The Tuberculosis Behavioral and Social Science Research Forum
Appendix C: TB Behavioral and Social Science Research
Gaps and Needs: Major Research Topics, Subtopics, and Research Questions
Major Research Topics, Subtopics, and Research
Interpersonal influences on behavior focus on the relationship
between two individuals or units regarded as a pair. Examples include
the patient-provider relationship and its impact on both the patient
and provider as well as influences of a family member, significant
other, or peer on a patient.
A. Communication between patients and providers
Communication between patients and providers is critical for effective
health care. It is a fundamental element that helps to shape the
patient-provider relationship and foster trust. Communication includes
appropriate linguistic concordance, optimal use of interpreters
when necessary, verbal and nonverbal expressions and cues, and good
listening skills by providers. Communication also ultimately reflects
the dynamics of the relationship between a provider and the patient.
Provider-patient communication can impact trust, patient satisfaction,
and treatment adherence.
Forum participants identified the need for additional research
to understand the role of provider-patient communication in effective
TB case management. Participants discussed the need to foster positive
interactions and to build trusting and caring relationships between
patients and providers.
- How do we create and improve positive interactions and build
trusting and caring relationships between patients and providers?
- What are the key components to building trust in the patient/provider
B. Family and peer influences
A TB patientís family, peers, and social networks can be very influential
on the patientís behavior. Family and peer influences can affect
an individualís decision to seek treatment and to adhere to provider
treatment recommendations. In addition, peer and social influences
can impact a TB patientís willingness to identify contacts during
a contact investigation.
Forum participants identified the need for research to further
understand the family and peer in terms of whether and when a patient
enters (and remains in) care.
- How can we reach supporting populations to reduce fear of TB
transmission in household/worksite?
- How does TB affect families as a whole?
- How do we better educate the coworkers, friends and relatives
of the TB patient? What messages do family members and others
need in order to accept and support the patientís diagnosis?
- How can TB program staff integrate the families (including
extended family members) and the communities of TB patients into
the TB process of education, case identification, treatment, follow-up,
prevention, and re-integration into the job and community to prevent
stigma and discrimination?
- What are some ways to develop culturally sensitive and appropriate
strategies to educate families and coworkers and communities about
- What is the effect of family member influences, especially
women, on their family memberís health seeking behavior?
- How can TB programs assist and support female patients in fulfilling
their familial roles given their illness?
- How can social networks be involved in positive and facilitating
ways regarding a patientís TB experiences?
- What are the community influences on health behaviors? What
is the impact of community health workers (peers) on treatment
initiation and completion?
- What is the role of social support in LTBI adherence in Latino
- What is the application of a social network framework to at-risk
- What is the relationship of the patientís role models to effectively
completing TB treatment?
- Who are the best, most effective role models or opinion leaders
of high-risk patients?
Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination - http://www.cdc.gov/tb
Please send comments/suggestions/requests
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333