针对结核病高风险移民社区开展并激励其参与潜伏性结核感染筛查项目的策略:一项针对厄立特里亚人的社区参与式混合方法研究

Strategies to reach and motivate migrant communities at high risk for TB to participate in a latent tuberculosis infection screening program: a community-engaged, mixed methods study among Eritreans.

作者信息

Spruijt Ineke, Haile Dawit Tesfay, Erkens Connie, van den Hof Susan, Goosen Simone, Ten Kate Andrea, Teshome Hewan, Karels Marja, Koenders Marga, Suurmond Jeanine

机构信息

KNCV Tuberculosis Foundation, The Hague, The Netherlands.

Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

BMC Public Health. 2020 Mar 12;20(1):315. doi: 10.1186/s12889-020-8390-9.

Abstract

BACKGROUND

In the Netherlands, migrant populations with a high tuberculosis (TB) incidence are an important target group for TB prevention. However, there is a lack of insight in effective community-engaged strategies to reach and motivate these migrants to participate in latent TB infection (LTBI) screening and treatment programs.

METHODS

In cocreation with Eritrean key figures and TB staff, we designed and executed six strategies to reach and motivate Eritrean communities to participate in LTBI programs, in five regions in the Netherlands. We registered participation in LTBI education and screening, and LTBI treatment uptake and completion. We used semi-structured group and individual interviews with Eritrean participants, key figures, and TB staff to identify facilitators and barriers.

RESULTS

Uptake of LTBI education (13-75%) and consequent screening (10-124%) varied between strategies. LTBI screening uptake > 100% resulted from educated participants motivating others to participate in screening. Two strategies, using face-to-face promotion and targeting smaller groups, were the most successful. The program resulted in high LTBI treatment initiation and completion (both 97%). Reported program barriers included: competing priorities in the target group, perceived good health, poor risk perception, and scepticism towards the program purpose. TB staff perceived the program as useful but demanding in terms of human resources.

CONCLUSIONS

Eritrean migrant communities can be successfully reached and motivated for LTBI screening and treatment programs, when sufficient (human) resources are in place and community members, well-connected to and trusted by the community, are engaged in the design and execution of the program.

摘要

背景

在荷兰,结核病发病率高的移民群体是结核病预防的重要目标群体。然而,对于有效的社区参与策略,以接触并激励这些移民参与潜伏性结核感染(LTBI)筛查和治疗项目,我们缺乏深入了解。

方法

我们与厄立特里亚的关键人物和结核病防治人员共同设计并实施了六种策略,以接触并激励荷兰五个地区的厄立特里亚社区参与LTBI项目。我们记录了参与LTBI教育和筛查的情况,以及LTBI治疗的接受率和完成率。我们通过对厄立特里亚参与者、关键人物和结核病防治人员进行半结构化的小组和个人访谈,以确定促进因素和障碍。

结果

不同策略之间,LTBI教育的参与率(13%-75%)以及随之而来的筛查率(10%-124%)有所不同。LTBI筛查参与率>100%是由于受过教育的参与者激励他人参与筛查。两种策略,即面对面宣传和针对较小群体,最为成功。该项目导致LTBI治疗的启动率和完成率都很高(均为97%)。报告的项目障碍包括:目标群体中有相互竞争的优先事项、自认为健康状况良好、风险认知不足以及对项目目的持怀疑态度。结核病防治人员认为该项目有用,但在人力资源方面要求较高。

结论

当有足够的(人力)资源,并且与社区联系紧密且受社区信任的社区成员参与项目的设计和实施时,可以成功地接触并激励厄立特里亚移民社区参与LTBI筛查和治疗项目。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1948/7068882/132da8db80ba/12889_2020_8390_Fig1_HTML.jpg

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