Perceptions of tuberculosis among immigrants and refugees at an adult education center: A community-based participatory research approach

Mark L. Wieland, Jennifer A. Weis, Barbara P. Yawn, Susan M. Sullivan, Kendra L. Millington, Christina M. Smith, Susan Bertram, Julie A. Nigon, Irene G. Sia

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

English as a Second Language programs serve large foreign-born populations in the US with elevated risks of tuberculosis (TB), yet little is known about TB perceptions in these settings. Using a community-based participatory research approach, we elicited perceptions about TB among immigrant and refugee learners and staff at a diverse adult education center. Community partners were trained in focus groups moderation. Ten focus groups were conducted with 83 learners and staff. Multi-level, team-based qualitative analysis was conducted to develop themes that informed a model of TB perceptions among participants. Multiple challenges with TB control and prevention were identified. There were a variety of misperceptions about transmission of TB, and a lack of knowledge about latent TB. Feelings and perceptions related to TB included secrecy, shame, fear, and isolation. Barriers to TB testing include low awareness, lack of knowledge about latent TB, and the practical considerations of transportation, cost, and work schedule conflicts. Barriers to medication use include suspicion of generic medications and perceived side effects. We posit adult education centers with large immigrant and refugee populations as excellent venues for TB prevention, and propose several recommendations for conducting these programs. Content should dispel the most compelling misperceptions about TB transmission while clarifying the difference between active and latent disease. Learners should be educated about TB in the US and that it is curable. Finally, TB programs that include learners and staff in their design and implementation provide greater opportunity for overcoming previously unrecognized barriers.

Original languageEnglish (US)
Pages (from-to)14-22
Number of pages9
JournalJournal of Immigrant and Minority Health
Volume14
Issue number1
DOIs
StatePublished - Feb 1 2012

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Keywords

  • Adult education
  • Community-based participatory research
  • Focus groups
  • Immigrants
  • Refugees
  • Tuberculosis

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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