TB Education in Jail: Transferring Research to Practice

监狱中的结核病教育：将研究转化为实践

• 批准号: 6332088
• 负责人: MARY Castle WHITE
• 金额: $ 7.38万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-05-01 至 2003-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6332088
• 关键词: clinical research; correctional institutions; disease /disorder proneness /risk; health education; health services research tag; human subject; human therapy evaluation; outcomes research; therapy compliance; tuberculosis

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.

我们工作的总体目标是提高监狱囚犯出狱后对潜在结核病感染的预防护理的坚持性。结核病（TB）在美国仍然是一个重要的问题，特别是在公认的高风险感染和发展活动性疾病的亚群中。监狱是一个主要的环境，在那里可以识别高风险人群，并在他们入狱时开始治疗。然而，一旦获释，他们就得靠自己继续在社区接受护理，而没有教养或保健系统的后续行动或提醒。在以前的工作中，我们发现，在监狱中的教育是一个有效的策略，在激励人们从监狱释放后继续治疗。我们的研究结果是有意义的，但是，只有当该策略可以被采用，并有效时，由监狱临床医生。本研究的目的是：1）将教育协议转移到监狱医疗人员; 2）测量协议在确保囚犯释放后预防治疗的连续性方面的有效性; 3）测量监狱医疗人员对教育协议的接受程度。这项前瞻性队列研究的目的是：1。衡量两个结果：在第二监狱接受预防性治疗的一批潜伏结核病感染囚犯中，在从监狱释放并完成预防性治疗后一个月内首次前往结核病诊所。通过是否由监狱医务人员提供教育，以及教育的特征（会议的数量和长度，会议的地点，语言，以及是否一对一或一组）分析两种结果。将该队列的两个结果与历史数据进行比较，一个是我们的研究团队在监狱中开发和进行教育课程之前的时间段，另一个是研究人员为囚犯提供教育的时间段4。描述监狱医务人员对教育计划的接受程度。本研究将回答有关采用常规护理方案后试验结果可持续性的问题。这将是有用的研究人员和临床医生检查的问题，从研究过渡到临床实践。