CDC Logo Tuberculosis Information CD-ROM   Image of people
jump over main navigation bar to content area
TB Guidelines
Surveillance Reports
Slide Sets
TB-Related MMWRs and Reports
Education/Training Materials
Ordering Information


U.S. Department of Health and Human Services

jump over right navigation bar
TB Notes 3, 2006
Highlights from State and Local Programs
  Art Therapy Helps Isolated Patients: Exhibition at Bellevue Hospital Center
  Surgeon General Visits Clinic in Hawaii
DTBE World TB Day Activities
National TB Controllers’ Association Poster Contest
EIS Conference a Success for DTBE
Regional Training and Medical Consultation Centers’ Needs Assessments
Laboratory Update
Communications, Education, and Behavioral Studies Branch Updates
TB Education and Training Network Update
  Member Highlight
  Cultural Competency Subcommittee
TB Epidemiologic Studies Consortium Update
  TBESC Task Order 6 (TO6) Update: Regional Capacity-Building in Low-Incidence Areas
  New TBESC Study to Be Launched: Evaluation of New Interferon-gamma Release Assays in the Diagnosis of Latent TB Infection in Health Care Workers
New CDC Publications
Personnel Notes
Calendar of Events
Return to Table of Contents

TB Notes Newsletter

No. 3, 2006

Centers of Excellence’ TB Education and Training Needs Assessments: Key Cross-Regional Findings

alt="Map of the United States spilt into 4 color coded regions. The symbol star black indicates center location. "

In 2005, CDC funded four Tuberculosis (TB) Centers of Excellence (COE):

  Francis J. Curry National TB Center
  Heartland National TB Center
  Northeastern National TB Center
  Southeastern National TB Center

The COE are regionally assigned to cover the 50 states, the District of Columbia, New York City, Puerto Rico, and seven other U.S. jurisdictions in the Pacific and Caribbean. The goal of the COE is to build TB training capacity and to provide medical consultation within each Center’s region. As part of their first year activities, the COEs conducted extensive needs assessments to determine TB education and training resources and needs in their regions.


Each COE developed its own strategy and tools to conduct its assessments; however, they all specifically focused on obtaining information on barriers to training; distance and technological training capabilities; preferred training topics and formats; awareness of existing TB resources; as well as preferred product topics and formats. The methods for the need assessments varied across regions but included

  • Key informant interviews
  • Online and print-based written instruments
  • Focus groups
  • Review of state TB program, epidemiology, and other data (e.g., Human Resource Development [HRD] plans)

The target audiences for the needs assessments included

  • TB controllers
  • TB program managers
  • TB training focal points
  • TB nurse consultants
  • Frontline TB staff (local health department staff, physicians, nurses, and outreach workers)
  • Private providers
  • Others (e.g., HIV/STD, corrections, and substance abuse staff)

Cross-Regional Findings

Although the results from the needs assessments varied by region, below are some common cross-regional findings.

Barriers to Training

Some of the barriers to training included factors such as the lack of staff coverage while employees were attending a training; travel restrictions due to limited funds and policies; lack of awareness of trainings; poor accessibility to trainings due to isolated geography; and limited technological capabilities.

Preferred Training Formats

Live, in-person training at workshops and conferences ranked highly as a preferred training format among most needs assessment respondents. Other preferred formats included in-service meetings and written/self-study format. Telephone and audio-conferencing ranked low as a preference among respondents. The preference for online or computer-based trainings varied across regions and by profession. State TB program staff ranked preference for use of distance-learning technologies (CD ROMs, online courses, and web conferencing) higher than did frontline TB staff.

Distance and Online Learning Capabilities

Technological capabilities for distance and online learning varied across the regions; however, findings suggested that video-conferencing and satellite capabilities are limited throughout the country. Moreover, while most state-level TB program staff have access to computers and the Internet, local level TB staff have limited access.

Training Topics

Training topic priorities (not listed in rank order) varied by region and occupation, but identified priorities included

  • Contact investigation (interviewing skills, locating contacts, outbreak response, working with the homeless and substance abusers)
  • Case management
  • Cultural competency
  • TB basics for new employees
  • Advanced TB training and CDC TB guideline updates for experienced staff
  • Training targeted toward private providers
  • Legal issues related to TB
  • Multidrug-resistant TB
  • Pediatric TB
  • TB/HIV coinfection
  • Laboratory issues

Awareness of Existing TB Resources and Products

Awareness of existing TB training and education resources differed between central level TB staff and frontline staff. Central level TB staff had a higher awareness of resources such as The TB Education and Training Resources Website (, the TB Education and Training Network (TB-ETN), and the TB-Educate electronic mailing list compared to frontline TB staff. Lower awareness of such resources among frontline TB staff could be related to their limited access to the Internet. In terms of awareness of existing training products, the CDC Core Curriculum and Self-Study Modules were widely utilized, as were products from the former Model Centers. 

Product Topics Desired

Products that help synthesize information in the new CDC guidelines (e.g., QuantiFERON-TB Gold Test, Contact Investigations, and Infection Control) in an easy-to-understand manner were identified as a need. Other desired products included a basic TB information packet for new employees, cultural competency materials, pocket reference lab guide, and products targeted towards private providers, homeless shelter staff, and infection control materials. In addition, patient education materials in low-literacy and multiple languages were also requested.

Preferred Product Formats

Although having access to materials online was considered important, findings also suggested that most respondents preferred printed materials to CD ROMs and other online-only resources. Furthermore, preference was high for products to be developed in quick and easy-to-read, easy-to-use formats such as reference cards, checklists, toolboxes, and videos.


The needs assessment provided the COEs with information that will lead to the development of targeted trainings and products for each region. Moreover, similar findings across COE regions will provide opportunities for cross-collaboration for training and product development. To address barriers to trainings and ensure awareness and access to products, the COEs should consider

  • Working with TB focal points to assist them in assessing and addressing local training needs
  • Offering trainings in a combination of formats (e.g., stand-up and distance learning)
  • Offering more trainings off-site within their regions
  • Marketing trainings well in advance to increase awareness and to allow programs adequate time to plan and allot funding for training and travel
  • Marketing products to frontline TB staff
  • Ensuring products are available in print format, especially for frontline TB staff

For detailed needs assessment reports for each region, please contact the COEs (see below).

Submitted by Amera Khan, MPH
Div of TB Elimination

Francis J. Curry National Tuberculosis Center

Francis J. Curry National Tuberculosis Center3180 18th Street, Suite 101
San Francisco, CA 94110-2028
415-502-4600 (Phone)
415-502-4620 (Fax) (E-mail)


Heartland National Tuberculosis Center

Heartland National Tuberculosis Center2303 SE Military Drive,
San Antonio, TX 78223-3542
800-TEX-LUNG (800-839-5864) (Phone)
210-531-4500 (Fax)


Northeastern National Tuberculosis Center

Northeastern National Tuberculosis Center225 Warren Street
Second Floor East Wing
Newark, NJ 07103
973-972-3270 (Phone)
800-482-3627 (Toll-Free)
973-972-3268 (Fax)

Southeastern National Tuberculosis Center

Southeastern National Tuberculosis Center1329 SW 16th Street
Room 5187
Gainesville, FL 32608
352-265-7682 (Phone)
352-265-7683 (Fax)


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