The effect of a cultural intervention on adherence to latent tuberculosis infection therapy in Latino immigrants.

OBJECTIVE: The purpose of this study was to examine the effect of a cultural intervention (CI) on increasing adherence to latent tuberculosis infection (LTBI) therapy among Latino immigrants. DESIGN AND SAMPLE: This clinical study used a preexperimental design. A nonprobability sample of 86 Latino immigrant clients who were starting LTBI therapy were enrolled in the intervention. The comparison group was an historical sample of 131 clients' records randomly selected from the previous year. INTERVENTION: The CI, designed by the principal investigator, was delivered by 2 Spanish-speaking interventionist nurses at each of 9 clinic visits. The intervention was based on Latino cultural values and included 5 components. MEASURES: The patients' adherence was measured by a self-report of the number of pills taken. RESULTS: The findings of this study were that clients in the CI group took a significantly greater number of doses of INH than those in the historical sample. CONCLUSIONS: Using a CI to increase adherence to LTBI therapy shows promise for public health nursing practice.

Predictors of adherence to latent tuberculosis infection therapy in Latino immigrants.

Adherence to Latent Tuberculosis Infection (LTBI) therapy is a continuing community problem. The purpose of this study was to examine the predictors of adherence to LTBI therapy in Latino immigrants at a public health clinic. A descriptive study was conducted to examine 153 randomly selected records from a population of Latino immigrant clients who had received a recommendation for 9 months of Isoniazid (INH) therapy. Most of the clients were women (64%), the mean age was 26.1, and the mean time in the U.S. was 4.58 years. The majority came from El Salvador, Bolivia, or Guatemala. Adherence dropped off in a linear fashion from month 1 (84%) to month 8 (34%). None of the demographic factors predicted adherence. Implications for community health nursing are discussed.

Adherence to latent tuberculosis infection therapy among latino immigrants.

BACKGROUND: One third of the world population is infected with Mycobacterium tuberculosis. In the United States, a key component for eliminating tuberculosis (TB) is treating latent TB infection (LTBI) in high-risk persons such as immigrants. OBJECTIVE: Examine the prevalence of adherence to LTBI therapy and the influence of basic conditioning factors on adherence among Latino immigrants, guided by Orem's Self-Care Deficit Theory. Adherence was treated as a health deviation self-care requisite; the self-care practice of taking daily medication for 9 months is essential to LTBI adherence. Conditioning factors include gender, age, sociocultural factors, environment, and health state. DESIGN: Exploratory, cross-sectional. SAMPLE: Nonprobability sample (n=53) of Latino immigrants attending an urban public health clinic in the Washington, DC metropolitan area. METHODS: Participants completed a brief questionnaire documenting selected conditioning factors, and 9-month adherence to LTBI therapy was determined from their medical records. RESULTS: Adherence dropped from 98% in month 2 to 72% at 9 months. The mean number of months adherent was 7.4. Adherence was not significantly associated with gender, country of origin, languages spoken, age, education, or years in the United States. Adherence was slightly lower (t=2.059, p=.059) in persons who knew someone with TB. CONCLUSIONS: Nurses should emphasize the importance of adherence for the full 9 months to this population.

Factors influencing osteoporosis knowledge: a community study.

According to the 2004 Surgeon General's report, more than 10 million people in the United States have osteoporosis, and another 34 million are at risk of developing this crippling disease that affects the quality of life. Efforts must be made to stem this disease that may be largely prevented with lifestyle changes. To engage in self-care to prevent osteoporosis, people need to have knowledge of risks and preventive behaviors. The purpose of this study was to examine factors influencing osteoporosis knowledge in 255 people in a university community. The Facts on Osteoporosis Quiz (Ailinger, Lasus, & Braun, 2003) was used to measure osteoporosis knowledge. Findings indicated that respondents had inadequate knowledge about osteoporosis. Age was positively correlated with knowledge (r = .27, p < .000), but education was not. There were marked differences in mean scores among ethnic groups. The findings suggest topics that community health nurses need to focus on in their osteoporosis educational interventions.

Latino immigrants' knowledge of tuberculosis.

This study examined tuberculosis (TB) knowledge in Latino immigrants receiving latent TB infection (LTBI) therapy. The study design was descriptive correlational. Knowledge was measured using the LTBI Knowledge Instrument. The convenience sample included 82 Latino immigrants primarily from Central America and Bolivia who attended a public health clinic for their LTBI therapy. The mean TB knowledge score was 66%. Knowledge scores were correlated with years of education, but not with age or number of years in the United States. More than 80% of study participants correctly answered questions about the importance of keeping monthly appointments and how Isoniazid works to eradicate TB germs in the human body. Questions that pertained to the contagiousness of active TB and how the disease spreads received the most incorrect responses. Public health nursing interventions should focus on increasing Latino immigrants' knowledge of TB, both in public health clinics and in the community.

Revision of the Facts on Osteoporosis Quiz.

BACKGROUND: Few instruments exist that measure knowledge of osteoporosis, a health risk for 28 million Americans. The original Facts on Osteoporosis Quiz (FOOQ), which was theoretically informed by Orem's (1995) Self-Care Theory, was published in 1998. In 2000, the National Institutes of Health (NIH) held a consensus conference on osteoporosis in which previous knowledge was modified based on current science. OBJECTIVES: The goal was to update the original instrument based on the latest scientific evidence and to determine its psychometric properties. METHOD: The quiz content was validated by osteoporosis experts and is theoretically informed by Orem's (2001) Self-Care Theory. An iterative process was used to design an instrument with an acceptable reading level. Reliability, item discrimination, and item difficulty were assessed in a convenience sample of 256 participants. RESULTS: The revised quiz, content-based on the 2000 NIH osteoporosis consensus conference, includes 20 questions. The quiz has a content validity index of.87, an internal consistency reliability of.76 and a 6th grade reading level. Item difficulty and item discrimination are also reported. CONCLUSIONS: The revised version of the FOOQ provides a valid, reliable, and theoretically informed instrument with acceptable psychometric properties.

Americans' knowledge and perceived risk of tuberculosis.

Tuberculosis (TB) has resurged as a major public health problem in the United States, but there is minimal information on the public's knowledge of TB. The general population must become aware of the seriousness of the reemergence of TB. Using data from the National Health Interview Survey Supplement, this study examined knowledge and perceived risk of TB of 14,727 U.S. respondents. Results demonstrated some general knowledge of TB, several misconceptions, and low concern regarding their risk of contracting TB. Only 10.2% of the respondents perceived risk for themselves. Respondents reported perceived knowledge of TB at a high level, while their actual knowledge was lower. Gender, education, income, and ethnicity were associated with knowledge and perceived risk. Older people responded correctly to questions about TB knowledge more often than younger people. Conclusions were that public health nursing efforts need to be redirected toward health education regarding TB risk and spread, complementing existing screening and therapy programs.