YISELL PP

Tuberculosis Prevention and Screening 1

Tuberculosis Prevention and Screening

Tuberculosis Prevention and Screening - Health Promotion Proposal Part 2

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: June 15, 2026

Proposed Health Promotion Program

The proposed health promotion program is a combination of evidence-based interventions, including community-based mobile tuberculosis (TB) screening, alongside integrated latent tuberculosis infection (LTBI) screening and education for high-risk individuals. The selection process for this intervention was based on evidence of effective mobile outreach programs to improve access to screening for targeted groups and systematic screening of LTBI to identify and treat early before developing active disease (Woodruff, 2024). The program will focus on populations who are homeless, living with HIV/AIDS, recent immigrants from high TB-burden countries, smokers, and those recently released from prison. Most will involve raising awareness on risk factors for TB, early screening, and minimizing access impediments to health services. Education sessions will be provided before screening activities to enhance the understanding of participants on TB transmission, symptoms, prevention, and treatment. The educational initiatives align with the HBM by trying to raise awareness about the threat faced, the seriousness of the health problem, the benefits of screening, and threat reduction (Khamai et al., 2024).

Several resources will be necessary to implement this intervention successfully. Advanced practice nurses (APNs), registered nurses, community health workers, public health educators, laboratory staff, and collaborating physicians will be among the human resources involved. Materials will involve the mobile screening unit, the education materials, personal protective equipment, TB skin tests/IGRA testing materials, referral forms, and data collection materials. Collaborations with local health departments, homeless shelters, correctional reentry programs, community health clinics, and HIV treatment centers will provide resources for outreach and referrals for treatment and follow-up services. An advanced practice nurse will be a key player in coordinating services, providing health education, monitoring screening activities, reviewing outcomes, and providing continuity of services for participants who are at risk of testing positive for latent or active TB.

Optimally, the proposed Plan will be established for 12-months. For Months one and 2, a partnership will be created, resources will be identified, education will be developed, and staff training will take place. Activities and outreach will take place monthly from month 3-10, there will be educational refreshers, and mobile screening events in month 3-10. Continual data collection will take place during implementation to track the percentage of people participating, screening results, and whether they are referred. The program will be evaluated in months 11 and 12, the comments of the stakeholders will be taken into account, and there will be recommendations for program improvement and sustainability. This timeframe is reasonable for an APN since it reflects the use of available community resources, today's evidence-based opportunistic screening, and incorporates partnerships that facilitate streamlined implementation.

Intended Outcomes

The mission of this program is to drive more individuals to TB screenings and to drive more people to knowledge about TB prevention and transmission; to identify potential latent TB infections; and to provide better referral and treatment for those with a positive TB screen. In the overall program the goal is within a 12-month period of the program’s implementation to raise the percentage of targeted groups who are screened for tuberculosis to at least 20%, to increase the tuberculosis knowledge score of screened participants by 25% from the baseline score, and to ensure that the majority (85%) who have a positive screen receive timely and adequate tuberculosis referral and Follow-Up Services. This objective is SMART (specific, measurable, achievable, relevant and time-bound) to the TB related health disparity’s goal and to the timeframe of the program.

Evaluation Plan

Process and outcome measures will be used to evaluate the program outcomes. Attend the screening, and screening logs will be retained for each screening event to measure screening participation. There will be a comparison of baseline data on current screening use and screening use at the conclusion of the 12-month period. The effectiveness of the education will be evaluated by pre- and post-education questionnaires that will determine the participants' knowledge about the TB symptoms, spread, prevention, and treatment (Jia et al., 2025). Increase in knowledge scores will be used to evidence the efficacy of the education aspects of the intervention. The data will be stored in a secure database and used to assess whether the desired increase in participation in screening and improvement in knowledge was achieved.

Outcomes' areas of concern will also be referrals and continuity of care. Anyone who is screened positive will receive referrals and follow up documentation. A percentage of those who successfully make it to the next appointment, the diagnostic evaluation, and a percentage of those who start treatment as recommended will be computed. Qualitative feedback will also be collected through participant surveys and interviews with community partners, healthcare providers and participants on what is working and what needs to be improved (Donnelly et al., 2023). These data will be used to evaluate the program's effectiveness to reduce barriers to care and improve access to TB prevention services for the target population.

Barriers and Challenges

The proposed TB screening and prevention program has the potential to be impacted by several barriers. Limiting factors to participation in this study by the high-risk population include lack of trust in the healthcare system, stigma of TB, competing social needs like work (employment), food insecurity and fear of TB diagnosis (Nagarajan et al., 2022). Individuals who are homeless as a result of a critically unstable housing situation, or a homeless shelter, may not have the ability to go to a screening event or follow-up appointments. Language differences or health literacy level gaps among individuals can further limit educational material meaning and understanding, and prevent these services from being used.

To overcome these challenges culturally sensitive educational approaches will be used and community health workers will employ community-based approaches. Instructional materials in different language and at an age-appropriate literacy level will be provided. Working with community-based organizations of trust, such as congregational and shelter-based organisations and social service agencies, can be useful in achieving better trust and engagement. Other interventions like transportation vouchers, hygiene packages or meal vouchers can also be used to encourage adherence and attendance.

The second is about the challenges facing the implementation of mobile screening programs from the point of view of budget and logistics. These are considerable expenses and funding is required for mobile activities, diagnostic testing equipment and supplies, staffing and continued outreach. Further, following up with a transient population could be difficult, due to the frequent change of contact information, especially transient population participants. But, if there isn't continuous care, those who test positive may not receive timely care, or it may not be effective.

To move around these barriers factors have been raised to look into public health agencies funding, collaborations with local actors of the health care system and the potential to find existing resources in the local community for cost reduction. Improving continuity of care can be achieved by establishing good referral networks and services, and by offering case management. New systems and secure databanks that should track patient data in an electronic manner can maintain records of which doctors have followed up with the patients and be used to share information between doctors. Regular meetings with stakeholders can also pinpoint issues that are expected to arise and enable changes to be made to program implementation plans in a timely manner.

In summation, although tuberculosis is a major public health problem, vulnerable groups at risk of increased contact with the disease and less likely to be able to access health care services are still a significant problem. It's very important to detect and cure latent and active TB early in the prevention and control of disease. The proposed health promotion program is a loosely linked collaborative effort that includes evidence-based screening, as well as education and outreach in the community to fill gaps in access to preventive services.

The goal of this program is to remove barriers to participation by educating participants and encouraging screening via using the Health Belief Model, and decreasing barriers that contribute to delayed diagnosis and treatment. Because of its emphasis on health promotion, patient education, patient care coordination and population health management, it is essential that advanced practice nurses be key players in supporting this effort. This program can enhance TB-related health disparities and health outcomes through TB screening that is improved or promoted in high-risk neighborhoods via collaborative partnerships, culturally appropriate interventions, and systematic evaluation.

References

Donnelly, C., Janssen, A., Shah, K., Harnett, P., Vinod, S., & Shaw, T. (2023). Qualitative study of international key informants’ perspectives on the current and future state of healthcare quality measurement and feedback. BMJ Open, 13(6), e073697–e073697. https://doi.org/10.1136/bmjopen-2023-073697

Jia, D., Song, H., Li, G., Xu, J., Zhu, L., & Li, Y. (2025). Evaluation of tuberculosis education effects on healthcare workers’ knowledge attitudes and practices in Jiangsu China 2019 to 2023. Scientific Reports, 15(1). https://doi.org/10.1038/s41598-025-28031-4

Nagarajan, K., Kumarsamy, K., Begum, R., Panibatla, V., Reddy, R., Adepu, R., Munjattu, J. F., Sellapan, S., Arangba, S., Goswami, A., Swamickan, R., & Muniyandi, M. (2022). A Dual Perspective of Psycho-Social Barriers and Challenges Experienced by Drug-Resistant TB Patients and Their Caregivers through the Course of Diagnosis and Treatment: Findings from a Qualitative Study in Bengaluru and Hyderabad Districts of South India. Antibiotics, 11(11), 1586. https://doi.org/10.3390/antibiotics11111586