title: Latent variable assessment of outcomes in a nurse-managed intervention to increase latent tuberculosis treatment completion in homeless adults.
abstract: OBJECTIVE
  To assess predictors of latent tuberculosis infection (LTBI) completion by using structural equation modeling (SEM) among homeless adults, a group at great risk for LTBI and active tuberculosis (TB). LTBI therapy is effective in stemming the progression to active TB, yet treatment adherence among homeless persons is difficult to attain.
  
  
  METHODS
  By using SEM, the authors assessed predictors of LTBI completion among a sample of 494 homeless adults in Los Angeles, CA, who received either a nurse case-managed program (NCM) or a usual care program.
  
  
  METHODS
  Latent variables were created with the baseline variables of site type, age, intervention status, dissatisfaction with health care, depression, TB risk assessment, alcohol use, heroin or cocaine use, and TB knowledge. Outcome variables included many of the same baseline variables as well as treatment completion.
  
  
  RESULTS
  LTBI treatment completion (100% adherence) was significantly and positively associated with participation in NCM, older age, and less heroin or cocaine use. NCM also predicted greater TB knowledge, greater ease of treatment, and more satisfaction with treatment (NCM completion rate = 64%, control rate = 42%).
  
  
  CONCLUSIONS
  The culturally competent NCM program, combined with active tracking and incentives, was successful in a difficult-to-treat and highly transient population.
authors.affiliation: School of Nursing, University of California, Los Angeles, Los Angeles, CA 90095-1702, USA. anyamath@sonnet.ucla.edu
authors.forename: Adeline
authors.initials: A
authors.lastname: Nyamathi
authors.forename: Judith A
authors.initials: JA
authors.lastname: Stein
authors.forename: Anja
authors.initials: A
authors.lastname: Schumann
authors.forename: Darlene
authors.initials: D
authors.lastname: Tyler
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage*; D019090:Case Management; D015897:Comorbidity; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006703:Ill-Housed Persons / Q000523:psychology*; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage*; D015141:Los Angeles; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D014376:Tuberculosis / Q000188:drug therapy / Q000451:nursing*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid