TB Education in Jail: Transferring Research to Practice

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The overall goal of our work is to improve adherence to preventive care for latent tuberculosis infection among jail inmates after they are released from jail. Tuberculosis (TB) remains an important problem in the United States, especially among recognized subgroups who are at high risk of becoming infected and developing active disease. Jails are a prime setting where high-risk populations can be identified and treatment begun while they are in jail. Once released, however, they are on their own to continue care in the community, without follow-up or reminders from either the correctional or the healthcare system. In previous work, we found that education in jail was an effective strategy in motivating persons to continue therapy after release from jail. Our study results are meaningful, however, only if the strategy can be adopted and is effective when done by jail clinicians. The purpose of this study is to: 1) transfer the educational protocol to jail medical personnel; 2) measure the effectiveness of the protocol in insuring continuity of preventive therapy after inmates are released; and 3) measure the acceptance of the educational protocol by jail medical personnel. The aims of this prospective cohort study are to: 1. measure two outcomes: the first visit to the TB Clinic within one month of release from jail and completion of preventive therapy, in a cohort of inmates with latent TB infection who are prescribed preventive therapy in jail 2. analyze the two outcomes by whether education was provided by jail medical personnel, and by the characteristics of the education (number and length of sessions, location of the session, language, and whether one-to-one or in a group) 3. compare the two outcomes in this cohort with historical data, one from the time period before our research team developed and conducted educational sessions in the jail, and the second from the time period when research personnel were providing educations to inmates 4. describe the acceptance of the educational program by jail medical personnel This study will answer questions about the sustainability of trial results after adoption of protocols as usual care. It will be useful to researchers and clinicians examining the question of the transition from research to clinical practice.