One of the aims of the Open Awards Program is to allow BCCDC researchers to develop research questions and projects as a pilot, prior to applying to larger peer-reviewed funding competitions. Dr Maureen Mayhew has done just that, submitting a 2017 CIHR Operating Grant: Knowledge to Action, to continue the work her team began with funds from the BCCDC Foundation.

The project “A Patient-centred TB risk assessment tool: reducing stigma, increasing knowledge”, led by Maureen Mayhew, Rosemin Kassam, Victoria Cook, Michelle Murti, Dick Menzies, James Johnston, Nash Dhalla, and Jennifer Gardy received $10,000 to develop pilot data over one year.

Background: Risk-based latent TB infection (LTBI) diagnosis and treatment is important in Canada but tools on how to target screening and treatment are missing. In 2008, “The Online TST/IGRA Interpreter” tool for clinicians to calculate a lifetime risk of TB disease was developed, yet patients have requested multi-lingual educational tools to facilitate their understanding of LTBI. In this research, literature reviews and knowledge synthesis will inform future research and clinical care.

Key objectives for the pilot study were threefold. First, a systematic review of literature on LTBI-related stigma was undertaken. Two main themes emerged from the synthesis: a) forms and characteristics of stigma—fear and shame and b) the impacts of stigma—rejection, suspicion, and certification.  Second, a patient survey was created to understand perceptions of LTBI-related risks. Third, LTBI surveillance data was analysed for data completeness and LTBI Screening and Treatment Results.

Impact of the study:  Directly addressing strategic objectives of the BC Strategic Plan for Tuberculosis Prevention, Treatment and Control in BC, Canada, that prioritizes improving access to TB prevention in those at risk, this project included detailed literature reviews of LTBI-related stigma and perceptions of TB risks, creation of a clinical patient survey on perceptions of LTBI-related risks, and quality assessment and analysis of LTBI surveillance data from 2010 to the first quarter of 2016. The results inform patient-centred health messages for our routine work at BCCDC TB Services, which have the potential to increase LTBI treatment initiation and completion in those at risk leading ultimately to an expected reduction in TB incidence.

The BCCDC Foundation is pleased to have played a part in getting the ball rolling for Dr Mayhew and her team’s work on this project.

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