Smokers, alcohol/drug users, LTBI patients living on the street or in shelters, health care workers, and women all have poor adherence rates and are less likely to complete treatment (Liu et al., 2018). Encouraging research within these populations to discover why adherence rates are low and developing strategies to improve treatment is needed. Goldberg et al. (2004) reported that implementing culturally appropriate programs that focus on specific migrant populations increased the rate of completion from 37% to 82% among new refugees in the United States. Closer monitoring, incentive programs, cultural case management and continuing education have proven successful within these populations.
The use of and culturally sensitive care are the most common reported interventions; home visits and incentive programs are the least utilized incentives. – this data is from the survey from the Facebook Nurse Practitioner page.
CULTURALLY SENSITIVE CARE
Goldberg et al. (2004) reported that implementing culturally appropriate programs that focus on specific migrant populations increased the rate of completion from 37% to 82% among new refugees in the United States. Tavares et al. (2019) reports that barriers to care for migrants include limited socioeconomic resources, communication and cultural barriers, lack of knowledge about the functioning of the healthcare system, and lack of knowledge about migrant and refugee health issues
Health campaigns that focus on cultural needs of migrant communities would help to raise awareness and improve health literacy.
Enabling heath care systems to adopt recommended strategies through “improved dissemination of policy, tracking and measuring LTBI outcomes, and reducing financial barriers” (Katrak et al., (2018), p. 54), is necessary to overcome barriers to care.
The use of interpreters, enlisting family support, the use of social workers to help patients navigate the health care system, and education for health care providers on migrant care is essential.
HOME VISITS
90% of LTBI patients in the United States complete treatment when they received home follow-up instead of clinic follow-up (Chang et al., 2013)
Working with organizations within the community to provide support
INCENTIVE PROGRAMS
Programs to increase compliance (Pai et al., 2015) include:
- Grocery gift cards
- Free lunch
- Bus passes
- Work excuses
- Paid time-off
- Phone cards
Liu et al. (2018) found that patients that received immediate, rather than delayed, incentives had higher completion rates, especially among the homeless and drug users. Suggestions include cash and noncash incentives – free lunch, grocery gift certificates, phone cards and bus tokens
EXPLANATION OF CARE
Assess knowledge of ways to prevent spread (Nyamathi et al., 2008)
Health campaigns that focus on cultural needs of migrant communities would help to raise awareness and improve health literacy.