Category: Audrey

Hello again!

This week, I finished my practicum with the TB Control Program, a subset of the NC Department of Health and Human Services. My practicum was the last phase of a project called “Civil Surgeon Educational Survey and Evaluation on Latent TB Infection (LTBI) Diagnosis and Treatment.” The project focused on strengthening the partnership with the community to combat active tuberculosis by increasing treatment initiation and completion of latent tuberculosis infection for those at higher risk of LTBI.

A previous student completed the beginning phases of this project: she confirmed which civil surgeons in NC are active/practicing, created a database of civil surgeon contact information, and assessed current civil surgeon knowledge of TB, and gauged interest in a presentation focusing on the most updated information on TB and LTBI care. My part of the project was the creation of educational materials and the delivery of information to the civil surgeons.

There are about 65 practicing civil surgeons in North Carolina. To try to reach as many civil surgeons as possible, we held 3 webinar sessions over the course of the summer. We hoped that, even with summer schedules, this flexible format would appeal to most providers. Information about the webinars and how to sign-up was sent to each civil surgeon utilizing the previously created NC civil surgeon database.

Each webinar lasted about an hour and focused on the medical screening for tuberculosis among people applying for adjustment of status for US permanent residence. This process must be completed by a civil surgeon, and involves a medical exam, physical examination, and other diagnostic tests for TB/LTBI. I ran the presentation and was accompanied by nurse consultants for the TB Control program. The nurse consultants were able to answer any questions that the civil surgeons had in real time.

Feedback from the webinars was positive! Two civil surgeons noted that the presentation was a great overview of pertinent TB information. Although more than 12 civil surgeons expressed interest in attending one of the webinars, only 10 were able to attend (10 spread out between the 3 presentations). However, these 10 civil surgeons represented 6 different counties across the state. Additionally, when given a pre-webinar “knowledge-check” survey which tested baseline TB knowledge, the average score was 75%. After the webinar, when the same knowledge-check was administered, the average score increased to 96%.

Although it would have been wonderful to reach more civil surgeons, these providers are busy people providing direct care to patients! We were happy to reach as many as we did and strengthen the relationship between providers and the health department.

Thanks for reading!

– Audrey

Hello! My name is Audrey and I am completing my practicum with the NC Department of Health and Human Services, specifically with the NC Tuberculosis (TB) Program.

Project Details: My practicum focuses on the completing the 4-phase project, “Civil Surgeon Educational Survey and Evaluation on Latent TB Infection (LTBI) diagnosis and treatment.” This project focuses on strengthening the partnership with the community to combat active tuberculosis by increasing treatment initiation and completion of latent tuberculosis infection for those at higher risk of LTBI.

One of the groups that is at higher risk for LTBI is immigrants from countries where tuberculosis is endemic. For example, some countries with a high TB burden include Vietnam, Mexico, and Ukraine. Whenever someone is pursuing a change in permanent resident status in the United States, they must be evaluated by a civil surgeon. Therefore, civil surgeons are in a unique position to address tuberculosis care since immigrants and refugees seeking a change in immigration status must complete a medical examination by a civil surgeon, which includes evaluation for tuberculosis. Civil surgeons are valuable partners in identifying individuals with latent tuberculosis and can be the first line of education surrounding treatment and referral to the health department, if necessary.

My practicum project builds off work completed by former students that assessed NC civil surgeon knowledge of tuberculosis care. The last phase of the project (which I will be completing) is the creation of a webinar that provides civil surgeons with the most updated information on TB and LTBI care.

Selection Process: This practicum role was posted in the Practicum Opportunities Newsletter, which is an email sent to MPH students that includes new opportunities that have been vetted by Gillings. I was looking for a role in the infectious disease space, and one that provided me with a new experience to practice my communication skills. I am a dual-degree pharmacy and public health student, and in my future career I want to feel confident when talking to multiple different people about health topics, including patients and providers. This experience provides me with an opportunity to directly talk to providers about infectious disease prevention!

This experience has already allowed me to work and grow independently as I plan the educational materials for this project. We are planning to hold 3 live webinars to present this information to civil surgeons around the state.

Thanks for reading!

-Audrey