7 FINAL CTCA tb free ca v2 2019 Neha · 2019-12-18 · Microsoft PowerPoint - 7_FINAL CTCA tb free...
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1 2 Disclosures California is NOT TB free yet The findings and conclusions in this presentation are those of the presenter and do not necessarily represent the views of the Centers for Disease Control and Prevention. 1 2
Transcript of 7 FINAL CTCA tb free ca v2 2019 Neha · 2019-12-18 · Microsoft PowerPoint - 7_FINAL CTCA tb free...
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Disclosures
California is NOT TB free yet
The findings and conclusions in this presentation are those of the presenter and do not necessarily represent the views of the Centers for Disease Control and Prevention.
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Why was TB Free California created?
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Why was TB Free California created?
Response to local programs and providers requesting help to
jumpstart and assist California with addressing latent TB infection.
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What is TB Free California?
Grant from the California Preventive Health and Health Services Block Grant
Multi‐year grant
TBCB awarded for the first time in 2017
Goal
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Who we are
New DirectorPast Director
It is not just 4 people..• TB programs
• Community Clinics
• External Partners• DPH internal partners
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What we do
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Accomplishments
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Partnerships
• Berkeley
• Imperial
• Los Angeles
• Marin
• Orange
• Sacramento
• San Francisco• San Joaquin• San Mateo
• Sutter• Yuba• San Diego
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Reached >400 health care providers.
14 trainings conducted to over 400 health care providers
Able to provide Maintenance of Certification (MOC) Continuing Medical Education (CME)
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Unifying logo.
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Created culturally‐appropriate updated communication materials.
9 educational tools
For patients, providers and high‐risk communities
Videos, pamphlets, posters
Multiple languages
Disseminated to 600 providers
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Educational Videos
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ProviderVideo-lettes
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Identified 2 key LTBI reporting metrics
Identified two LTBI reporting metrics % non‐US‐born with positive test % non‐US‐born with a positive test
who completed treatment
Developed reporting mechanism in state surveillance system
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Year 2
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Building Care Cascade
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Assess risk Test for TB CXR Treatment initiated
Retain in care
Cured
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Community clinics are scaling up testing and treatment
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Multi‐phase project in Imperial CountyMallory Schmitt
Phase I
Provider Knowledge, Attitudes, Practices (KAP) Survey
• Baseline Data Collection from Patient Charts
Phase II
• Provider Education
• Staff Training
Phase III
• TB Risk Assessment revision
• Patient Outreach and Education
Phase IV
• AdditionalTraining and Webinars for Other Clinic Locations
• Post‐Education and Outreach Data Collection
Collaborators: Setie Asfaha, Paula Kriner, Afshan Baig, Hector Perez, Tessa Mochizuki
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Assess risk Test for TB CXR Treatment initiated
Retain in care
Cured
Scaling up LTBI treatment one barrier at a timeEmily Tomich and Lauri Thrupp
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Training
QFT order set Fax CXR
F/u callsSide Effects
Collaborators: Emily Dow, Manisha Ati, Ruby Gonzales, Sangyuk Shin, Tessa Mochizuki, Shereen Katrak, Mike Carson, Julie Low,
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High risk Vietnamese Clinic project Faye Truax
Similar phased project as Imperial
Different population
Main focus patient outreach
Collaborators: Tessa Mochizuki, Setie Asfaha, Julie Low, Mike Carson, Duc Nguyen
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Patient with risk factors are not being tested
102 97
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8 40
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Vietnamese‐speaking No previous treatment forTB or LTBI
Tested for LTBI Positive
Tested outside clinic
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Patient with risk factors are not being testedBarriers are being addressed
102 97
8 3
8 40
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Vietnamese‐speaking No previous treatment forTB or LTBI
Tested for LTBI Positive
Tested outside clinic
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Patient with risk factors are not being testedBarriers are being addressed
102 97
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8 40
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Vietnamese‐speaking No previous treatment forTB or LTBI
Tested for LTBI Positive
Tested outside clinic
Risk assessment implemented
QFT now in‐house and cheaper
Provider in‐service and monthly check‐ins
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Lessons learned: EMRs were not made for data abstraction
Data element Available in EMR
Clinic #1 Clinic #2 Clinic #3
Country of birth NO NO YES
IGRA result YES YES YES
CXR result YES YES YES
Treatment started YES YES YES
Treatment completed NO NO NO
Yes‐available and can extract with a lot of workYes‐available but cannot extractNo‐not available
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Lessons LearnedSlow and steady
Scaling up LTBI in community settings is resource intensive and slow going
Many funding‐required competing interests
Need local interest and on‐site lead
But it can be done!
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Next Up
Evaluation of patient‐focused communication products
State and national indicators
New sites to work with
Reaching out to community‐based organizations
Social media: @tbfreecalifornia
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Other partners…
And more…
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Need more TB partners
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tbfreecalifornia.org
Thank you
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