This multi-method study used a participatory action research approach to examine the complex net of socio-cultural factors that influenced behaviour related to tuberculosis (TB) prevention and treatment in the 10 highest risk cultural groups consisting of immigrant and Aboriginal populations in the province of Alberta, Canada. Trained community research associates collected qualitative interview data and helped with interpretation and evaluation. A community advisory committee established foundation principles and monitored the ethical and cultural appropriateness of the research process. A key finding is that although patients with active disease learn about TB from health professionals, people in high-risk populations need to learn more about TB transmission and prevention prior to contact. This is particularly important given that lack of knowledge of TB was strongly associated with negative attitudes towards TB and a worse experience of the disease. The study results underline the need for accessible and culturally appropriate health education about TB in the high risk groups. This can be accomplished in collaboration with lay people, particularly those who have recovered from active TB, their family members and health workers from the community. © 2004 Elsevier Ltd. All rights reserved.

immigrants tuberculosis Health education Participatory action research Canada Aboriginal

cultural anthropology Indians, North American immigrant Consumer Participation disease treatment human community ethics indigenous population interview North America family side effect attitude worker Antitubercular Agents tuberculostatic agent Canada Tuberculosis, Pulmonary Humans tuberculosis Alberta socioeconomics qualitative analysis Western Hemisphere Health Knowledge, Attitudes, Practice Article disease transmission experience patient compliance Social Environment health education Prejudice World Emigration and Immigration Cultural Characteristics Directly Observed Therapy patient high risk patient health practitioner immigrant population