Table 3:

Proposed interventions to address needs of adolescents and young adults (AYAs) with or at risk of tuberculosis (TB), Part II

The following setting-specific components can be included in national plans to develop and provide AYA-centered TB services
Ensure management of AYAs by providers who are knowledgeable and skilled in caring for this age group. Carry out regular training of TB clinicians, nurses, and multidisciplinary staff in AYA health, with the goal of better understanding and responding to the needs, values, and preferences of AYAs, and providing confidential, nonjudgmental, destigmatizing care. Train general and specialist health care providers to increase their awareness of AYA-specific risks with respect to TB, and appropriate use of TB screening, diagnostics, and referral. Increase AYAs’ access to TB services, such as by offering after-school and weekend clinic hours; minimizing clinic wait times for AYAs; providing community-based or decentralized TB care for AYAs; and facilitating easy transfer between TB care sites when AYAs need to relocate, such as for school, work, or changing living situations. Actively identify wider healthcare needs of AYAs with TB by integrating TB care with other health services, such as within comprehensive AYA health clinics. In the absence of co-located services, ensure clear referral pathways and linkages for common health concerns and conditions, such as sexual and reproductive health care, prenatal care, HIV care, treatment of substance use disorders, and mental health care. Provide education and youth-friendly information that is accessible to AYAs, their caregivers, and the general public, with the goal of reducing TB-related stigma and increasing public awareness about AYAs’ susceptibility to TB, TB symptoms, and ways to access TB testing. Address the psychosocial and mental health needs of AYAs with TB, including risks for depression and substance use. Interventions to prevent common mental disorders (e.g., depression and anxiety) can promote social connectedness. Consider routine screening for mental health disorders, provision of counseling and other forms of psychological support, employment of trained peer counselors, and formation of peer support groups. Empower caregivers to effectively support AYAs’ TB treatment, including through education, counseling, and identifying and addressing family or caregiver needs, such as financial hardship. Collaborate with the education sector to develop policies that promote school engagement and retention of students with TB, facilitate TB screening and contact tracing, and provide adherence support for TB treatment if needed for students at school. Actively engage with local schools to build their understanding of TB, and support schools to practically and positively respond to students with TB. Collaborate with other sectors to address basic needs for AYAs with TB and their families. These needs may relate to catastrophic financial impacts (direct and indirect) of TB and its treatment, food security, needs for continued education, and protection against violence.

The following setting-specific components can be included in national plans to develop and provide AYA-centered TB services

Ensure management of AYAs by providers who are knowledgeable and skilled in caring for this age group. Carry out regular training of TB clinicians, nurses, and multidisciplinary staff in AYA health, with the goal of better understanding and responding to the needs, values, and preferences of AYAs, and providing confidential, nonjudgmental, destigmatizing care.
Train general and specialist health care providers to increase their awareness of AYA-specific risks with respect to TB, and appropriate use of TB screening, diagnostics, and referral.
Increase AYAs’ access to TB services, such as by offering after-school and weekend clinic hours; minimizing clinic wait times for AYAs; providing community-based or decentralized TB care for AYAs; and facilitating easy transfer between TB care sites when AYAs need to relocate, such as for school, work, or changing living situations.
Actively identify wider healthcare needs of AYAs with TB by integrating TB care with other health services, such as within comprehensive AYA health clinics. In the absence of co-located services, ensure clear referral pathways and linkages for common health concerns and conditions, such as sexual and reproductive health care, prenatal care, HIV care, treatment of substance use disorders, and mental health care.
Provide education and youth-friendly information that is accessible to AYAs, their caregivers, and the general public, with the goal of reducing TB-related stigma and increasing public awareness about AYAs’ susceptibility to TB, TB symptoms, and ways to access TB testing.
Address the psychosocial and mental health needs of AYAs with TB, including risks for depression and substance use. Interventions to prevent common mental disorders (e.g., depression and anxiety) can promote social connectedness. Consider routine screening for mental health disorders, provision of counseling and other forms of psychological support, employment of trained peer counselors, and formation of peer support groups.
Empower caregivers to effectively support AYAs’ TB treatment, including through education, counseling, and identifying and addressing family or caregiver needs, such as financial hardship.
Collaborate with the education sector to develop policies that promote school engagement and retention of students with TB, facilitate TB screening and contact tracing, and provide adherence support for TB treatment if needed for students at school. Actively engage with local schools to build their understanding of TB, and support schools to practically and positively respond to students with TB.
Collaborate with other sectors to address basic needs for AYAs with TB and their families. These needs may relate to catastrophic financial impacts (direct and indirect) of TB and its treatment, food security, needs for continued education, and protection against violence.