Nurse-led intervention to decrease drug use among LTBI positive homeless adults
Open accessAbstract
BACKGROUND: People experiencing homelessness (PEH) are disproportionately diagnosed with active tuberculosis. While promoting latent tuberculosis infection (LTBI) treatment has been a call to action, PEH engaging in substance use often experience challenges in completing LTBI treatment. METHODS: In this non-randomized single arm study, we tested an innovative, community-based, nurse-led community health worker (RN-CHW) model, on reducing drug use among 50 PEH, residing in homeless shelters or living on the streets in Los Angeles. Follow-up was at 3- and 6- months. RESULTS: Findings revealed significant and ongoing decrease in any drug use (odds ratio [OR] = 0.30; 95% confidence interval [CI] = 0.14-0.68); p = .004), amphetamine use (OR = 0.14; 95% CI = 0.02-0.81; p = .029), cannabis use (OR = 0.26; 95% CI = 0.12-0.57; p = .001) and methamphetamine use (OR = 0.30; 95% CI = 0.10-0.90; p = .031) at 6-month follow-up. CONCLUSIONS: To our knowledge, this pilot study is the first to evaluate the impact a RN-CHW delivered intervention on reduction in drug use among PEH enrolled in a LTBI intervention. LTBI interventions may serve as an entryway into reduction in drug use among this underserved population.
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For people experiencing homelessness, community- and outreach-based delivery-such as nurse-community-health-worker teams that meet patients in shelters or on the street-has been shown to improve engagement with TB and latent TB infection treatment while also reducing drug use.
“For people experiencing homelessness, community- and outreach-based delivery—such as nurse–community-health-worker teams that meet patients in shelters or on the street—has been shown to improve engagement with TB and latent TB infection treatment while also reducing drug use [44,45].”
From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [44]
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“For people experiencing homelessness, community-and outreach-based delivery—such as nurse–community-health-worker teams that meet patients in shelters or on the street—has been shown to improve engagement with TB and latent TB infection treatment while also reducing drug use [44,45].”
Exploring the Perspectives of Unhoused Adults and Providers Across the HCV Care Continuum
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- Authors
- Nyamathi, A., Morisky, D., Wall, S. A., Yadav, K., Shin, S., Hall, E., Chang, A. H., White, K., Arce, N., Parsa, T., & Salem, B. E.
- Affiliations
- University of California, Irvine (US)
- University of California, Los Angeles (US)
- Los Angeles County Department of Public Health (US)
- Los Angeles Christian Health Centers Los Angeles California
- Corresponding author
- Nyamathi, Adeline
- ORCID
- Venue
- Public Health Nursing
- Publisher
- Wiley
- Published
- 2022-01-10
- Volume
- 39
- Issue
- 4
- Pages
- 778-787
- ISSN
- 0737-1209 (ISSN-L)
- 1525-1446
- PMC
- PMC9271130
- OpenAlex
- W4206058661
- Cited by
- 5
- References
- 53
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2
- FWCI
- 1.15
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Public Health Nursing (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (R21MD012696)
- Topics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Keywords
- latent tuberculosis infection, homeless people, drug use reduction, nurse-led intervention, community health workers, homeless shelters, substance use, cannabis use, methamphetamine use, amphetamine use, tuberculosis prevention
- MeSH terms
- Adult, Ill-Housed Persons, Humans, Pilot Projects, Substance-Related Disorders, Nurse's Role, Latent Tuberculosis
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