Text for Figures and Slides in TB Behavioral and Social Science Research Forum Proceedings

PRELIMINARY RESULTS FROM THE TUBERCULOSIS BEHAVIORAL AND SOCIAL SCIENCE LITERATURE REVIEW

Cathy Rawls, M.P.H., C.H.E.S.
ASPH Fellow
Division of Tuberculosis Elimination,
Centers for Disease Control and Prevention

Cristina Booker, M.P.H.
Analyst
Public Health Applications and Research Area
Abt Associates Inc.

Slide #1: TB Behavioral and Social Science Research Literature Review

Presented by:
Cathy Rawls, M.P.H., CHES,
ASPH Behavioral Research Fellow, DTBE, CDC

Cristina Booker, M.P.H.,
Abt Associates, Inc.

Tuberculosis Behavioral and Social Science Research Forum
December 10-11, 2003

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Slide #2: Literature review and database development

Activities:

• Created abstraction form and guide
• Reviewed and analyzed articles
• Developed access database
• Synthesized preliminary results

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Slide #3: Literature review methods

Search strategy:

• Conducted in OVID across 5 databases
  • CINAHL, Embase, Medline, PsycInfo, and Sociofile
• Focused on behavioral, sociological, and cultural factors for TB prevention and treatment
• Used refined subject headings and keywords

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Slide #4: Inclusion criteria

• TB research that used social science methods or applied social science theory or concepts
• Published after 1980
• US-based and/or international literature in English
• Published works (including scientific, peer-reviewed literature, review articles, books (including book chapters), and meta-analyses)

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Slide #5: Key items abstracted

• Study descriptions and methods
  • Topic areas, study design, theory, sampling design, data collection methods, target populations, geographical and structural settings
• Key results/findings
• Limitations
• Conclusions
• Recommendations

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Slide #6: This pie chart illustrates a breakdown of the types and percentages of articles reviewed/abstracted for the TB behavioral and social science research literature review. Of the 175 documents reviewed/abstracted, 59% of the articles were research; 29% were non-research; and 12% were evaluation articles.

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Slide #7: This graph shows the numbers and percentages of explicit domains addressed in the literature review/abstraction. Of the 175 articles reviewed/abstracted, the following domains were addressed:

• Patient Adherence, n=82 (47%)
• Cultural/Social, including knowledge, attitudes, and behaviors, n=78 (45%)
• Structural Influences, n=57 (33%)
• Health Seeking Behavior, n=33 (19%)
• Provider Adherence, n=25 (14%)
• Other, n=21 (12%)

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Slide #8: This chart includes the geographic location of where the literature (n=175) was based.

• U.S.-based, n=82 (47%)
• International-based, n=63 (36%)
• Non-location specific (e.g., concept/position papers), n=30 (17%)

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Slide #9: This graph shows the numbers and percentages of U.S. target populations addressed in the literature review/abstraction. Of the 175 articles reviewed/abstracted, the following U.S. target populations were addressed:

• People with TB, n=33 (19%)
• U.S.-born racial/ethnic groups, n=32 (18%)
• Foreign-born in U.S., n=28 (16%)
• Patients, n=26 (15%)
• Health care providers, n=14 (8%)
• Homeless, n=12 (7%)
• Substance users, n=12 (7%)
• Low-income persons, n=12 (7%)
• General population, n=11 (6%)
• People with HIV/AIDS, n=8 (5%)
• People with MDR-TB, n=5 (3%)
• Migrant farm workers, n=5 (3%)
• Students (universities/colleges), n=4 (2%)
• People in corrections, n=2 (1%)
• Other, n=9 (5%)

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Slide #10: This graph shows the numbers and percentages of international target populations addressed in the literature review/abstraction. Of the 175 articles reviewed/abstracted, the following international target populations were addressed:
-People with TB, n=65 (37%)
-Patients, n=33 (19%)
-Low-income persons, n=22 (13%)
-General population, n=14 (8%)
-Health care providers, n=11 (6%)
-Substance users, n=4 (2%)
-Homeless, n=3 (2%)
-People with HIV/AIDS, n=3 (2%)
-People with MDR-TB, n=5 (3%)
-Students (universities/colleges), n=1 (1%)
-People with LTBI, n=1 (1%)
-People with MDR-TB, n=1 (1%)
-Other, n=6 (3%)

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Slide #11: Themes from the literature review

• Underlying social/cultural factors:
  • Poverty, gender differentials
  • Health beliefs
• Health seeking behavior:
  • Barriers and facilitators to care
• Patient-related adherence:
  • Social support, economic aid, & education
• Provider-related adherence:
  • Medical education about TB diagnosis & treatment

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Slide #12: Themes from the literature review (cont.)

• Health education strategies:
  • Essential for TB control/eradication
• TB control/eradication strategies:
  • Integration with other health services
• Resource/funding allocations:
  • Interdisciplinary research and interventions that integrate biological, psychological, behavioral, and social variables

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Slide #13: Next steps: literature review report

• Based on the data abstraction forms & Access database
• Features:
  • Descriptive data
  • Key outcomes/results
  • Needs, gaps, and recommendations for future research or practice
• Expected to be finalized for CDC in early 2004

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Slide #14: Next steps: database

• Created in Access to store the data abstraction forms
• Database features:
  • Keyword searches
  • Preset queries and reports
• Expected to be finalized for CDC in early 2004

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Slide #15: Acknowledgements

Literature review team:

CDC Team

Nick DeLuca
Kelly McCarrier
Jane Mezoff
Cathy Rawls
Robin Shrestha-Kuwahara

Abt Assoc. Team

Cristina Booker
Ted Hammett
Brandon Long
Jotham Stavely

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