|Arkansas Coalition of Marshallese (Springdale, AR)
Title: TB Education and Testing in the Pacific Islander Community in Arkansas
The Arkansas Coalition of Marshallese (ACOM) serves the highest population of Compact of Free Association (COFA) citizens living in the United States. The United States and the Marshallese community have a unique relationship. Nuclear testing in the Marshall Islands created negative health conditions leaving the Marshallese community prone to cancer, chronic diseases, Hansen’s disease and a high incidence of TB. Marshallese migration to Arkansas can be attributed to attaining better opportunities for education and healthcare services. Asians and Native Hawaiians/Pacific Islanders are disproportionately impacted by TB at a greater rate compared to other racial and ethnic groups. Ethnic sub-groups such as the Marshall Islands within the Micronesia Region of the Pacific Islands reported an incidence rate of about 160 new cases of TB per 100,000 persons over a 5-year period (2014-2018).
For our second year in this mini-grant program, ACOM will partner with the John Bates Clinic under the Arkansas Health Department to provide virtual health education events on Facebook to raise awareness about tuberculosis (TB) and promote TB testing in the Pacific Islander community in Arkansas. Our goal is to increase the number of TB tests to 30-50 based on the number of tests that were conducted during our first year in this mini-grant program. ACOM will also offer a mini-conference for women and a conference for the community to address the intersectionalities of TB, COVID, and other diseases. Lastly, ACOM will translate TB education materials that are culturally and linguistically appropriate for the Pacific Islander community.
|Asian American Community Services (Columbus, OH)
Title: Reaching the hard to reach: Awareness, education, screening, and linkage to care for Latent Tuberculosis Infection (LTBI)
This project goal is to promote culturally relevant tuberculosis education and to raise awareness for better treatment, control and prevention of tuberculosis among Asian Americans and Asian immigrant families in Central Ohio. This project will utilize community health workers and train-the-trainer for outcomes of awareness, education, screening, and linkage to care for latent tuberculosis.
|Asian Pacific Health Foundation (San Diego, CA)
Title: Implementing D.O.T.S. to Raise Awareness of LTBI and TB in the Vietnamese Community in San Diego
The Direct Outreach through Train-the-Trainers Strategy (D.O.T.S.) is a pilot educational program about latent tuberculosis/tuberculosis (LTBI/TB) targeting the Vietnamese community in San Diego. In the U.S., about 20% of TB cases were in California, with most cases among the foreign-born. San Diego County has the third largest Vietnamese population in California, with also the lowest English proficiency compared to other Asian groups. Due to these factors, APHF will focus on the Vietnamese community in San Diego to maximize the impact of TB control efforts. Reaching out to Vietnamese to educate them is crucial since Vietnam has one of the highest TB burdens in the world. Additionally, more than 80% of TB cases are people with untreated LTBI. In the train-the-trainers strategy, APHF will create LTBI/TB videos and accompanying handouts in English and Vietnamese to educate a group of “trainers” quarterly, who will then educate and share information with their “trainees”. APHF will also conduct an online seminar on LTBI/TB for health professionals. These educational activities aim to raise awareness about the link between LTBI and TB disease, address misperceptions, decrease stigma, and encourage and facilitate testing and treatment for LTBI and TB.
|Center for Pan Asian Community Services Inc. (Atlanta, GA)
Title: CPACS Tuberculosis Prevention and Screening Project
As of 2020, there were a total of 7,163 cases reported; however non-U.S.-born Asians comprised of 48% of all people reported with TB nationally. In the state of Georgia, non-Hispanic Asians had the highest TB case rate among other race/ethnic groups, accounting for 43.6% of cases. CPACS has worked and maintained a strong relationship with local county health districts mostly affected with TB. CPACS aims to improve awareness of TB among AAPIs in the state of Georgia by, encouraging preventive screening, coordinating intake process and case management for clients that are screened, creating culturally and linguistically appropriate LTBI and TB educational and informational activities that resonate with AAPI communities, improve access to TB screening, encourage and educate providers to screen and treat LTBI among at-risk populations with support from local county health department, and collect qualitative data to analyze community and provider knowledge. CPACS projects to provide 100 vouchers for free LTBI blood screening tests. Our goal is to also provide virtual educational/training sessions to the providers, community leaders, volunteers, and at-risk populations. At the end of our project, our results and findings will confirm if we were able to meet our baseline measurements: that 60% of community members will show an increase in TB/LTBI knowledge and awareness, 70% of healthcare providers will increase in TB/LTBI knowledge and awareness, and 100 vouchers will be distributed to the target population for free LTBI blood screening tests and given their results.
|Colorado Alliance for Health Equity and Practice (Denver, CO)
Title: CAHEP’s AAPCHO Grant Application Abstract 2021-2022
CAHEP is a non-profit organization serving the most vulnerable populations through culturally and linguistically sensitive means. CAHEP provides medical, dental, and behavioral health services. There are three CAHEP providers working in one clinic. The population served is approximately 70% Asian American and Pacific Islanders (AAPI), equating to about 3,200 individuals per year. CAHEP has been serving these populations for 20 years and has gained trust and respect through working in the clinical setting and at sites within the community (churches, temples, and cultural-enclaves). The key to improving the health of vulnerable immigrant families, with culture-specific health beliefs, is providing culturally and linguistically appropriate care in partnership with the community. As culture and language influence health, healing, and wellness-beliefs, perception of disease and illness; health-seeking behaviors of patients, and attitudes toward preventative care, the role of patient navigators and community health workers is extremely important. Fifteen patient navigators from fourteen different cultures are employed to assist in providing culturally and linguistically appropriate care. Moreover, certain diseases such as HIV and TB raise significant taboo and trust issues. CAHEP has conducted such services with AAPI families of various races and ethnicities, for over ten years. Therefore patient-engagement, treatment, education, and awareness services have successfully supported patients. Best practices require community-supported clinics to work with Public Health agencies, as proposed in this grant.
|DeKalb County Board of Health (Decatur, GA)
Title: Community Alliance for Resilience and Engagement (CARE) to Enhance LTBI/TB Testing and Treatment Project
Goal: Enhance community engagement and education, as well as provider education to increase and facilitate access to LTBI/TB testing and treatment in DeKalb County’s Asian American (AA), Native Hawaiian (NH) and Pacific Islander (PI) Communities.
Methods: The CARE Project will (1) identify trusted communities to serve as “influential network agents” (INAs) to communicate the LTBI/TB’s burden and the importance of testing and treatment and (2) develop an educational webinar for providers. Anticipated outcomes: (1) INAs demonstrate increased knowledge of the burden of LTBI/TB in AA, NH, and PI communities as a result of completing training, as measured by pre- and post-tests; (2) INAs demonstrate increased capacity to identify and correct myths and misconceptions about LTBI/TB as a result of completing training, as measured by pre- and post-tests; and (3) Increased uptake of LBTI/TB testing services by members of AA, NH, and PI communities in months 3, 6, 9, and 12 of the project period compared to baseline, as recorded in the electronic medical record system; (4) Increased TB testing from baseline at months 3, 6, 9, and 12, as measured by pre- and post-training surveys from providers viewing the webinar; and (5) Increased uptake of shorter LTBI treatment regimen from baseline at months 6 and 12, as measured through pre- and post-training surveys from providers viewing the webinar.
|Drexel University School of Medicine – Dr. Ehrlich Lab (Philadelphia, PA)
Title: Educational Outreach to Tuberculosis in Burmese Refugees & Children in Philadelphia
Tuberculosis (TB) disease was reported in 3,190 Asians in the United States, accounting for 35% of all people reported with TB disease nationally. Moreover, 56% of TB cases in the United States occur in foreign-born persons, with refugee populations particularly vulnerable to both TB and drug-resistant TB. There have been reported studies that migration seems to trigger a latent to active form of the disease. At Drexel University Dr. Garth Ehrlich’s lab, we are working towards research on latent TB and its human susceptibility genes that lead to active TB as opposed to latent TB. Our lab will be collaborating with the Nationalities Service Center (NSC) and Hansjörg Wyss Wellness Center to do educational outreach programs on the types of TB, drug-resistant TB, and its treatments to incoming Refugees and Asian communities in Philadelphia. We will also be working closely with St. Christopher Children Hospital on finding diagnosed TB children and promoting TB awareness. To those who are diagnosed, we will be helping them to get appropriate treatment and follow up with them to check whether the patients follow their medication and help enroll in case management services provided by the Philadelphia Health Department.
|Ministry of Health and Human Services (Ebeye, Kwajelein)
Title: Addressing misperceptions about the link between LTBI and TB disease could lead to greater benefits for the Ebeye TB Program and RMI community in the future
In 2017, organizations from the US and WHO led the TB-Free Ebeye with their main goals as follows: 1. Detect early active TB cases, 2. Reduce poor treatment outcomes (long term health problems, and adverse social and economic consequences of TB), and 3. Reduce TB transmission by shortening the duration of infectiousness. The outcomes for the screening activities showed a positive impact. We diagnosed 175 LTBI cases and 83 TB cases. The number of LTBI cases identified increased, and the active TB cases fluctuated. However, the main problem for both LTBI and TB disease is that the treatment outcome is not 100% effective. The treatment outcomes for LTBI ranges from 85-93%, and for TB disease is from 75-88%. By looking at these outcomes, we believe that treatment is one of the most important steps in eliminating TB for the Ebeye community in the Republic of the Marshall Islands.
In this project, our goal is to educate, test and treat 300 people in three different zones. We will raise awareness about the link between LTBI and TB disease, address misconceptions, decrease stigma, and encourage and facilitate testing and treatment for LTBI and TB disease. In this one-year project funded by the TB Elimination Alliance, I trust and hope that we will come to improve our community and develop a better understanding of LTBI and TB disease, so they do not believe in myths and misperceptions in the future.
|Philippine Nurses Association (Canton, Michigan)
Title: Raising Awareness about Latent Tuberculosis Infection and Tuberculosis (LTBI/TB) among Asian-Americans living in Michigan
Michigan (MI) is home to the second largest Asian population in the Midwest. Asians are heterogeneous groups and Asian immigrants make up a majority of the total foreign-born and immigrant population in MI at 52.3%. Data showed that most of the cases of TB were among the foreign-born individuals. There is evidence in the literature on the disparities of Asian Americans, particularly Filipinos to TB. Asians were among the non-US born persons with the highest TB rate of 25.7per 100,000 individuals. In 2019, although the overall TB incidence in the US had decreased by 1.6% compared to 2018, the TB rate among non-US born persons was 15.5x more compared to those US born. Socioeconomic factors such as access to health care, poverty, language barriers, lack of knowledge, and stigma may affect disparities in infection amongst Asian Americans. Therefore, the goal of this proposed project is to create a culturally and linguistic LTBI/TB education, training, and community engagement resources and activities that resonate with Filipino high priority Asian Americans living in MI. To achieve this goal, we aim to 1) train clinical and non-clinical staffs on testing and treating LTBI/TB and the shorter courses of LTBI treatments in MI and 2) raise awareness of LTBI/TB among local Asian American communities. The intended outcomes of this project are to train 25 clinical and nonclinical staff on testing and treating LTBI/TB and shorter courses of LTBI/TB treatments, and to raise awareness of LTBI/TB among local Asian Americans.
|Philippine Nurses Association (New York City, New York)
Title: Optimizing TB Care Outcomes Through the Implementation of Patient Navigators
In August 2017, the Bureau of Tuberculosis Control (BTBC) tested a total of 68 people at community-based tuberculosis (TB) testing events in West Queens, the neighborhood with the highest number of TB cases in New York City. Twenty-one people tested positive on blood based-TB test for latent TB infection (LTBI) and of those, 17 were foreign-born Filipinos. The BTBC recognized that Filipinos are high-risk population and treatment for LTBI is essential to reduce cases of TB among this population. Of the 17 Filipino that tested positive, only 5 clients have visited the BTBC Chest Center for TB valuation and only 3 have initiated LTBI treatment. Language barriers and cultural differences are major challenges when working with foreign-born populations. The task of following up with these patients and scheduling Chest Center appointments relies on a trusted member of the community that serves as a link between health services and the community. Our objective is to implement two Filipino patient navigators (PN) to facilitate access to TB services and improve the quality and cultural competence of service delivery. It is hoped that pairing culturally and linguistically competent PNs with Filipino clients will encourage visit to BTBC Chest Centers for TB evaluation and increase initiation of LTBI treatment thus reducing the incidence of TB among this population.
|San Diego County Medical Society Foundation, dba Champions for Health (San Diego, CA)
Title: Collaboration for Action to achieve Results toward the Elimination of TB: CARE TB in the San Diego County Asian-Pacific Islander (API) Communities
CARE TB is a private-public partnership consisting of two San Diego-based agencies, Champions for Health (CFH) and the San Diego County TB and Refugee Health Branch (TBCRHB), supported by the work of TB Free California (CA), a partnership among the California Department of Public Health (CDPH), community clinics and health departments throughout California to eliminate TB. Our agencies each have a well-documented history of outreach and education to high-burden communities challenged by health disparities. Round 2 of the TB Elimination mini grant expands on the development of TB prevention messaging materials developed directly to San Diego County Filipino and Vietnamese communities during the initial round of funding. With this new round of funding, CARE TB’s goal is to provide immediate and convenient opportunities for individuals to receive TB education and materials at CFH vaccine/flu clinics in high-risk TB areas with low access to healthcare. Once these areas are selected, CARE TB proposes to conduct TB risk assessments, using the five-question San Diego County TB Risk Assessment, translated in Tagalog and Vietnamese, and implemented by Filipino and Vietnamese community members and distribute the TB prevention materials created per the evaluations done in the first round and provide individual education. A demonstration project will also be implemented to provide the option of appropriate TB testing for those deemed at-risk via the risk assessment, following up with test results, and offering an exam and treatment to those testing positive and are uninsured and coordinate treatment transition with their provider.
|Southeast Asian Coalition of Central Massachusetts, Inc. (Worchester, MA)
Title: Southeast Asian Coalition of Central Massachusetts, Inc. LTBI/TB Elimination Education Campaign, 2021
Southeast Asian Coalition of Central Massachusetts, Inc. (SEACMA) will increase awareness of LTBI and TB in Asian community members in Central and Western Massachusetts. SEACMA will distribute translated information to community members via community gathering places (e.g., faith-based institutions, community centers, markets, etc.), direct contact, a social media campaign, and annual cultural events (e.g., the Moon Festival, Annual Asian Festival, etc.). Further, SEACMA will hold a minimum of six (6) training sessions for community members to increase participant knowledge of LBTI and TB. Topics covered will include the link between LBTI and TB disease, address misconceptions, decrease stigma, and encourage and facilitate treatment for LTBI and TB.
For Asian immigrants, refugees, and asylees in Central and Western Massachusetts, the barriers to health information and access to care are high. Members of the community often lack basic health information delivered in a linguistically and culturally relevant way. A culturally and linguistically appropriate health campaign for LBTI/TB would be beneficial to community members to raise awareness of the disease and give concrete interventions.
|The Regents of the University of California, San Francisco (San Francisco, CA)
Title: Digital health for Community Health: Utilizing the electronic medical record to engage families in LTBI Care in the Asian-American, Native Hawaiian and Pacific Islander Community
Electronic medical record (EMR)-based tools can help providers evaluate and manage patients with latent TB infection (LTBI). However, greater efforts are needed to utilize the EMR to improve engagement with patients and the community, and guide future activities to increase the quality of LTBI care. Our overall goal is to leverage EMR tools and data to improve completion of latent TB infection (LTBI) testing and initiation of LTBI treatment for children in the Asian-American, Native Hawaiian, and Pacific Islander (AA/NHPI) community. To achieve this goal, we have developed a set of EMR tools to improve data collection and monitoring of LTBI screening, diagnosis, and treatment in a pediatric-specific federally qualified health center (FQHC) in Oakland, CA. With these tools, we will 1) generate monthly LTBI Care Cascade Reports to contact families and increase completion of LTBI testing and initiation of treatment by at least 25% over 1 year; and 2) lead two dissemination meetings to share data generated from the EMR to AA/NHPI community partners to receive feedback and increase community AA/NHPI acceptance of LTBI testing and treatment by at least 15% over 1 year. If successful, we hope to expand these efforts to other clinics to improve patient and family engagement in LTBI care in the AA/NHPI community.
|Vietnamese American Cancer Foundation (Fountain Valley, CA)
Title: TB Free OC
According to the Orange County Health Care Agency – Pulmonary Disease Services, in 2020, four in five TB cases in Orange County, California occurred among Asians, and top country of birth of those cases was Vietnam (47.5%). Orange County (OC) is the home of the largest Vietnamese population outside of Vietnam. In addition, CDC estimates that over 200,000 people in OC have latent tuberculosis infection (LTBI), and one in six non-U.S. born persons in Orange County have LTBI. Without early detection and timely treatment for LTBI, persons with LTBI are at risk for developing TB disease. Thus, VACF’s TB-FREE OC Initiative’s goal is to increase LTBI/TB awareness, knowledge, testing, and treatment for the Vietnamese population in OC through culturally and linguistically appropriate interventions. To achieve this goal, VACF will conduct four (4) half-hour educational radio shows to raise awareness and provide information about LTBI/TB; three (3) to six (6) educational workshops and/or one-on-one education to educate at least 200 community members about LTBI/TB; and organize 2-4 free TB screening events and individualized testing service to at least 60 community members in total.
|We Are TB (National)
Title: Storytelling and Community Empowerment to End TB
The We Are TB in collaboration with Wisconsin Tibetan Association (WTA) and Public of Madison and Dane County aims to harness the power of storytelling and community empowerment to address the disproportionate impact of Tuberculosis (TB) among Tibetans and work to prevent certain inequities from manifesting further. If we are to work towards ending TB in the world, that work must involve addressing latent TB infection (LTBI) and cultivating the awareness and engagement of communities necessary to meaningfully create this change. The objectives of the project are twofold: to raise awareness about the link between LTBI and TB disease, address misconceptions, and reduce stigma and to create culturally and linguistically appropriate LTBI and TB education and community engagement resources to cultivate agency and informed decision making when it comes to testing and treating LTBI Tibetans in Madison, Wisconsin. The goals of the project will be achieved through a compilation of educational and community building programming facilitated for and primarily by the members of the Tibetan American community of Wisconsin and particularly those affected by TB and LTBI. Through hybrid and virtual offerings, this project has the capability to reach beyond the primarily audience impacting Tibetan communities worldwide. This project will thoughtfully and creatively work with communities impacted to address TB and LTBI and provide community members the tools and access to improve their health outcomes.