The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69383

Marylyn M McEwen, PhD(c), APRN, BC, College of Nursing, University of Arizona, PO Box 210203, Tucson, AZ 85721-0203, 520-626-6926, mmcewen@nursing.arizona.edu

One third of the world's population are infected with Mycobacterium tuberculosis and without proper treatment 10% will develop active disease. Tuberculosis along the U.S.-Mexico border exceeds the national rate maintaining a reservoir for TB infection. Further challenging the goal of TB elimination is the inadequate completion rate of preventive therapy for persons diagnosed with Latent Tuberculosis Infection (LTBI). Effective treatment requires understanding of the local (emic) beliefs, values, and norms of behavior. A critical ethnographic methodology was used to discover the health culture, or explanatory model(EM) of Mexican immigrants diagnosed with LTBI. This study analyzed Mexican immigrants' explanatory model of the cultural context of care in which preventive therapy of LTBI occurs; illuminates the conflicting U.S. and Mexican professional and popular explanatory models of LTBI; and identifies the facilitators and barriers to adherence of preventive therapy. Three cultural themes have been identified:US-Mexico Professional EMs; Colliding Policy Experiences; Lesser of Two Evils. Categories and supporting data will be presented and are expected to inform culturally competent community based interventions that are congruent with the beliefs, values, and practices of Mexican immigrants. Dr. JoAnn Glittenberg is the dissertation chair and the expected date of graduation is May, 2003.

Learning Objectives:

• Recognize the conflict that the U.S. and Mexican professional explanatory models of TB and LTBI create for the Mexican immigrant diagnosed with LTBI.
• Acknowledge the influence of conflicting explanatory models of TB and LTBI on the Mexican immigrants' decision to begin and complete preventive therapy for LTBI.
• Identify the affects that conflicting explanatory models of illness have on the nurse/client relationship.
• Discuss strategies for negotiating conflicting explanatory models.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.