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U.S. Department of Health and Human Services


TB Notes Newsletter

No. 2, 2005


TB ETN Member Highlight

Gayle M. Schack, BSN, is a Nurse Consultant with the Colorado Department of Public Health and Environment. She received her BSN from Arizona State University in 1979, and a Health Services Credential from California State University – Los Angeles in 1991.

Gayle provides expert consultation, case management, and guidance in the care of persons with suspected or confirmed TB and their contacts, and supervises patient care provided by the public health nurses in local health care agencies. She provides technical advice as well as education and training about TB to physicians, nurses, and other professionals throughout the state.

She heard about the TB Education and Training Network (TB ETN) through mailings and e-mails sent out by TB ETN, as well as from Judy Gibson of DTBE, who sends informational e-mails to other nurses. Gayle joined TB ETN to become a member of a group of nurses and other health care providers who see the need for TB education. She also wanted to learn what is available and what other education and training strategies have been used around the nation; in addition, she wanted to learn from others. Gayle joined the Membership subcommittee of TB ETN in an effort to learn more about what TB ETN has to offer; she also wanted to understand the difference between TB ETN and the TB resource network.

Gayle is optimistic about what TB ETN can accomplish. “Basically, I see education as a means to improve patient care. Improved patient outcomes are a result of timely and appropriate diagnosis and treatment. Once a case is diagnosed, contact investigation can be initiated quickly and more cases identified or prevented,” Gayle stated. She would like to see an increased awareness around the nation of how TB ETN can help improve patient care by ensuring providers are educated. “I see this group as an important organization in assisting public health providers to acquire the knowledge and tools necessary to provide education to other health care providers in a time of few TB experts. By providing continued and current education to those who see the patients, we should see a lessening in misdiagnosis,” Gayle commented.

Gayle has a “TB 101” slide presentation that she revises to meet the needs of each audience. “I spend most of my training time educating local public health nurses. I particularly enjoy discussing current cases with the health care providers and helping solve problems through education,” Gayle explained. Last summer she presented a modified TB 101 to epidemiologists in the local bioterrorism program, hoping that these persons would be able to help in a future TB outbreak by assisting in contact investigations and surveillance. In addition to the TB 101 training, Gayle also worked with the bioterrorism program in staging an exercise. A large contact investigation being conducted in a rural community was chosen to become a bioterrorism response exercise; the second round of testing of the contact investigation was chosen for the exercise. Her job was to provide quick education to the nurses and others regarding TB and how to place or read a TST. You can read more about this event in Gayle’s article, Misdiagnosis in Rural Colorado, which appears earlier in this issue.

Gayle is involved with TB Epidemiologic Studies Consortium (TBESC) Task Order #6, Regional Capacity Building in Low-Incidence Areas. She is part of the technical team charged with writing a TB manual for low-incidence states. Since she has been involved in Task Order #6, she has enjoyed working with other nurses such as Kim Field and Brenda Ashkar (who about 18 years ago told her to go and get more TB experience when Gayle, as a young PHN, approached her for a position in Los Angeles TB control). Gayle is also a long-time member of the planning committee for the Four Corners TB/HIV conference.

Gayle has a personal reason for her dedication to TB control. “My parents were both hospitalized in the TB sanatorium in Phoenix in the early 1960s. The Arizona TB program assisted me recently in obtaining the records of their treatment. All that is left is a note card for each of my parents. My mother was in the sanatorium for 1½ years and released ‘with consent.’ My father was in the sanatorium for 4 months and left against medical advice. I didn’t know you could do that back then! That [period of hospitalization] left seven kids at home. I was about 5 at the time and second to the youngest. Arrangements were made so we could all remain at home. My older siblings went to high school half days, some in the morning and some in the afternoon, so they could take care of us younger kids. I remember visiting with my mother through a chain link fence. Even though I have worked in TB for 18 years and have a family history of TB, I remain TST negative!” Gayle shared.

Gayle’s favorite relaxation activity is “baking” on a beach with a good book. “Most of my vacations involve warm weather and a beach,” Gayle notes. Gayle has two wonderful sons, Chris, 22 and Brian, 18; both are in college, soon to start their own adventures. She and her husband of 25 years enjoy traveling: “My husband and I hope to travel more in the near future. We have recently enjoyed the beaches in Maui and Nassau. We also enjoy road trips and plan to take more of them starting in 2005,” Gayle says. She also reads a lot now that her children are grown.

If you’d like to join Gayle as a TB ETN member and take advantage of all TB ETN has to offer, please send an e-mail requesting a TB ETN registration form to You can also send a request by fax to (404) 639-8960 or by mail to the following:

CEBSB, Division of TB Elimination
1600 Clifton Rd., N.E., MS E10
Atlanta, Georgia 30333

If you would like additional information about the TB Education and Training Network, visit the website at

Submitted by Regina Bess
Div of TB Elimination


Cultural Competency Subcommittee: Update

The goal of the Cultural Competency Subcommittee is to promote cultural competency among members of TB ETN. The subcommittee strives to do this by -

  • identifying tools, materials, and other resources in the area of cultural competency and make these available to TB ETN members,
  • providing a forum for TB ETN members to network with others in the area of cultural competency, and
  • promoting the availability of the cultural competency subcommittee as a resource for input on cultural or linguistic issues.

In recent months, our Subcommittee has provided input for the New Jersey Model TB Center’s Cultural Competency Newsletter and their case studies solicitation effort. Lauren Moschetta, a Subcommittee member, is working on this project and our Subcommittee has given ideas as well as support for this endeavor.

We have provided feedback for the CDC’s ethnographic studies project, spearheaded by Cathy Rawls. We reviewed the draft of the outline that will be used to share the results and plan to review the ethnographic profiles when completed. The data were collected at four sites in the United States and includes five profiled population groups, including immigrants from Mexico, Laos, China, Vietnam, and Somalia. The research study includes information on immigration history and patterns, beliefs about TB, and immigrants’ experiences with TB treatment in the United States.

A needs assessment regarding cultural competency issues began in the fall of 2002, and the results were presented at the TB ETN conference in August 2003.  The results of this needs assessment have driven our activities as a Subcommittee since that time. However, with the growth in membership of TB ETN, we see a need for revisiting and possibly repeating the needs assessment.  A team from our Subcommittee was formed to address this issue.

The Cultural Competency Subcommittee is composed of TB trainers and educators who are dedicated to cultural competency and its application to TB control activities. If you are interested in joining this subcommittee, please send an e-mail to

Cultural Competency Quote

“A multicultural curriculum must address how to articulate a relationship between unity and difference that moves beyond simplistic binarisms. That is, rather than defining multiculturalism as against unity or simply for difference, it is crucial for educators to develop a unity-in-difference position in which new forms of democratic representation, participation, and citizenship provide a forum for creating unity without denying the particular, the multiple, and the specific. In this instance, the interrelationship of different cultures and identities become borderlands, sites of crossing, negotiation, translation, and dialogue.”
- Giroux Henry A. ''Curriculum, multiculturalism, and the politics of identity.'' NASSP* Bulletin Dec. 1992; 76 (548):1-11.

*National Association of Secondary School Principals

-Submitted by Julie McCallum, RN, MPH
American Lung Association of
TB ETN Cultural Competency Subcommittee



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

Please send comments/suggestions/requests to:, or to
CDC/Division of Tuberculosis Elimination
Communications, Education, and Behavioral Studies Branch
1600 Clifton Rd., NE - Mailstop E-10, Atlanta, GA 30333