Tuberculosis Epidemiologic Studies Consortium (TBESC)

Task Order 16: African refugee women’s health improvement project

Task Order 16 seeks to provide the public health systems of Massachusetts with practical and formative findings that will increase tuberculin skin testing and treatment initiation and completion in targeted foreign-born populations. African Refugee Women’s Health Improvement Project is a program designed to address the health disparities among foreign-born women resettled in Massachusetts, with a particular focus on TB among Liberian, Somali and Somali Bantu women. These Liberian, Somali and Somali Bantu women are the main focus of the project because the majority of these women are TB infected and are at high risk of developing active TB disease. In addition, these women and girls have limited knowledge about LTBI and treatment of LTBI to prevent active disease.

Sites

Massachusetts Department of Public Health – Refugee and Immigrant Health Program and Division of Tuberculosis Prevention and Control

Study Objectives

1. Reduce TB case rates among Liberian, Somali and Somali Bantu women in Massachusetts by identifying high risk women with LTBI and providing culturally and linguistically responsive support during treatment, and improved capacity of the TB services network to deliver care to these women.
2. Develop an assessment tool to collect data on the ethnographically mediated beliefs, attitudes, and behavior that affect TB services among Liberian, Somali and Somali Bantu women resettled in Massachusetts.
3. Interview and collect information about the TB beliefs and attitudes of 100 Liberian and Somali Bantu women who resettled in Massachusetts.
4. Conduct focus group discussions among women recruited from the Liberian, Somali and Somali Bantu women’s community who resettled in Massachusetts; 6 to discuss TB and 5 to discuss women’s health.
5. Conduct a TB knowledge, beliefs and attitudes interview in at least 80% of the 15 key community staff that work in resettlement agencies to collect information relative to the support (or lack of support) refugee women might receive relative to TB treatment from people involved in their resettlement.
6. Conduct a basic TB informational sessions for at least 80% of the 30 community agency staff that work in resettlement agencies.

Study Design

The African Refugee Women’s Health Improvement Project will be implemented in 3 major stages. In the pre-program stage, the director of the Refugee and Immigrant Health Program (RIHP) and the project coordinator will hire and train staff. In the implementation stage, RIHP services will be extended to refugee women with linguistically and culturally appropriate TB education, screening an preventive therapy services, a data collection tool for the interviews will be finalized; women will be identified to participate in an interview that will inform us on client and community knowledge, attitudes and beliefs related to TB through structured interviews and focus group discussions and following an in-person interview a basic TB training session will be given for staff working in community agencies. In the final stage, the results obtained from the interview will be keyed back and matched to the RIHP database and will then be analyzed, the project coordinator will summarize these results and prepare a final report.

Study Progress

All instruments have been developed and approved. Six focus groups on TB conducted in 5 cities, with 59 women participating; draft report in progress. Five focus groups on women’s health conducted in 4 cities, with 49 women participating; coding in progress. 104 interviews have been completed with refugee women; 20 case managers from refugee resettlement agencies have been interviewed. Data cleaning and analysis are currently underway. Also, findings from TO16 were used to develop and pilot an audio drama on TB in Maay Maay (Somali Bantu language).

Last Modified: 07/25/2007

Last Reviewed: 05/18/2008
Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

 
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