Date of Publication


Project Team

Jessica Tjong, DNPc, RN; Mary Val Palumbo DNP, APRN, GP-BC; Erin Leighton DNP, APRN, FNP-C; Laura Catoe DNP, APRN, AGNP-C


Purpose: Non-Native English speakers face significant barriers to medical education and are disproportionately affected by healthcare inequities. The Vermont Department of Health reports that about 35% of refugees test positive for tuberculosis. Poor understanding of Latent Tuberculosis Infection (LTBI) and treatment can lead to a misunderstanding of the diagnosis.There is a deficit in the necessary materials required to provide LTBI education to those whose native language is not English.

Objectives: The aim of this quality improvement project was to (1) increase patient knowledge of LTBI, (2) Increase the proportion of adults whose healthcare provider checked their understanding and, (3) assess provider likeability of the developed materials.

Methods: New Americans completing their domestic health screen at an academic medical center in the northeast and tested positive for LTBI were invited to participate in the project. Two fully graphic educational materials were created about LTBI and common LTBI medication therapies. A teach back survey was created for the provider to administer to patients and assess patient knowledge through the method of teach back.

Results: Between June 2022 to the end of December 2022, a total of 25 New Americans were recruited. 40% tested positive for LTBI, 50% started medication, and 60% attended their 1-month follow up appointment. Compared to the previous year where 35.4% tested positive for LTBI, 88% started medication therapy and 58.8% attended their 1-month follow up visit.

Conclusion: Providing graphic medical educational materials for non-native English speakers who tested positive for LTBI increased knowledge about LTBI but did not affect medication therapy initiation.

Document Type


Available for download on Thursday, May 01, 2025