This study is a scoping review protocol and does not involve a randomized controlled trial; therefore, trial registration is not applicable. This review will be conducted following established methodological frameworks by Arksey and O’Malley [14], with enhancements by Levac et al [21], and guided by the Joanna Briggs Institute methodology for scoping reviews [22]. This approach involves 6 key stages: identifying the research question; identifying relevant studies; selecting studies; charting the data; collating, summarizing, and reporting results; and consulting with stakeholders. The PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist is shown in Multimedia Appendix 1.

We will explore patterns in how HCWs think about the risk of occupational TB and how well they follow TB prevention and control measures by performing a thematic analysis of the qualitative and quantitative data we collected. The process will be based on Braun and Clarke’s 6-phase framework [24] for thematic analysis. The 6 steps are as follows: (1) getting to know the data, (2) making initial codes, (3) looking for themes, (4) reviewing themes, (5) defining and naming themes, and (6) writing the report. We will organize the data in order and analyze with NVivo (version 14; QSR International) to help with coding and developing themes in a systematic way. Each reviewer will code each study on their own. If they do not agree, they will talk about it or, if necessary, have a third reviewer to help. Thereafter, the codes will be arranged into groups, and then those groups will be used to develop overarching themes.

We will maintain an audit trail to make the analysis open and trustworthy, and we will hold regular team meetings to talk about new themes and make sure everyone agrees. There will be both descriptive and analytical themes in the synthesis, which will show what people think is a risky job, how they act in response to it, what helps and hurts, and how these things change in different health care settings. The last themes will be tweaked to fit the review’s goals, and the results section will show them with evidence from the studies that were used. We will consider heterogeneity across data sources by stratifying findings based on key study characteristics such as geographic region, health care setting (eg, hospital vs primary care), type of HCW, and study design (quantitative, qualitative, or mixed methods). This stratified approach will help us capture the variations in HCWs’ perceptions and adherence to TB preventive measures across different contexts.

As this study is a scoping review that involves the synthesis of data from publicly available literature and does not include any research involving human participants, identifiable personal data, or animals, an ethics review board assessment was not required. According to institutional and international guidelines, including the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (article 2.2) and equivalent regional policies, research that does not involve interaction with humans or access to nonpublic identifiable data is exempt from formal ethical review. Therefore, no application was submitted to an ethics committee for this protocol.

The findings of this scoping review are expected to offer several real-world applications for health care systems, particularly in high TB burden countries. By identifying the key factors influencing HCWs’ perceptions of occupational TB risk and their adherence to preventive measures, this review will support the development of targeted, evidence-informed interventions aimed at improving workplace safety. Policymakers and hospital administrators can utilize these insights to strengthen institutional policies—such as the provision of adequate personal protective equipment, regular TB screening, and comprehensive training—while also addressing structural and psychosocial barriers, including TB-related stigma. Additionally, this review will provide a valuable foundation for researchers and TB program implementers to design context-sensitive strategies that enhance infection control efforts, protect frontline health workers, and ultimately reduce nosocomial transmission of TB. The synthesis of diverse study contexts and health care settings will further ensure that the recommendations are adaptable and applicable across a range of health system environments.

In addition, this review highlights the interaction between individual and organizational factors in influencing HCWs’ preventive actions. It is essential to consider, in addition to the resources being available, that adherence is mediated by perceptions of support from the institution in addition to the presence of a work culture that is supportive. Stigmas associated with TB, barriers to accessing human resources and workload pressures, and insufficient comprehensive training programs are other hindrances that contribute to the observed situation. The translation of these results further outlines the knowledge gap in the current literature and highlights contributory ideas to better fit potential interventions for this demographic. If these barriers are addressed through improved policies, capacity development/training initiatives, and institutional reforms, there can be a significant improvement in adherence to TB preventive measures, which could reduce the occupational risk of TB among HCWs across the world.

This scoping review has some strengths. First, it has a wide scope of included study designs (qualitative, quantitative, and mixed methods) and sources that ensure a comprehensive evidence base. The addition of peer-reviewed papers and grey literature also provides a wide range of data. Second, the methodology follows the Arksey and O’Malley [14] framework, with enhancements by Levac et al [21], and guided by the Joanna Briggs Institute methodology for scoping reviews [22] to ensure rigor and transparency. Third, engagement with health care professionals, TB specialists, and policymakers increases the real-world relevance and applicability of the results. Fourth, and particularly important, by considering data from HCWs in low-, middle- and high-income countries, the results are globally relevant and add weight to a global case for policy and practice based on evidence. Finally, the review findings have potential implications for the design of targeted interventions that could enhance TB prevention and adherence among HCWs.

However, this review also had a few limitations. First, limiting the review to English language publications may miss pertinent studies published in other languages. Second, by restricting the review to studies published from 2000 onwards, earlier research and historical trends may have been overlooked. Third, using published studies may be subject to publication bias by excluding unpublished or not publicly accessible data. Fourth, differences in design, population, and setting of the included studies’ designs make data synthesis and comparison challenging. Finally, although independent reviewers strived to reduce potential bias, the interpretation of themes in this thematic analysis represented somewhat subjective accounting. These limitations should be borne in mind when interpreting the findings of the review.

This scoping review is the first of its kind, to our knowledge, focusing on presenting methodological and technical guidance on assessing and understanding HCWs’ perceptions of occupational TB risk and adherence to preventive measures. This scoping review will systematically map the existing literature to address critical knowledge gaps and provide a comprehensive overview of the factors influencing HCWs’ behaviors across different health care settings. These findings will guide policymakers, health care institutions, and researchers in formulating targeted strategies and interventions to improve TB prevention and control efforts, particularly in high-burden areas. The findings from this review will support upcoming research and operationalization to be implemented to ensure the safety and wellness of the primary receptors of frontline risk, that is, humanitarian health workers, across the globe.