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Appendix C: TB Behavioral and Social Science Research Gaps and Needs: Major Research Topics, Subtopics, and Research Questions

Major Research Topics, Subtopics, and Research Questions

III. Interpersonal

Interpersonal influences on behavior focus on the relationship between two individuals or units regarded as a pair. Examples include the patient-provider relationship and its impact on both the patient and provider as well as influences of a family member, significant other, or peer on a patient.

A. Communication between patients and providers

Communication between patients and providers is critical for effective health care. It is a fundamental element that helps to shape the patient-provider relationship and foster trust. Communication includes appropriate linguistic concordance, optimal use of interpreters when necessary, verbal and nonverbal expressions and cues, and good listening skills by providers. Communication also ultimately reflects the dynamics of the relationship between a provider and the patient. Provider-patient communication can impact trust, patient satisfaction, and treatment adherence.

Forum participants identified the need for additional research to understand the role of provider-patient communication in effective TB case management. Participants discussed the need to foster positive interactions and to build trusting and caring relationships between patients and providers.

  • How do we create and improve positive interactions and build trusting and caring relationships between patients and providers?
  • What are the key components to building trust in the patient/provider relationship?

B. Family and peer influences

A TB patient’s family, peers, and social networks can be very influential on the patient’s behavior. Family and peer influences can affect an individual’s decision to seek treatment and to adhere to provider treatment recommendations. In addition, peer and social influences can impact a TB patient’s willingness to identify contacts during a contact investigation.

Forum participants identified the need for research to further understand the family and peer in terms of whether and when a patient enters (and remains in) care.

  • How can we reach supporting populations to reduce fear of TB transmission in household/worksite?
  • How does TB affect families as a whole?
  • How do we better educate the coworkers, friends and relatives of the TB patient? What messages do family members and others need in order to accept and support the patient’s diagnosis?
  • How can TB program staff integrate the families (including extended family members) and the communities of TB patients into the TB process of education, case identification, treatment, follow-up, prevention, and re-integration into the job and community to prevent stigma and discrimination?
  • What are some ways to develop culturally sensitive and appropriate strategies to educate families and coworkers and communities about TB?
  • What is the effect of family member influences, especially women, on their family member’s health seeking behavior?
  • How can TB programs assist and support female patients in fulfilling their familial roles given their illness?
  • How can social networks be involved in positive and facilitating ways regarding a patient’s TB experiences?
  • What are the community influences on health behaviors? What is the impact of community health workers (peers) on treatment initiation and completion?
  • What is the role of social support in LTBI adherence in Latino immigrants?
  • What is the application of a social network framework to at-risk TB populations?
  • What is the relationship of the patient’s role models to effectively completing TB treatment?
  • Who are the best, most effective role models or opinion leaders of high-risk patients?

 
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