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Carolyn F. Fisher, Ranjani K. Paradise, Ceylon Auguste-Nelson, Martina Todaro, and Blessing Dube. “Finding the meaning in the numbers: a mixed-methods evaluation of a latent tuberculosis infection testing and treatment program”, Presented at the 2019 American Evaluation Association Annual Conference, Minneapolis, MN.


The Institute for Community Health was the evaluator for a demonstration project at a Massachusetts community health center that aimed to increase testing and treatment for latent tuberculosis infection (LTBI) among high-risk community members. Our evaluation monitored patient progression through the LTBI cascade of care, from testing through treatment completion. One goal for the evaluation was to extract successful practices and lessons learned; to accomplish this, we supplemented the cascade of care data with information from semi-structured and highly-structured interviews, ethnographic observation, time-tracking studies, and facilitated discussions. We used an appreciative inquiry approach throughout to engage clinical stakeholders in the evaluation. The mixed methods and appreciative inquiry techniques improved our understanding of the successes and challenges at each stage of the cascade of care and to identify practices that other institutions might use or adapt to address LTBI in their settings.