Knowledge and Perceptions of Latent Tuberculosis Infection among Chinese Immigrants in a Canadian Urban Centre

Table 3

Learning objectives used to change knowledge and perception of LTBI among Chinese immigrants.

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.