This study will contribute to the current knowledge base about the reach and implementation fidelity of the new guidelines through the following aims: 1) to determine civil surgeons’ adherence to new Centers for Disease Control (CDC) guidelines, specifically the percentage of civil surgeons who screen using a blood test, report LTBI-positive GCAs to the health department, and inform GCAs of their LTBI diagnosis; 2) to determine the effect of the implementation of new CDC guidelines on LTBI treatment rates among GCAs; and 3) to explore facilitators and potentially modifiable barriers to guideline adherence among civil surgeons. We will generate critical preliminary data for developing public health outreach programs to maximize the uptake of the new guidelines and, ultimately, prevent TB among GCAs. As TB screening is already routinely done in this population, focusing on extending LTBI treatment services to GCAs may be a sustainable strategy that substantially contributes to TB elimination in the US. This fellowship training will take place at the University of California-Irvine and will enable the applicant to achieve the following goals: 1) mastery of skills for quantitative research, specifically in research design, statistical analysis, and survey building; 2) mastery of skills for qualitative research, specifically in qualitative study design, fieldwork analysis, data collection, interview techniques, content analysis, and write-up of qualitative data; 3) expand knowledge of theories, models, and frameworks of implementation science; and 4) engagement in health disparities, migrant health, and community-based research.
National Heart, Lung and Blood Institute