Journal of Immigrant and Minority Health
Volume 14, Issue 1, 2012, Pages 14-22

Perceptions of tuberculosis among immigrants and refugees at an adult education center: A community-based participatory research approach (Article)

Wieland M.L.* , Weis J.A. , Yawn B.P. , Sullivan S.M. , Millington K.L. , Smith C.M. , Bertram S. , Nigon J.A. , Sia I.G.
  • a Primary Care Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55904, United States
  • b Research Services: Center for Translational Sciences Activities (CTSA), Mayo Clinic College of Medicine, Rochester, MN, United States
  • c Olmsted Medical Center, Rochester, MN, United States
  • d Winona State University, Rochester, MN, United States
  • e Mayo Clinic College of Medicine, Rochester, MN, United States
  • f Behavioral Health Research, Mayo Clinic College of Medicine, Rochester, MN, United States
  • g Olmsted Medical Center, Rochester, MN, United States
  • h Hawthorne Education Center, Rochester, MN, United States
  • i Infectious Diseases, Mayo Clinic, College of Medicine, Rochester, MN, United States

Abstract

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. Using a community-based participatory research approach, we elicited perceptions about TB among immigrant and refugee learners and staff at a diverse adult education center. Community partners were trained in focus groups moderation. Ten focus groups were conducted with 83 learners and staff. Multi-level, team-based qualitative analysis was conducted to develop themes that informed a model of TB perceptions among participants. Multiple challenges with TB control and prevention were identified. There were a variety of misperceptions about transmission of TB, and a lack of knowledge about latent TB. Feelings and perceptions related to TB included secrecy, shame, fear, and isolation. Barriers to TB testing include low awareness, lack of knowledge about latent TB, and the practical considerations of transportation, cost, and work schedule conflicts. Barriers to medication use include suspicion of generic medications and perceived side effects. We posit adult education centers with large immigrant and refugee populations as excellent venues for TB prevention, and propose several recommendations for conducting these programs. Content should dispel the most compelling misperceptions about TB transmission while clarifying the difference between active and latent disease. Learners should be educated about TB in the US and that it is curable. Finally, TB programs that include learners and staff in their design and implementation provide greater opportunity for overcoming previously unrecognized barriers. © Springer Science+Business Media, LLC 2011.

Author Keywords

immigrants tuberculosis Adult education focus groups Refugees Community-based participatory research

Index Keywords

information processing refugee psychological aspect human Refugees Minnesota ethnology United States Humans male Emigrants and Immigrants female tuberculosis Article migration participatory research Community-Based Participatory Research attitude to health Focus Groups
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84860586075&doi=10.1007%2fs10903-010-9391-z&partnerID=40&md5=f3a7d5fc4265924fed69aa994d5c4a55
DOI: 10.1007/s10903-010-9391-z
ISSN: 15571912
Cited by: 23
Original Language: English