Abstract
Homeless adults are at increased risk of latent tuberculosis infection (LTBI), which can lead to active tuberculosis (TB) disease. The purpose of this study was to assess acceptability and feasibility of a six-month, nurse-led, community health worker-partnered short-course treatment (3HP) LTBI adherence model for a high risk, LTBI positive, homeless population. Informed by our community advisory board (CAB) and community-based participatory research principles (CBPR), a qualitative study was undertaken and used focus group discussions to identify perspectives of homeless men and women who had undergone LTBI treatment (N = 11, Mage = 51.2, SD 8.60, range 35–60). Three themes formed, which were engaging and recruiting LTBI intervention participants, delivering an LTBI intervention, and retaining LTBI intervention participants. Within those themes, barriers (e.g., lack of LTBI treatment readiness, substance use, etc.), and facilitators (e.g., LTBI and TB health education, familiarity with homeless population, etc.) were discussed to facilitate program recruitment, program delivery and program retention. These findings provide a greater understanding of how to effectively utilize a nurse-led, Community Health Worker (CHW) intervention delivery method to not only improve 3HP LTBI medication adherence, but also decrease substance use, improve mental health, and decrease unstable housing among this vulnerable population at high risk for active tuberculosis.
Highlights
Tuberculosis (TB) is caused by Mycobacterium tuberculosis bacteria [1] and is associated with poverty and homelessness [2]
“Please tell us what health services you have sought in the last few years?” and “What would you say are the biggest barriers to completing the 12-week therapy that would prevent getting sick with TB in the future?” Another question included, “How can the community health worker (CHW) and nurse be most supportive to you in successfully completing the treatment in the community?”
Facilitators for engaging and recruiting participants into a latent tuberculosis infection (LTBI) intervention are divided into desire to change and LTBI and TB disease education
Summary
Tuberculosis (TB) is caused by Mycobacterium tuberculosis bacteria [1] and is associated with poverty and homelessness [2]. In the United States (US), as compared to the general population, homeless persons have a 10-fold increase in TB incidence [3]. 7.6% of TB cases occur among those experiencing homelessness [4]. Prior to a TB diagnosis, over 5% of individuals report being homeless within the last year [5]. As compared to the general population, homeless populations are at higher risk for recent TB transmission [6,7,8] due to lack of TB treatment completion, malnutrition, and substance abuse (e.g., alcohol use) [5,9]. Additional risk factors include residing in a homeless shelter with persons with active TB disease [7] and length of stay in shelters [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
