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Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study

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Listed:
  • Lelia H Chaisson
  • Achilles Katamba
  • Priscilla Haguma
  • Emmanuel Ochom
  • Irene Ayakaka
  • Frank Mugabe
  • Cecily Miller
  • Eric Vittinghoff
  • J Lucian Davis
  • Margaret A Handley
  • Adithya Cattamanchi

Abstract

Background: Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. Methods: We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care (ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough ≥ 2 weeks’ duration. Results: The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10% to +20%, p

Suggested Citation

  • Lelia H Chaisson & Achilles Katamba & Priscilla Haguma & Emmanuel Ochom & Irene Ayakaka & Frank Mugabe & Cecily Miller & Eric Vittinghoff & J Lucian Davis & Margaret A Handley & Adithya Cattamanchi, 2015. "Theory-Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-13, July.
    • Handle: RePEc:plo:pone00:0132573
    DOI: 10.1371/journal.pone.0132573
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