Integration of hepatitis B preventive interventions into community pharmacy services in a resource-limited setting: a pilot study - hepatitis B virus (HBV) infection remains a major public health…

The National Institute of Allergy and Infectious Diseases awarded The University of North Texas Health Science Center at Fort Worth $280,791 on April 17, 2026, under the Allergy and Infectious Diseases Research program (CFDA 93.855) to conduct a pilot study on integrating hepatitis B preventive interventions into community pharmacy services.

The funded project will evaluate the feasibility of incorporating HBV screening and vaccination into routine community pharmacy operations and generate preliminary data for a future effectiveness-implementation trial. Using the EPIS and RE-AIM frameworks, the recipient will pursue two primary aims: co-creating implementation strategies with stakeholders including community pharmacists, implementing partners, policymakers, and patient advocates; and implementing and evaluating HBV screening and vaccination services using a sequential explanatory mixed-methods design to assess implementation outcomes such as reach, effectiveness, adoption, implementation, and maintenance.

The study addresses a documented gap in pharmacist-led HBV prevention services. Over 1.7 million individuals in the United States currently live with HBV infection, with an estimated 14,400 new infections annually. Community pharmacists are highly accessible but remain underutilized in delivering HBV screening and vaccination despite being well-positioned to expand prevention services in resource-limited settings.

Performance occurs in Fort Worth, Texas, with a period of performance from April 17, 2026, through March 31, 2028.

Integration of hepatitis B preventive interventions into community pharmacy services in a resource-limited setting: a pilot study - hepatitis B virus (HBV) infection remains a major public health problem in the united states (U.S.) and a leading cause of liver cancer, affecting over 1.7 million individuals. With an estimated 14,400 new infections annually, limited access to HBV prevention services, including screening and vaccination, continues to impede effective disease prevention and control. Community pharmacists are highly accessible healthcare providers and are well-positioned to expand HBV prevention services. However, they remain underutilized in delivering and improving the uptake of HBV screening and vaccination, highlighting the need for effective implementation strategies. Despite this opportunity, there is a paucity of implementation research to inform and strengthen pharmacist-led HBV prevention services. This pilot study will evaluate the feasibility of integrating HBV screening and vaccination into community pharmacy services and generate critical preliminary data for a future effectiveness-implementation trial. Guided by the exploration, preparation, implementation, sustainment (EPIS) and reach, effectiveness, adoption, implementation, and maintenance (RE-aim) frameworks, we propose two specific aims: 1) CO-create implementation strategies to integrate hepatitis B screening and vaccination into routine community pharmacy services. We will engage stakeholders, including community pharmacists, implementing partners, policymakers, and patient advocates to identify contextually appropriate implementation strategies. 2) implement and evaluate the integration of HBV screening and vaccination into routine community pharmacy services. We will implement HBV screening and vaccination and use a sequential explanatory mixed-methods design to assess: (I) implementation outcomes, including: (a) reach (number and characteristics of individuals receiving HBV screening and initiating vaccination); (B) effectiveness (completion of the HBV vaccine primary series); (C) adoption (uptake of HBV screening and vaccination by community pharmacies); (D) implementation (fidelity to HBV screening and vaccination protocols); (E) maintenance (likelihood of sustained delivery of HBV screening and vaccination beyond the study period); and (II) the barriers and facilitators influencing the implementation outcomes. Nigeria provides a strong scientific rationale for this study due to its high HBV burden and well-established network of community pharmacies, with findings expected to inform the design of HBV prevention intervention in the U.S. The substantially higher HBV prevalence compared with the U.S. Enhances study efficiency by increasing the likelihood of measurable outcomes. Furthermore, community pharmacies in this context frequently serve as frontline points of care, delivering basic health services beyond the scope of typical community pharmacy practice in the U.S. These structural features support large-scale implementation and evaluation of HBV screening and vaccination within community pharmacy settings. This project will generate implementation strategies that can be adapted to strengthen pharmacy-led HBV prevention efforts in the U.S., expand HBV screening and vaccination coverage, and improve liver cancer prevention.