Abstract:
TRIAL DESIGN:Cluster randomised controlled trial. OBJECTIVE:To compare current practice for encouraging homeless people to be screened for tuberculosis on a mobile digital X-ray unit in London, UK, with the additional use of volunteer peer educators who have direct experience of tuberculosis, homelessness or both. PARTICIPANTS:46 hostels took part in the study, with a total of 2342 residents eligible for screening. The study took place between February 2012 and October 2013 at homeless hostels in London, UK. INTERVENTION:At intervention sites, volunteer peer educators agreed to a work plan that involved moving around the hostel in conjunction with the hostel staff, and speaking to residents in order to encourage them to attend the screening. RANDOMISATION:Cluster randomisation (by hostel) was performed using an internet-based service to ensure allocation concealment, with minimisation by hostel size and historical screening uptake. BLINDING:Only the study statistician was blinded to the allocation of intervention or control arms. PRIMARY OUTCOME:The primary outcome was the number of eligible clients at a hostel venue screened for active pulmonary tuberculosis by the mobile X-ray unit. RESULTS:A total of 59 hostels were considered for eligibility and 46 were randomised. Control sites had a total of 1192 residents, with a median uptake of 45% (IQR 33-55). Intervention sites had 1150 eligible residents with a median uptake of 40% (IQR 25-61). Using Poisson regression to account for the clustered study design, hostel size and historical screening levels, there was no evidence that peer educators increased uptake (adjusted risk ratio 0.98; 95% CIs 0.80 to 1.20). The study team noted no adverse events. CONCLUSIONS:This study found no evidence that volunteer peer educators increased client uptake of mobile X-ray unit screening for tuberculosis. Further qualitative work should be undertaken to explore the possible ancillary benefits to peer volunteers. TRIAL REGISTRATION NUMBER:ISRCTN17270334.
journal_name
BMJ Openjournal_title
BMJ openauthors
Aldridge RW,Hayward AC,Hemming S,Possas L,Ferenando G,Garber E,Lipman M,McHugh TD,Story Adoi
10.1136/bmjopen-2015-008050subject
Has Abstractpub_date
2015-09-21 00:00:00pages
e008050issue
9issn
2044-6055pii
bmjopen-2015-008050journal_volume
5pub_type
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