title: A multi-perspective service evaluation exploring tuberculosis contact screening attendance among adults at a North London hospital.
abstract: Non-attendance at TB contact screening clinics has been highlighted as a common phenomenon across a number of sites during recruitment to the PREDICT TB Study. This has obvious implications for the safety of patients, their communities and for NHS resources. The objective of this study was to explore why adults who have been in contact with TB do, and do not, attend their screening appointment, thereby allowing identification of interventions to reduce non-attendance.
  
  
  
  A multi-method approach was taken using 15 questionnaires with adults who attended for screening, 15 telephone questionnaires with adults who did not attend and in-depth interviews with 8 TB nurses. Interviews were coded to trace emerging descriptive themes, then refined through an iterative process of interpretation and recoding.
  
  
  
  Findings from the questionnaires and interviews were categorized into three principle themes following analysis: awareness, hospital factors and leadership. These themes deconstruct the complex phenomena of patients' lack of attendance at this TB contact screening service.
  
  
  
  Recommendations related to issues of leadership, outreach services, flexibility of clinic timing and awareness amongst both the local community and GPs were made.
authors.affiliation: Royal Free Hospital, London, UK Department of Infection & Population Health, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: MacLellan
authors.affiliation: Royal Free Hospital, London, UK.
authors.forename: K
authors.initials: K
authors.lastname: Wallace
authors.affiliation: Social Policy Research Centre, Middlesex University, London, UK.
authors.forename: E
authors.initials: E
authors.lastname: Vacchelli
authors.affiliation: TB Services, Northwick Park Hospital, Middlesex, UK.
authors.forename: J
authors.initials: J
authors.lastname: Roe
authors.affiliation: TB Services, Northwick Park Hospital, Middlesex, UK.
authors.forename: R
authors.initials: R
authors.lastname: Davidson
authors.affiliation: Department of Infection & Population Health, University College London, London, UK Tuberculosis Section, Public Health England, London, UK.
authors.forename: I
authors.initials: I
authors.lastname: Abubakar
authors.affiliation: Tuberculosis Section, Public Health England, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Southern
mesh_terms: D000293:Adolescent; D000328:Adult; D016358:Contact Tracing / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006786:Hospitals, Urban; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control*; D055815:Young Adult
keywords: communicable diseases; public health; quality