护士主导的干预措施减少潜伏结核感染阳性的 homeless 成年人的药物使用。
Nurse-led intervention to decrease drug use among LTBI positive homeless adults.
机构信息
Sue & Bill Gross School of Nursing, University of California, Irvine, California.
Fielding School of Public Health, University of California Los Angeles, Los Angeles, California.
出版信息
Public Health Nurs. 2022 Jul;39(4):778-787. doi: 10.1111/phn.13044. Epub 2022 Jan 10.
BACKGROUND
People experiencing homelessness (PEH) are disproportionately diagnosed with active tuberculosis. While promoting latent tuberculosis infection (LTBI) treatment has been a call to action, PEH engaging in substance use often experience challenges in completing LTBI treatment.
METHODS
In this non-randomized single arm study, we tested an innovative, community-based, nurse-led community health worker (RN-CHW) model, on reducing drug use among 50 PEH, residing in homeless shelters or living on the streets in Los Angeles. Follow-up was at 3- and 6- months.
RESULTS
Findings revealed significant and ongoing decrease in any drug use (odds ratio [OR] = 0.30; 95% confidence interval [CI] = 0.14-0.68); p = .004), amphetamine use (OR = 0.14; 95% CI = 0.02-0.81; p = .029), cannabis use (OR = 0.26; 95% CI = 0.12-0.57; p = .001) and methamphetamine use (OR = 0.30; 95% CI = 0.10-0.90; p = .031) at 6-month follow-up.
CONCLUSIONS
To our knowledge, this pilot study is the first to evaluate the impact a RN-CHW delivered intervention on reduction in drug use among PEH enrolled in a LTBI intervention. LTBI interventions may serve as an entryway into reduction in drug use among this underserved population.
背景
无家可归者（PEH）被诊断患有活动性肺结核的比例不成比例。虽然促进潜伏性结核感染（LTBI）治疗已成为行动呼吁，但经常使用药物的 PEH 在完成 LTBI 治疗时往往会遇到挑战。
方法
在这项非随机单臂研究中，我们测试了一种创新的、基于社区的、由注册护士领导的社区卫生工作者（RN-CHW）模式，该模式旨在减少 50 名居住在洛杉矶无家可归者收容所或流落街头的 PEH 的药物使用。随访时间为 3 个月和 6 个月。
结果
研究结果显示，任何药物使用（比值比 [OR] = 0.30；95%置信区间 [CI] = 0.14-0.68）；p = 0.004）、安非他命使用（OR = 0.14；95% CI = 0.02-0.81；p = 0.029）、大麻使用（OR = 0.26；95% CI = 0.12-0.57；p = 0.001）和甲基苯丙胺使用（OR = 0.30；95% CI = 0.10-0.90；p = 0.031）在 6 个月随访时均显著下降。
结论
据我们所知，这项试点研究是首次评估由注册护士领导的社区卫生工作者提供的干预措施对参与 LTBI 干预的无家可归者减少药物使用的影响。LTBI 干预措施可能成为减少这一服务不足人群药物使用的切入点。
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