YISEL-HEALTH P 2

Tuberculosis Prevention and Screening 1

Tuberculosis Prevention and Screening

Health Promotion Proposal Part 1

Student’s name: Yisell Gonzalez

Instructor: Nora Hernandez Pupo

Institution: Florida National University

Course: Health Promotion & Role Development in Adv. Nursing Practice-DAX-DL02

Date: May 27, 2026

Health Problem Overview

In 2023, TB claimed an estimated 1.3 million lives of those who did not have HIV, of which 10.6 million people were diagnosed with TB (Williams, 2024). One of the most significant disease-causing deaths in the world is due to an infection. Treatment outcomes are complicated by the presence of drug-resistant TB and the rising cost of healthcare expenses due to drug-resistant forms of TB, such as multidrug-resistant TB (MDR-TB).

While not as common as TB in Africa, in the USA, TB strikes with more than 9,000 reported cases annually (Williams, 2024). This is evidence of sustained transmission, especially among people at high risk. The planned health promotion program will target the awareness of early TB screening and TB prevention among the high-risk communities to decrease the windows of opportunity for undiagnosed latent TB (LTB) and prevent the progression to active TB. People identified as being at a higher risk of TB should be 20% more likely to receive TB testing services within 12 months of the program's launch.

Vulnerable Population

Some populations are at an increased risk for TB because of environmental, biological, and social risk factors. High-risk groups include those who are homeless, incarcerated, immunocompromised (e.g., people living with HIV/AIDS), smokers, and people who are from or frequently travel from high TB burden countries (Goletti et al., 2022). Due to a vulnerable immune system, high workload in the clustered environment, and limited access to healthcare services, these populations are more vulnerable.

Spread of TB is a respiratory disease, and as such, is spread through airborne respiratory droplets, and there is a high risk of airborne transmission in shelters, correctional facilities, and informal settlements where there is overcrowding. Furthermore, slow diagnoses are a problem because there are not enough healthcare resources to provide the diagnosis in a timely fashion, which leads to community transmission. Susceptibility is further increased, and immediate treatment is less likely in the face of socio-economic factors like poverty, malnutrition, and lack of health insurance coverage. HIV increases the risk of AIDS. AIDS is associated with a 15x to 18x increased risk of developing TB (active TB) due to lowered immune function (World Health Organization, 2024). All these factors highlight the important role of these populations in the event of targeted screening and prevention measures.

Evidence-Based Literature Review: Intervention Studies

The active case finding of TB coupled with mobile/ outreach screening services is one evidence-based practice in TB control. In the study that was conducted by Woodruff (2024), they found that mobile TB screening units were very effective in early detection in underserved populations by making diagnostic services more accessible. Its strength is that it is able to reach out to individuals who are going to the healthcare facilities, but not very often. There are constraints, such as high operation costs and the need for continuous funding, which could impact the scalability in the long term.

Integrated LTBI (I-LTBI) screening in primary care works well as another intervention. Woodruff (2024) indicates that in high-risk groups, using a method for systematic LTBI screening, interferon gamma release assays (IGRAs) with preventive treatment for active TB is reduced. A strong and adequate influence of an appropriate strategy is for disease activation prevention in the early stages of disease. However, there are some weak areas, such as a lack of uniformity in systems' implementation and difficulty patients have with compliance to preventive therapy.

Based on a review of these interventions, it seems that both community-based screening and clinical screening programs work, but they will be more successful if the screening is easily accessible, the healthcare systems are found to have adequate infrastructure, and the patients are willing to adhere to the regimen. The community-based models increase reach and clinical diagnostic precision.

Theoretical Framework

The proposed prevention and screening for tuberculosis fits the theory of the Health Belief Model (HBM) (Khamai et al., 2024). The model is based on the way health behavior occurs as a result of the individuals' perception of susceptibility, severity, benefits, and barriers to action. Within the TB field, one might not be willing to consider screening because they do not think that they are at risk for developing TB, or because they do not believe TB is a serious illness.

This program will target high-risk groups through education on TB transmission and risk factors to boost the perception of susceptibility using HBM. It will also focus on how serious the situation is, including combinations and use of death as a consequence if it remains untreated, and MDR-TB. We will illustrate the effectiveness of early screening/treatment through promotion, whereas issues of access, cost, and stigma will be mitigated through community outreach and free screening offers (Woodruff, 2024).

The model also includes prompts to action, such as community health outreach events, reminders, and community health campaigns, which can help to create ongoing activation of preventive behaviors. Accessible screening and education will also increase the feeling of control and self-efficacy that should be enhanced among all individuals when it comes to their health. Thus, the Health Belief Model (HBM) is well suited to the development of more and better uptake of TB screening and to attaining and sustaining improvements in TB screening uptake in high-risk populations (Khamai et al., 2024).

References

Goletti, D., Delogu, G., Matteelli, A., & Migliori, G. B. (2022). The role of IGRA in the diagnosis of tuberculosis infection, differentiating from active tuberculosis, and decision making for initiating treatment or preventive therapy of tuberculosis infection. International Journal of Infectious Diseases, 124. https://doi.org/10.1016/j.ijid.2022.02.047

Khamai, N., Seangpraw, K., & Ong-Artborirak, P. (2024). Using the Health Belief Model to Predict Tuberculosis Preventive Behaviors Among Tuberculosis Patients’ Household Contacts During the COVID-19 Pandemic in the Border Areas of Northern Thailand. Journal of Preventive Medicine and Public Health, 57(3), 223–233. https://doi.org/10.3961/jpmph.23.453

Williams, P. M. (2024). Tuberculosis — United States, 2023. MMWR. Morbidity and Mortality Weekly Report, 73(12). https://doi.org/10.15585/mmwr.mm7312a4

Woodruff, R. (2024). Progress Toward Tuberculosis Elimination and Tuberculosis Program Performance — National Tuberculosis Indicators Project, 2016–2022. MMWR. Surveillance Summaries, 73. https://doi.org/10.15585/mmwr.ss7304a1