|
Findings | | Impact on adherence | Interventions |
|
Perceptions of LTBI |
Definition | What is LTBI | Hinders | Provide correct information about LTBI. |
Cause and transmission | The risks of contracting LTBI | Facilitates | Make patient-perceived susceptibility more consistent with an individual’s actual risk. |
Diagnosis | Knowledge about the absence of symptoms and tests for LTBI | Hinders | Provide information on symptoms of TB and contrast with the absence of LTBI symptoms. Describe where the tests are available. |
Prevention | The benefits of prevention to reduce risk of LTBI | Facilitates | Educate patients about the benefits of preventing active TB from LTBI and what action can be taken. |
Treatment | Concerns about taking medicines: length of treatment, side effects, and costs | Hinders | Correction of the misinformation on side effects and costs; provide incentives and assist patients with treatment completion. |
| Taking any treatment in the absence of symptoms | Hinders | Educate patients that having no symptoms does not mean there is no LTBI. |
| Belief in some traditional treatment | Hinders | Replacing traditional treatment with standard LTBI treatment and potentially encourage harmless traditional treatments when that approach is beneficial. |
| Benefits of LTBI treatment | Facilitates | Specify the positive effects of treating LTBI and what actions to take. |
| Confidence in one’s ability to take action to support for LTBI treatment completion: costs, jobs, financial resources, health insurance, and being familiar with the environment | Hinders | Inform patients that there is no financial burden for the treatment of LTBI; provide support to patients, including reminding patients to take medicine, counseling to reduce their anxiety, and providing opportunity for clinic hours that coincide with patient availability. |
|
Concerns of the health system |
Health insurance | Barriers to adhering to treatment because of the health system: costs | Hinders | Inform patients that the treatment of LTBI is free and help them navigate the health care system. |
Family doctor | Barriers to adhering to treatment because of the family doctor: knowledge, authority, and communication | Hinders | Reassure patients that family doctors are qualified to diagnose and treat LTBI and increase their communication skills through education or training programs. Provide easy-to-use tools to family doctors to help portray information more efficiently. |
Waiting time | Barriers to adhering to treatment because of the health system: efficiency | Hinders | Improve the efficiency of the health system through strengthening the partnership between the primary health care system and TB services. |
Trust | Benefits of trusting family doctors: good skills and ethics | Facilitates | Educate patients about the positive effects of trusting family doctors and adhering to their prescriptions. |
| Barriers to adhering to treatment because of the family doctor: perception that family doctors use drugs as a test | Hinders | Educate immigrants on the rules of Canadian medical practice and how using medication for inappropriate reasons is not acceptable nor is it tolerated. Explain that a trial of treatment can be acceptable practice. |
|
Marginalization from society |
Rejection by others | Barriers to adhering to treatment: rejection by others | Hinders | Increase social awareness and acceptance of LTBI. |
Stigma | Barriers to adhering to treatment: a diagnosis of LTBI would become known to others | Hinders | Reduce the stigma of LTBI patients at a community level through community-wide educational interventions. |
Culture and race | Barriers to adhering to treatment: rejection by communities | Hinders | Be aware of the cultural perceptions and increase the awareness and acceptance of LTBI in Chinese communities. |
|
Ways of raising awareness |
| Strategies to activate “readiness” | Facilitates | Create, test, and evaluate health promotional materials to raise awareness. |
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