Date of Conferral

7-9-2025

Degree

Ph.D.

School

Public Health

Advisor

Adebowale Awosika-Olumo

Abstract

Early detection and treatment of latent tuberculosis infection (LTBI) is crucial in preventing active TB and supporting elimination efforts. However, adherence to LTBI treatment is challenging, especially among racial and ethnic minorities, with Black/African Americans showing particularly low rates. A quantitative retrospective chart review was conducted to examine sociodemographic factors affecting LTBI adherence in Black/African American individuals and to evaluate various adherence strategies. Using the health belief model, 435 deidentified secondary data records were analyzed from the Houston Health Department from 2012 to 2022, covering both native and foreign-born Black/African American patients undergoing LTBI treatment. Descriptive and inferential statistics, including univariate, bivariate, and logistic regression analyses, were performed to examine the relationships between variables while controlling for confounding variables. The findings showed an overall treatment completion rate of 57.2%. Employment status and smoking were statistically significant predictors of LTBI treatment adherence. Employed individuals (p = .036, OR = 1.53, 95% CI [1.03, 2.28]) were 1.53 times more likely to adhere to LTBI treatment than the unemployed. Smokers (p = .045, OR = 0.64, 95% CI [0.42, 0.99]) were approximately 36% less likely to adhere to LTBI treatment than nonsmokers. Short-term treatment regimens improved adherence, with patients nearly six times more likely to complete treatment than those on undefined regimens. Directly observed therapy achieved the highest LTBI treatment adherence rate (88.5%). Implications for positive social change could result through targeted interventions to address treatment adherence barriers among Black/African Americans for better management of LTBI treatment in this population.

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