HIV/AIDS (PLWHA). Liver disease primarily due to HCV has emerged as a serious cause of mortality among PLWHA. We used an interrupted time series design to evaluate a social-ecologically based intervention for PLWHA, where an infectious disease clinic serving a six-county intervention area was monitored before (7 months) and after (17 months) intervention onset. The intervention included education of PLWHA and medical providers, HIV/HCV support groups and resource guides, and adaptation of the patient chart top sheet to include HCV test information. Clinic-level outcomes were assessed prospectively every other week for two years by interviewing patients (n=259) with clinic appointments on assessment days. Abrupt, gradual and delayed intervention effects were tested. Weighted regression analyses showed higher average HCV knowledge and a higher prevalence of patients reporting HCV discussion with their medical providers after intervention onset. A delayed effect was found for HCV awareness, and a gradually increasing effect was found for knowing one‘s HCV status. Other communities may consider adopting this intervention. Additional HCV interventions for PLWHA with HIV are needed.

Health education is needed to prevent HCV infections and increase HCV treatment-seeking. Higher education levels were related to more accurate HCV knowledge, indicating the need for health promotion for PLWHA of lower education levels.

Work-related stress is experienced at a high level in the United States. Clergy are particularly likely to over-extend themselves to act on their sacred call. Sabbath-keeping may offer a practice that is beneficial for mental health, yet many Protestant clergy do not keep a regular Sabbath. We examined whether United Methodist clergy who attended informative Sabbath-keeping workshops reported changes in spiritual well-being and mental health post-workshop. Compared to baseline, at 3 and 9 months post-workshop, participants reported an increase in Sabbath-keeping. In adjusted random effects and Poisson models, compared to not changing Sabbath-keeping frequency, increasing Sabbath-keeping was related to only one outcome: greater feelings of personal accomplishment at work. Decreasing Sabbath-keeping was related to worse anxiety symptoms, lower spiritual well-being in ministry scores, and a higher probability of having less than flourishing mental health. For four outcomes, there were no significant associations with changes in Sabbath-keeping over time. Although lacking a control group, this study adds to cross-sectional Sabbath-keeping studies by correlating changes in Sabbath-keeping with changes in mental health outcomes over time.

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