Effect of a Nurse-Led Community Health Worker Intervention on Latent Tuberculosis Medication Completion Among Homeless Adults.

The study was single-arm and used a historical clinic comparison, not a concurrent randomized control group. Only 50 participants were enrolled and 49 were analysed for completion, so the study was small and underpowered for secondary mental health and substance use outcomes. Many screened adults did not proceed: 416 were screened, 153 were lost to follow-up after screening, and 215 were ineligible after screening. The intervention combined directly observed treatment, education, case management, referrals and tracking, so the contribution of any single component cannot be separated. The sample came from a small area of Los Angeles, so the results may not generalize to rural homeless adults or other populations. The paper states inclusion ages 18 to 60 but reports participants over 60, which makes the baseline sample description unclear.

The authors reported no conflicts of interest. The supplied publication types list NIH extramural research support.

Do not read the 91.8% completion rate as proof that the nurse-led community health worker program caused higher completion. The study had no concurrent control group, used a historical comparison, enrolled a small number of participants, and lost many screened people before analysis.