Development and Initial Testing of Messages to Encourage Tuberculosis Testing and Treatment Among Bacille Calmette-Guerin (BCG) Vaccinated Persons
- 189 Downloads
Misperceptions surrounding the Bacille Calmette-Guerin (BCG) vaccine can lead some vaccinated individuals to resist being tested and treated for tuberculosis (TB). Educational messages to best explain the risk of TB to BCG-vaccinated, Hispanic persons were systematically developed and tested. First, TB program staff provided messages they considered effective. These were analyzed and validated by TB experts, and then presented in group interviews initially to foreign-born Hispanic persons with a TB diagnosis, and then persons without a prior TB diagnosis. Based on interviewees’ feedback, preferred statements were used to develop one long and three short comprehensive messages. One-on-one interviews were conducted with Hispanic persons to assess the saliency of the comprehensive educational messages. Participants preferred messages that were gain or positively-framed and explained that BCG does not confer lifelong protection against TB. Participants confirmed the messages would likely have a positive impact on patient decisions to undergo TB testing and treatment.
KeywordsTuberculosis BCG vaccine Health beliefs Patient education Message development
This project was supported by a Social Behavioral Research Grant (SB-160793-N) from the American Lung Association and the American Lung Association of the Southeast. We are grateful to the TB professionals in Alabama, Florida, Illinois, South Carolina, and Virginia, as well as the clinicians, and individuals who participated in the interviews for their interest, time, and willingness to share their experiences, thoughts, and opinions—which are summarized in this report. We would like to also acknowledge the support provided by the TB Program at the Broward County Health Department in Ft. Lauderdale Florida; A.G. Holley State Tuberculosis Hospital (closed in 2012); the American Lung Association of Florida, Inc. South Area; and Farmworkers Self-Help Inc. in Dade City Florida for their assistance in recruiting participants and graciously allowing us to conduct interviews in their facilities; Dr. Paula Hamsho-Diaz for her assistance translating messages; and Dr. Miriam Castillo-Gil for her diligence in transcribing and translating all interviews. Finally, we would like to express our sincere appreciation to our ALA project officer Elizabeth Lancet and Dr. Wanda Walton and Ms. Amera Khan of the CDC’s Division of Tuberculosis Elimination for their support.
- 9.CDC. Reported Tuberculosis in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, CDC, October 2012. Retrieved 4 Feb 2013, from http://www.cdc.gov/tb/statistics/reports/2011/pdf/report2011.pdf.
- 12.Centers for Disease Control and Prevention. Trends in Tuberculosis: United States, 2008. MMWR. 2009;58(10):249–53.Google Scholar
- 13.Griffin R, Young D: The future of tuberculosis vaccinology. In Raviglione MC, ed. Reichman and Hershfield’s Tuberculosis A comprehensive, international approach. Third Edition, Part B. New York: Informa Healthcare USA, Inc.; 2006: 1153–1168.Google Scholar
- 14.Centers for Disease Control and Prevention: BCG vaccine Factsheet. (1 Jun 2009). Retrieved 27 Sept 2009, from http://www.cdc.gov/tb/publications/factsheets/prevention/BCG.htm.
- 18.Tuberculosis Prevention Trial. Trial of BCG vaccines in South India for tuberculosis prevention: first report. Bull World Health Organ. 1979;57(5):819–27.Google Scholar
- 20.Watson JC, et al: Measles, Mumps, and Rubella—Vaccine Use and Strategies for Elimination of Measles, Rubella, and Congenital Rubella Syndrome and Control of Mumps: Recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR Recomm Rep 1998; 47(RR-8); 1–57.Google Scholar
- 26.Strecher VJ, Rosenstock IM. The health belief model. In: Glanz K, Lewis FM, Rimer BK, editors. Health behavior and health education: theory, research, and practice. 2nd ed. San Francisco: California Jossey-Bass Inc.; 1997. p. 41–59.Google Scholar
- 27.Petty RE, Cacioppo JT. The elaboration likelihood model of persuasion. In: Berkowitz L, editor. Advances in experimental and social psychology. New York: Academic Press; 1986. p. 123–205.Google Scholar
- 28.Petty RE, Cacioppo JT. Attitudes and persuasion: classic and contemporary approaches. Dubuque, IA: William C. Brown Co; 1981.Google Scholar
- 29.Ben-Nun P. Respondent fatigue. In: Lavrakas P, editor. Encyclopedia of survey research methods. Thousand Oaks: SAGE Publications, Inc.; 2008. p. 743–4.Google Scholar
- 30.Glanz K, Rimer BK: Theory at a Glance: Application to Health Promotion and Health Behavior (Second Edition) National Cancer Institute, National Institutes of Health, US Department of Health and Human Services. NIH Pub. No. 05-3896 Washington, DC: NIH; Sept 2005.Google Scholar
- 32.World Health Organization: Global tuberculosis report 2012. Retrieved 25 Mar 2013 from http://www.who.int/tb/publications/global_report/gtbr12_main.pdf.