Developing a tailored bio-behavioural survey on viral hepatitis among migrants: mixed-methods preparations for the HepMig pilot study, Germany, July 2022–March 2023

Migrants in Germany from countries with a high prevalence of viral hepatitis may need improved access to healthcare services but have not been adequately included in health surveys so far. The HepMig pilot study aims to develop and pilot an integrated bio-behavioural survey on viral hepatitis among migrants from high-prevalence countries living in Germany. The design should be robust, acceptable, feasible, non-stigmatising, non-discriminatory, and community-centred. This paper describes the preparatory research that informed the pilot study design. We defined our populations of interest as adults (≥ 18 years) born in Bulgaria, Romania, Russia, Syria, or Türkiye living in Germany, irrespective of current citizenship or residence status. Analysis of sociodemographic data from the Federal Statistical Office (DESTATIS) revealed considerable differences between these populations in age distribution, duration of residence, and geographic distribution in Germany. An inductive analysis of information provided by community experts – who shared the same country of birth and /or history of migration or closely worked with the populations in focus – from clinical medicine, academia, non-governmental organizations, and public health identified four themes: (i) sampling of heterogeneous populations of interest; (ii) accessibility and trustworthiness as prerequisites for study participation; (iii) opportunities for community engagement and empowerment; and (iv) ethical considerations. Results will inform sampling, recruitment, data collection, and piloting the study design.