Behavior Change and Digital Health Interventions for Improved TB Treatment Outcomes
Tuberculosis, Adherence, Patient, Adherence, Medication
About this trial
This is an interventional treatment trial for Tuberculosis focused on measuring Keheala, tuberculosis, adherence, behavior change, mobile health, mhealth, behavioral interventions, patient-centered care
Eligibility Criteria
To be eligible for the study, subjects must:
- be either clinically diagnosed or bacteriologically confirmed to have TB, MDR TB or EP TB.
- communicate in either Swahili or English.
- have access to a mobile phone (shared or owned).
- have at least two months of treatment remaining.
Exclusion Criteria:
- subjects who do not consent to participate.
Note that subjects are randomized into intervention groups or the control group after providing consent.
Subjects who are enrolled but are found, retrospectively to not meet the criteria (i.e. they had less than two months remaining when they were enrolled) will be monitored as part of a, fifth "non-eligible" group, and will not count towards the enrollment targets.
Sites / Locations
- Kenya National TB Program
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Experimental
Experimental
Experimental
Control
SMS-Only
Social Behavior Change Communication (SBCC)
Keheala
The standard-of-care protocol in Kenya includes diagnosis, the provision of medications - typically administered for a 1-2 week period at which point patients are expected to return to the clinical site - periodic on-the-ground follow-up by community health volunteers (CHVs)(at the discretion of local clinicians and CHVs) and nutritional support, as is sometimes provided.
Patients in the SMS reminder group will receive a single, medication reminder SMS once daily at their indicated treatment time. The reminder message will read "Please take the medication on time" consistent with messages used by Liu and colleagues (2015).
Patients assigned to this intervention will have access to a mobile health platform that provides reminders, information and motivation - designed with behaviorally-informed strategies - but no follow up support from a human beyond what the standard of care allows. Further details of the intervention can be found in the study protocol section. The intervention will send automated motivational messages and regular prompts for patients to self-verify their adherence. Messages include reminders about the community benefits of adherence, and a measure of the patient's adherence performance relative to successful peers. Clinicians can view individual or aggregate patient histories to leverage limited resources.
An automated system sends motivational messages and regular prompts for patients to self-verify their adherence. Messages include reminders about the community benefits of adherence, and a measure of the patient's adherence performance relative to successful peers. If a patient fails to correctly verify her compliance, the system automatically alerts the support-sponsor, who then intervenes with a supportive dialogue. Clinicians can view individual or aggregate patient histories to leverage limited resources. Further details of the intervention can be found in the study protocol section.