The prevention and control of tuberculosis (TB) in the homeless population is an important public health goal, hampered by the reluctance of some homeless people to undergo medical screening, as well as the lack of evidence to support the best interventions for encouraging and increasing screening among those seeking shelter. This project will identify which of three legal mechanisms will result in the greatest reduction of undetected active TB cases among homeless people using emergency shelters.

It will focus on state workplace safety regulations intended to protect employees from TB and other aerosol transmissible diseases (ATDs), mandatory enforcement of local health department guidelines for preventing and controlling TB and other ATDs in emergency homeless shelters, or voluntary implementation of the Los Angeles County Department of Public Health guidelines for homeless shelters. This project will also provide qualitative data about barriers and facilitators for the use of various legal measures.