Development and Initial Testing of Messages to Encourage Tuberculosis Testing and Treatment Among Bacille Calmette-Guerin (BCG) Vaccinated Persons
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.
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