دورية أكاديمية
Effect of a Nurse-Led Community Health Worker Intervention on Latent Tuberculosis Medication Completion Among Homeless Adults.
| العنوان: | Effect of a Nurse-Led Community Health Worker Intervention on Latent Tuberculosis Medication Completion Among Homeless Adults. |
|---|---|
| المؤلفون: | Nyamathi, Adeline, Salem, Benissa E, Shin, Sanghyuk S, Jones, Adrianna A, Garfin, Dana R, Yadav, Kartik, Chang, Alicia H, White, Kathryn, Morisky, Donald |
| المصدر: | Nursing research, vol 70, iss 6 |
| بيانات النشر: | eScholarship, University of California |
| سنة النشر: | 2021 |
| المجموعة: | University of California: eScholarship |
| مصطلحات موضوعية: | Humans, Isoniazid, Pilot Projects, Nurse's Role, Adult, Aged, 80 and over, Middle Aged, California, Female, Male, Patient Education as Topic, Medication Adherence, Latent Tuberculosis, Community Health Workers, Practice Patterns, Nurses', Ill-Housed Persons, Homelessness, Health Services, Tuberculosis, Depression, Clinical Research, Rare Diseases, Mental Health, Infectious Diseases, Behavioral and Social Science, Prevention, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals |
| جغرافية الموضوع: | 433 - 442 |
| الوصف: | BackgroundTuberculosis (TB) disproportionately affects marginalized and impoverished homeless adults. Although active TB can be prevented by treating latent TB infection (LTBI), individual factors, such as high prevalence of depression and anxiety, drug and alcohol use, and unstable housing, lead to poor LTBI treatment adherence and completion among homeless adults.ObjectivesWe hypothesized that the delivery of a tailored nurse-led, community health worker (RN/CHW) program across the LTBI continuum of care (e.g., screening, diagnosis, and treatment) that delivers 3HP treatment (3HP: rifapentine plus isoniazid) for homeless adults (e.g., sheltered and unsheltered) and is tailored to their health and social service needs will overcome existing treatment completion barriers. We also hypothesized that mental health symptoms (e.g., depression and anxiety), drug use score, and problematic alcohol use will decline over time among clients receiving this treatment.MethodsWe assessed the effect of delivering a theoretically guided, RN/CHW-based, single-arm study among eligible LTBI-positive homeless adults (N = 50) on completion of a weekly, directly observed, 12-dose 3HP LTBI treatment in Central City East (Skid Row). Completing 3HP treatment was compared to the only known historical, clinic-based control that obtained 65% completion among homeless adults. Secondary outcomes included drug and alcohol use, depression, and anxiety.ResultsThe RN/CHW program achieved a 91.8% 3HP treatment completion rate among homeless adults. Younger homeless adults (<50 years old) were less likely to complete 3HP treatment compared to those who were older. Neither drug use, depression, nor anxiety was associated with 3HP treatment completion. Decrease in anxiety was observed at 3 months, but not at 6 months, compared to baseline.DiscussionTo our knowledge, the pilot study is the first to evaluate an effective RN/CHW-delivered, community-based intervention, which can reduce the burden of active TB for homeless adults. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | unknown |
| العلاقة: | qt9xb7x2hs; https://escholarship.org/uc/item/9xb7x2hsTest; https://escholarship.org/content/qt9xb7x2hs/qt9xb7x2hs.pdfTest |
| DOI: | 10.1097/nnr.0000000000000545 |
| الإتاحة: | https://doi.org/10.1097/nnr.0000000000000545Test https://escholarship.org/uc/item/9xb7x2hsTest https://escholarship.org/content/qt9xb7x2hs/qt9xb7x2hs.pdfTest |
| حقوق: | public |
| رقم الانضمام: | edsbas.DC82029A |
| قاعدة البيانات: | BASE |
| DOI: | 10.1097/nnr.0000000000000545 |
|---|