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TB Notes 1, 2000
Where We've Been and Where We're Going: Perspectives from CDC's Partners in TB Control
Changes I've Seen
TB Control in New York City: A Recent History
Not by DOT Alone
Baltimore at the New Millennium
From Crickets to Condoms and Beyond
The Denver TB Program: Opportunity, Creativity, Persistence, and Luck
National Jewish: The 100-Year War Against TB
Earthquakes, Population Growth, and TB in Los Angeles County
TB in Alaska
CDC and the American Lung Association/ American Thoracic Society: an Enduring Public/Private Partnership
The Unusual Suspects
The Model TB Prevention and Control Centers: History and Purpose
My Perspective on TB Control over the Past Two to Three Decades
History of the IUATLD
Thoughts about the Future of TB Control in the United States
Where We've Been and Where We're Going: Perspectives from CDC
Early History of the CDC TB Division, 1944-1985
CDC Funding for TB Prevention and Control
Managed Care and TB Control - A New Era
Early Research Activities of the TB Control Division
The First TB Drug Clinical Trials
Current TB Drug Trials: The Tuberculosis Trials Consortium (TBTC)
TB Communications and Education
TB Control in the Information Age
Field Services Activities
TB's Public Health Heroes
Infection Control Issues
A Decade of Notable TB Outbreaks: A Selected Review
International Activities
The Role of CDC's Division of Quarantine in the Fight Against TB in the U.S.
The STOP TB Initiative, A Global Partnership
Seize the Moment - Personal Reflections
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This is an archived document. The links are no longer being updated.

TB Notes 1, 2000

TB Communications and Education

by Wanda Walton, M. Ed.
Chief, Communications and Education Branch

Image 1: Picture of a woman working on a computer. Through the availability of technology, such as the Internet, TB training and education have changed dramatically over the years.

Training and education in TB have changed dramatically over the years. In the not-too-distant past, these efforts were primarily limited to face-to-face classroom instruction and the distribution of print-based materials. Educational films, then later videotapes, were developed and distributed, but often these materials had a very limited distribution because of the costs of the films and tapes and the limited availability of audiovisual equipment for viewing.

Today, through the availability of technology and reduced production costs, we have a vast array of materials and courses that are distributed through a wide variety of media. Some of the media include print-based curricula with slides (e.g., the Core Curriculum on Tuberculosis); CD ROM (e.g., Tuberculosis: An Interactive CD ROM for Clinicians); satellite-based courses (e.g., the Satellite Primer on Tuberculosis); videotapes (e.g., the Skin Testing Video); audiotapes (e.g., the TB voice information system); and Internet-based courses (e.g., the Web-Based Self-Study Modules). With the use of satellite-based courses, instructors can simultaneously reach thousands of health care providers in every US state and territory with accurate, up-to-date information. Reduced costs for the reproduction of videotapes and CD ROMs allow for wide-spread distribution of materials. In addition, the Internet allows for distribution of materials and courses to audiences we may have never reached before, both professionally and geographically, at no additional cost after initial production.

Image 2: Picture of TB training and education materials and courses available through a wide variety of media.

Print-based materials are also accessible in a variety of ways. Hard copies can be ordered by mail, by telephone, by fax, or through the Internet online ordering system. Materials can also be downloaded and printed from the Internet. The electronic files of the materials available through the Internet can also be utilized as the basis for adaptation and development of site-specific or population-specific materials.

Another big change in TB training and education is in the methodologies used to influence health care providers' implementation of TB recommendations. In the past, the primary method utilized was information dissemination to increase the health care providers' knowledge of the recommendations. However, we know that information alone is not sufficient to change the practice of many health care providers. In addition to knowledge or information, health care providers must be persuaded to try the new recommendations. This persuasion can occur if the health care provider thinks that the recommendations provide an advantage (is it better than what it's replacing?); is compatible with the current system (no major conflicts created in the current system to implement); is not too complex (how hard is it to do or use?); can be tried beforehand (can I try it before I decide to really use it with patients?); can be observed (can I actually see the result of using this innovation?); and is flexible to being adapted to the current system. After being persuaded that there is an advantage to the new recommendation, health care providers must progress through a decision process (adopt or reject), then to implementation, then to continued, ongoing use of the recommendations. Behavioral theories and models can be utilized to guide the development of educational and training interventions to aid in this progress. Interventions such as academic detailing and the use of opinion leaders can be utilized to facilitate the progress.

For current and future efforts, utilization of behavioral science and implementation of operational research are essential for developing effective interventions in TB communications, training, and education. With decreasing TB cases in the United States, it becomes even more important to be vigilant, efficient, and effective in our efforts to keep health care providers aware of recommendations, and utilizing them appropriately.

Note: Please feel free to use the DTBE Educational and Training Materials order form included in this issue. Materials can also be ordered from the DTBE web site at


Released October 2008
Centers for Disease Control and Prevention
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Division of Tuberculosis Elimination -

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