Effective TB Interviewing for Contact Investigation: Self-Study Modules
The TB interview
It is possible that not all information will be collected in the first interview with the patient. Even if the interviewer conducts a comprehensive first interview, a second interview should be completed. A second interview will allow the patient to recall any further information that may assist in the contact investigation and may facilitate additional questions for the interviewer. If the first interview was conducted in the hospital or health department, the second interview should be done in the patient’s living space, such as a home, apartment, shelter, or correctional facility. Observations made in a patient’s living space can provide additional information about contacts, as well as identify or confirm any environmental information that can aid in decisions about transmission and testing. The patient may also feel more comfortable participating in an interview in a familiar environment, and may provide information more readily. In between interviews, the interviewer should ask the patient to make notes of questions, concerns, additional contacts, and other topics to be addressed at the time of the re-interview. In addition, the interviewer’s contact information should be provided to the patient so that the patient can contact the interviewer with any additional information or questions.
Before a re-interview, do the following:
- Review original interview documentation
- Identify gaps in first interview that need clarification
- Review infectious period to ensure all time is accounted for in collected information from the patient
- Formulate a strategy as was done for the first interview
- Clarify known contact information to plan additional questions.
Assessing for Additional Contacts and Risk of Transmission
While conducting a re-interview, the interviewer can evaluate environmental characteristics of the place in which exposure occurred, and may be able to obtain additional information about identified contacts, as well as identify additional contacts.
During a re-interview, the interviewer should
- Continue building trust and rapport;
- Provide additional TB education, as needed;
- Observe environmental characteristics such as room size, crowding, and ventilation, to estimate the risk of TB transmission;
- Identify additional contacts, especially children and immunocompromised persons; collect their locating and identifying information, such as phone numbers, addresses, and physical descriptions;
- Look for evidence of other contacts who may not be present at the time of the visit. Evidence may include photographs, toys, extra jackets, and shoes. In addition, take notice of trophies or plaques, as well as other items that may suggest outside leisure activities in which the index patient participates;
- Verify previously identified contact information by observing characteristics of who is present;
- Follow up on contact referrals already made; and
- Discuss any problems with locating previously identified contacts.