Table 1 Strategies to reach and motivate Eritrean migrants living in Dutch communities

Strategy 1:Invitation through mail and social media

The local community of PHS 1 lacked regular social gatherings, for example a church, which could be used as approaching strategy. Therefore, the PHS 1 project team approached the target group through individual invitation -consisting of a flyer in Tigrinya- by mail, for which addresses of the target group where obtained by the PHS through the municipality. Additionally, the key figure posted an invitation on a Facebook group for Eritreans in that city (approximately 120 members).

LTBI education: organized twice, during a week night, at two different local community centres

LTBI screening: approximately 1 week after education, on appointment, at the PHS

One key figure of PHS 3 promoted the education session in a WhatsApp group of the church. (Additional to strategy 2)

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Strategy 2:Face-to-face promotion

The key figure of PHS 1 asked other key figures -working for other PHS departments- to spread the invitation and promote participation within their network during face-to-face contacts. (Additional to strategy 1)

The project team of PHS 3 identified various places - Dutch language classes, libraries, the church, and the gym- where Eritreans regularly gather. At those places, key figures approached individuals to promote the upcoming education session verbally and by handing out flyers with invitations.

LTBI education: organized twice, during week night, at a local community centre

LTBI screening: organized three times, approximately 1 week after the education, during week day, at the PHS

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Strategy 3:Dutch language classes

PHS 1 and 2 used Dutch language classes (PHS 1 at one school, PHS 2 at two schools) to reach Eritrean migrants. The project team approached the school management to discuss the possibility to organize education sessions at the school. After agreement, a teacher (Strategy 3.1 - PHS 1) or the key figures (Strategy 3.2 - PHS 2) approached students to come to the education session and handed out flyers. One school handed out flyers and displayed posters in the school (Strategy 3.3 - PHS 2) to promote the education session.

LTBI education: organized three times, at two different schools

LTBI screening: approximately 1 week after the education session, once during week night at the PHS, twice on appointment during week day at the PHS

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Strategy 4:Group housing

The key figures of PHS 2 (Strategy 4.1 and 4.2) and the TB nurse of PHS 4 (Strategy 4.3) utilized existing contacts with resident(s) of group housings. Group housings are temporary residents with up to 35 young adult females or males, who transferred from an asylum seeker centre and are waiting individual housing to come available. In consultation with the residents, the key figures organized an education session in a community space of the houses.

LTBI education: during a week night, at the house

LTBI screening: organized approximately 1 week after the education, during a week day at the house (strategy 4.3 (PHS 4)) or on appointment at the PHS (strategy 4.1 and 4.2 (PHS 2))

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Strategy 5:Sports club

The TB nurse of PHS 2 approached an Eritrean soccer coach who organizes weekly soccer trainings for Eritrean migrants. In consultation with the coach, the TB nurse organized an education session after soccer training.

LTBI education: during a week night, after training at the sport club

LTBI screening: organized approximately 1 week after the education, during a week night, at the PHS

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Strategy 6:Eritrean church

Strategy 6.1: One PHS4 key figure was a member of the church board of trustees and obtained their consent to promote the LTBI education and screening after a church service. Interested church members were asked to sign up for the screening. Registered members received an invitation by mail. Those who did not show-up for the first screening appointment were invited a second time.

Strategy 6.2: The key figure of PHS 4 brought the project researcher (IS) in contact with a priest of a church in the PHS 5 region. The priest allowed the team to promote the LTBI education and screening after a church service. After the promotion, church members were handed-out invitations with date and time of screening.

LTBI education: promotion of the intervention organized after the church service

LTBI screening: organized 1 week (PHS 4) / 2 weeks (PHS 5) after education session on appointment at the PHS

We arranged for church members who did not live in the PHS 4 or PHS 5 region to visit the PHS in their own region.

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