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Principal Investigator(s): Jenny Pang, MD, MPH1;
J. Carey Jackson, MD, MPH, MA2; Nickolas DeLuca, PhD, MA2;
Project Dates: October, 2003 - September, 2008
Project Overview: The Centers for Disease Control and Prevention
(CDC), Seattle & King County Public Health Department, and the University of
Washington have partnered to develop and conduct a study to understand the
barriers and facilitators that influence primary care management of latent and
active tuberculosis (TB) among immigrant populations. Epidemiologic data
indicates that United States (US) populations with the highest incidence of
acute TB disease are recent immigrants from Mexico, the Philippines, and Vietnam.
Most newly arrived foreign-born individuals present for general medical care in
"safety net" settings: community clinics, public clinics, and private
practitioners caring for these communities. Effective TB control strategies
require that primary care providers be adept at screening for and managing latent
TB infection (LTBI) and include active TB disease in their differential diagnosis
in certain clinical settings. This 3-year, multi-phase study was developed to
elicit and clarify the knowledge, attitudes, and practices of primary care
providers who see foreign-born patients at risk for LTBI and active tuberculosis
(TB) disease. Ultimately, this project will develop and implement educational
strategies for successfully addressing identified barriers and limitations.
Objectives: The objectives of this study are to: 1) conduct
formative research to describe the factors influencing the efficient management
of latent and active tuberculosis among primary care providers caring for
immigrants from Mexico, the Philippines, and Vietnam; and, 2) design, implement,
and assess the impact of an intervention to address the knowledge, attitudes,
and practice factors amenable to an intervention
Target Audience: Non-public health providers with large
foreign-born patient populations from high burden TB disease and LTBI incidence
areas (e.g., Mexico, the Philippines, and Vietnam)
Methods: This study will be conducted in three phases. During
the first phase (Phase I), qualitative interviews will be conducted, including a
combination of focus groups and individual interviews with health care providers
to elucidate aspects of primary care practice that impact TB screening and
management. The next two phases (Phase II-III), the intervention phases, will be
designed, executed and evaluated using the information and knowledge gained from
Phase I.
Contact Information:
Jenny Pang, MD
Seattle & King County Public Health Department
999 3rd Avenue
Suite 1200
Seattle, WA 9810
E-mail: pang.j@ghc.org
J. Carey Jackson, MD
University of Washington
School of Medicine
Department of General Internal Medicine
325 9th Avenue
Box 359959
Seattle, WA 98104
E-mail:
jackson.c@u.washington.edu
Nickolas DeLuca, PhD
Centers for Disease Control and Prevention
Division of Tuberculosis Elimination
1600 Clifton Road, NE
Mailstop E-10
Atlanta, GA 30333
E-mail: ncd4@cdc.gov
Publications:
N/A
Relative Content:
1 Seattle & King County Public Health Department, Seattle, Washington
2 University of Washington, Seattle, Washington
3 Division of Tuberculosis Elimination, Centers for Disease Control
and Prevention, Atlanta, Georgia
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