J. Lorvick et al., Incentives and accessibility: A pilot study to promote adherence to TB prophylaxis in a high-risk community, J URBAN H, 76(4), 1999, pp. 461-467
Citations number
26
Categorie Soggetti
Envirnomentale Medicine & Public Health
Journal title
JOURNAL OF URBAN HEALTH-BULLETIN OF THE NEW YORK ACADEMY OF MEDICINE
Setting. A community-based directly observed preventive therapy (DOPT) prog
ram for treatment of latent tuberculosis infection among injection drug use
rs (IDUs) in an inner-city neighborhood. To test adherence to a 6-month cou
rse of DOPT using cash incentives and an
Objective. To test adherence to a 6-month course of DOPT using cash incenti
ves and an easily accessible neighborhood location.
Design. Street-recruited IDUs (N = 205) were screened for Mycobacterium tub
erculosis (TB) infection using the Mantoux test and two controls. Subjects
who had a purified protein derivative (PPD) reaction of greater than or equ
al to 5 mm, were anergic, or had a history of a positive PPD received clini
cal evaluation at a community field site, provided in collaboration with th
e San Francisco Department of Public Health :Tuberculosis Clinic. Twenty-ei
ght subjects were considered appropriate candidates for prophylaxis with is
oniazid, and 27 enrolled in the pilot study. Participants received twice-we
ekly DOPT at a community satellite office, with a $10 cash incentive at eac
h visit.
Results. The 6-month (26-week) regimen was completed by 24/27 (89%) partici
pants. The median time to treatment completion was 27 weeks (range 26 to 34
weeks). The median proportion of dosing days attended in 6 months was 96%.
Conclusion. Community-based DOPT using cash incentives resulted in high lev
els ol: adherence and treatment completion among drug users.