A M Nyamathi1, A Christiani, P Nahid, P Gregerson, B Leake. 1. School of Nursing, University of California-Los Angeles, Room 2-250, Factor Building, Box 951720, Los Angeles, CA 90095-1702, USA. anyamath@sonnet.ucla.edu
Abstract
SETTING: Few studies have examined strategies for optimizing adherence to latent tuberculosis infection (LTBI) treatment programs in homeless populations. OBJECTIVES: 1) To compare the effectiveness of an intervention program employing nurse case management and incentives (NCMI) vs. a control program with standard care and incentives on completion of LTBI treatment; and 2) to compare the impact of the two programs on tuberculosis (TB) knowledge among participants. DESIGN: A prospective, two-group site-randomized design conducted among 520 homeless adults residing in the Skid Row region of Los Angeles from 1998 to 2003, assessing completion rates of a 6-month isoniazid (INH) treatment program and change in TB knowledge. RESULTS: Using intent-to-treat analysis, 62% of participants in the intervention program, compared with 39% of controls, completed the full 6-month course of LTBI treatment with INH. Logistic regression modeling revealed that intervention participants had three times greater odds of completing INH treatment than controls. TB knowledge improved in both programs, but the increase was greater among the intervention participants (P < 0.001). CONCLUSIONS: Nurse case management combined with education, incentives, and tracking dramatically improves both adherence to LTBI treatment and TB knowledge in homeless persons compared to a standard approach of outreach and incentives.
RCT Entities:
SETTING: Few studies have examined strategies for optimizing adherence to latent tuberculosis infection (LTBI) treatment programs in homeless populations. OBJECTIVES: 1) To compare the effectiveness of an intervention program employing nurse case management and incentives (NCMI) vs. a control program with standard care and incentives on completion of LTBI treatment; and 2) to compare the impact of the two programs on tuberculosis (TB) knowledge among participants. DESIGN: A prospective, two-group site-randomized design conducted among 520 homeless adults residing in the Skid Row region of Los Angeles from 1998 to 2003, assessing completion rates of a 6-month isoniazid (INH) treatment program and change in TB knowledge. RESULTS: Using intent-to-treat analysis, 62% of participants in the intervention program, compared with 39% of controls, completed the full 6-month course of LTBI treatment with INH. Logistic regression modeling revealed that intervention participants had three times greater odds of completing INH treatment than controls. TB knowledge improved in both programs, but the increase was greater among the intervention participants (P < 0.001). CONCLUSIONS: Nurse case management combined with education, incentives, and tracking dramatically improves both adherence to LTBI treatment and TB knowledge in homeless persons compared to a standard approach of outreach and incentives.
Authors: Adeline Nyamathi; Alecia Y Hanson; Benissa E Salem; Sanjeev Sinha; Kalyan K Ganguly; Barbara Leake; Kartik Yadav; Mary Marfisee Journal: Nurs Res Date: 2012 Sep-Oct Impact factor: 2.381
Authors: Adeline Nyamathi; Barbara Leake; Cynthia Albarran; Sheldon Zhang; Elizabeth Hall; David Farabee; Elizabeth Marlow; Mary Marfisee; Farinaz Khalilifard; Mark Faucette Journal: Issues Ment Health Nurs Date: 2011 Impact factor: 1.835
Authors: Adeline Nyamathi; Benissa E Salem; David Farabee; Elizabeth Hall; Sheldon Zhang; Mary Marfisee; Farinaz Khalilifard; Stefanie Musto; Barbara Leake Journal: Addict Res Theory Date: 2014-12
Authors: Adeline Nyamathi; Maria Ekstrand; Benissa E Salem; Sanjeev Sinha; Kalyan K Ganguly; Barbara Leake Journal: West J Nurs Res Date: 2013-03-27 Impact factor: 1.967
Authors: Adeline Nyamathi; Steven Shoptaw; Allan Cohen; Barbara Greengold; Kamala Nyamathi; Mary Marfisee; Viviane de Castro; Farinaz Khalilifard; Daniel George; Barbara Leake Journal: Drug Alcohol Depend Date: 2010-02-01 Impact factor: 4.492