Date of Award

Spring 5-25-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Mary Barger, PhD, MPH, BSN

Abstract

Background: San Diego’s tuberculosis (TB) incidence is 2.5 times higher than the national rate. Five cases of active TB in the county’s public high schools during 2018 demonstrated the need for prevention interventions in this setting.

Objectives: This evidence-based project aimed to increase awareness, screening, and treatment of latent TB infection (LTBI) in the school setting.

Methods: A one-time TB educational presentation was given to high school freshman students with a pretest and posttest. A TB risk assessment and consent was sent home with the students. For at-risk students, a confidential package was sent to the parents recommending testing along with a letter to the child’s provider offering the option of rifapentine and isoniazid (3HP) to be administered at school. Incentives were provided throughout the program.

Results: After the educational intervention, there was an average increase of 24.57% in posttest results (95% CI [21.14, 28.01])and 87% of students agreed that the presentation improved their knowledge about TB. Of 294 Freshman students, 56 (19%) returned the TB risk assessment, 43% (n= 24) of those were found at risk for TB. A total of 7 students (29.2%) were tested for TB, all with negative results.

Conclusions: There was a low return of TB risk assessments but a high percentage of students at risk and who had not been tested. These results highlight the need to increase screening efforts in this setting. Future projects will be needed to assess the feasibility of offering 3HP via directly observed therapy at school.

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