Current Concepts in the Management of Tuberculosis
Symposium on Antimicrobial Therapy Apr 2011
Tuberculosis (TB) continues to be a major global health challenge, especially in low-income countries. It spreads through airborne droplets and can affect any organ, though the lungs are most commonly involved. People with weakened immune systems—such as those with HIV, diabetes, or malnutrition—are at higher risk of developing active TB. Diagnosis involves a combination of tests, including skin or blood tests for latent TB, chest X-rays, sputum analysis, and nucleic acid amplification. Treatment for latent TB typically involves isoniazid for several months, while active TB requires a multi-drug regimen over at least six months, often with directly observed therapy to ensure adherence.
Managing TB also involves public health strategies like contact tracing, isolation of infectious patients, and targeted testing for high-risk groups. Drug-resistant TB, including multidrug-resistant (MDR-TB) and extensively drug-resistant (XDR-TB) forms, presents additional challenges and requires specialized treatment. TB in special populations—such as pregnant women, children, and people with HIV—needs tailored approaches. Despite effective treatments, TB remains difficult to eliminate due to poverty, limited healthcare access, and global migration. Continued collaboration between healthcare providers and public health agencies is essential to control and eventually eradicate TB.
Community-Engaged Bidirectional Crisis and Emergency Risk Communication With Immigrant and Refugee Populations During the COVID-19 Pandemic
Crisis and emergency risk communication (CERC) frameworks encourage public participation in pandemic prevention and containment, but effective implementation depends, in part, on reaching populations with a history of health disparities and limited access to culturally and linguistically tailored health information.
SAGE Publishing and Public Health Reports 2022
During the COVID-19 pandemic, RHCP adapted a crisis and emergency risk communication (CERC) framework to support immigrant and refugee communities in southeast Minnesota. Communication leaders from six ethnic groups delivered messages in seven languages using platforms like social media, phone calls, and texts. These messages focused on prevention, testing, and the social and economic impacts of the pandemic. Leaders also gathered feedback from their communities, which helped refine messages and inform local policies. Over nine months, the intervention reached nearly 40,000 people and was seen as credible, timely, and culturally relevant.
The program’s success was rooted in trust, collaboration, and real-time responsiveness. Communication leaders felt empowered and supported, and their efforts led to tangible changes, such as improved access to resources and adjustments to regional health policies. RHCP’s long-standing partnership and commitment to community engagement made the intervention sustainable beyond initial funding. The experience showed that bidirectional communication—where information flows both to and from communities—is essential for effective public health messaging, especially in times of crisis.
The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States.
Minority groups are disproportionately affected by chronic medical conditions and lower access to healthcare that may portend worse COVID-19 outcomes. Furthermore, minority communities are more likely to experience living and working conditions that predispose them to worse outcomes.
Clinical Infectious Diseases Feb 2021
COVID-19 has had a devastating impact on racial and ethnic minority communities in the U.S., including African American, LatinX, and Native American populations. These groups have experienced significantly higher rates of infection, hospitalization, and death compared to white populations. The disparities stem from a combination of biomedical factors—such as higher rates of chronic conditions like diabetes and hypertension—and social determinants of health, including poverty, limited access to healthcare, and unsafe working and living conditions. Many minorities work in essential jobs without the option to work remotely or access to paid sick leave, increasing their exposure to the virus.
Beyond individual health risks, structural racism plays a major role in these disparities. Historical policies like redlining and ongoing inequities in housing, employment, and healthcare access have created environments that make it harder for minority communities to stay healthy. Clinicians are encouraged to provide equitable care, advocate for systemic change, and build partnerships with community organizations to support vulnerable populations. Addressing implicit bias and improving communication with marginalized groups are also key steps toward reducing health disparities and promoting long-term equity in healthcare.
Emergency Preparedness and Risk Communication Among African American Churches: Leveraging a Community-Based Participatory Research Partnership COVID-19 Initiative
Partnerships with faith-based organizations are pivotal in rapidly engaging with racial/ethnic minority populations, who are often socially and economically marginalized and medically underserved, to address public health crises.
Preventing Chronic Disease Dec 2020
To help African American communities during the early months of the COVID-19 pandemic, the FAITH! program partnered with 120 churches across Minnesota to share accurate health information and emergency resources. Using a framework from the CDC, they created a culturally tailored communication strategy that included daily Facebook posts and weekly emails. These messages covered spiritual and physical wellness, COVID-19 prevention, financial support, and social connection. The initiative reached over 6,500 people on Facebook and an estimated 12,000 through email, helping churches form emergency preparedness teams and distribute trusted information quickly.
Church leaders and community messengers found the approach useful, empowering, and easy to manage. Interviews showed that the program improved emergency readiness and built trust in FAITH! as a reliable source. The effort also helped dispel myths and misinformation, especially through real-time updates and community feedback. By leveraging existing relationships and technology, the initiative demonstrated how academic-community partnerships can respond rapidly and effectively to public health crises in underserved populations.
Sustainability of a Tuberculosis Screening Program at an Adult Education Center Through Community-Based Participatory Research
The majority of active tuberculosis (TB) cases in the United States occur through reactivation of latent TB infection among foreign-born individuals. While screening of at-risk individuals through community partnerships is recommended, it is not commonly accomplished.
Journal of Public Health Management and Practice. Nov 2019
A tuberculosis (TB) screening program developed through RHCP at Hawthorne Education Center in Rochester, Minnesota demonstrated long-term sustainability and effectiveness in serving a large foreign-born population. Initiated through a community-based participatory research (CBPR) approach, the intervention addressed barriers such as fear and stigma by fostering open dialogue and culturally sensitive education. Over eight years, more than 618 TB skin tests were administered, with 121 positive results. Of those, 101 individuals completed evaluations, 72 began treatment for latent TB infection (LTBI), and 57 completed the full course of medication. The program’s success was attributed to collaborative design, flexible staffing, and shared ownership among Hawthorne, the public health department, and RHCP.
The intervention’s longevity beyond its initial grant funding highlights the power of participatory frameworks in public health. Classroom education, tailored communication, and on-site testing created a trusted environment that encouraged participation. The program adapted to changing circumstances, including administrative shifts and learner turnover, while maintaining its core mission. Adult education centers like Hawthorne proved to be effective venues for health interventions targeting immigrant communities. This case study underscores the importance of sustained partnerships, community engagement, and flexible implementation strategies in addressing health disparities through locally grounded public health initiatives.
Evaluation of a Tuberculosis Education Video Among Immigrants and Refugees at an Adult Education Center: A Community-Based Participatory Approach
Tuberculosis disproportionately affects immigrants and refugees to the United States.
Journal of Health Communication Dec 2012
RHCP and the Hawthorne Education Center (HEC) in Rochester, Minnesota, collaborated to create and evaluate a tuberculosis (TB) education video using a community-based participatory research (CBPR) approach. The project aimed to address TB knowledge gaps among immigrant and refugee learners, a population at elevated risk for TB. Focus groups with learners and staff identified key misconceptions and emotional barriers, which informed the development of a culturally tailored video. The video featured narratives from HEC community members and was designed, scripted, and produced collaboratively by learners, staff, and academic partners. It was shown to all classrooms during World TB Day, and pre- and post-surveys assessed its impact on knowledge, self-efficacy, and acceptability.
The evaluation showed significant improvements in TB knowledge (from 56% to 82% correct) and self-efficacy (from 73% to 90%) after viewing the video. The vast majority of learners (94%) rated the video as highly acceptable, citing its clarity, helpfulness, and relevance. Teachers also found it valuable and recommended its continued use. The participatory process enhanced cultural relevance, literacy alignment, and community ownership, though it required substantial time and resources. This initiative demonstrated that adult education centers can serve as effective venues for health education and that CBPR-guided video production can be a powerful tool for engaging diverse communities in public health promotion.
Screening for Tuberculosis at an Adult Education Center: Results of a Community-Based Participatory Process
More than half of active TB cases in the Unites States occur in foreign-born individuals, and the majority of these cases are attributable to reactivation of latent TB infection (LTBI).
American Journal of Public Health July 2011
RHCP partnered with the Hawthorne Education Center (HEC) to address tuberculosis (TB) among immigrant and refugee learners through a community-based participatory research (CBPR) approach. The collaboration involved focus groups to understand community perceptions of TB, followed by culturally tailored education and voluntary TB skin testing. Of the 259 adult learners tested, 18.5% had positive results, with nearly all positive cases occurring among individuals from Africa, Latin America, and Asia. The participatory process—featuring community input at every stage—led to significantly higher testing participation compared to previous traditional approaches and helped reduce stigma and increase trust in the testing process.
The initiative demonstrated that adult education centers serving large immigrant populations can be effective venues for TB prevention. Learners and staff were actively engaged in planning and implementation, which contributed to high follow-through rates for evaluation and treatment. The CBPR model not only improved participation but also fostered a sense of ownership and empowerment among community members. While the findings may not be generalizable to all settings, they suggest that similar partnerships could be replicated in other communities to enhance TB control efforts. Future research should explore the long-term impact of participatory approaches on stigma reduction and treatment adherence.
Perceptions of Tuberculosis Among Immigrants and Refugees at an Adult Education Center: A Community-Based Participatory Research Approach
English as a Second Language programs serve large foreign-born populations in the US with elevated risks of tuberculosis (TB), yet little is known about TB perceptions in these settings.
Journal of Immigrant Minority of Health Sept 2010
RHCP collaborated with the Hawthorne Education Center (HEC) in Rochester, Minnesota, to explore perceptions of tuberculosis (TB) among immigrant and refugee learners and staff. Using a community-based participatory research (CBPR) approach, the team conducted ten focus groups with 83 participants from diverse cultural backgrounds. The findings revealed widespread misconceptions about TB transmission, limited understanding of latent TB, and strong emotional responses such as fear, shame, and secrecy. These perceptions were shaped by past experiences in participants’ home countries and contributed to barriers in testing and treatment, including low awareness, stigma, and practical challenges like transportation and work conflicts. Despite these barriers, participants showed a growing openness to discussing TB, especially when education was delivered in trusted, culturally sensitive environments.
The project emphasized the importance of involving community members in the design and implementation of TB education programs. Recommendations included clarifying the difference between active and latent TB, addressing misconceptions, and linking education to accessible testing and treatment resources. The study also highlighted the potential of adult education centers like HEC as effective venues for TB prevention, particularly among foreign-born populations. Participants’ willingness to share personal experiences and engage in dialogue suggested a readiness to learn, which is a key factor in successful adult education. The CBPR approach fostered trust and empowered the community, reinforcing the value of collaborative, culturally informed public health interventions.