Fig 1.
Overview of Intervention Development Process.
To develop a multi-faceted intervention to improve adherence to the International Standards of TB Care (ISTC), we first developed a conceptual model based on the Theory of Planned Behavior. In this model, providers’ intention to follow ISTC-recommended TB evaluation practices is based on knowledge of and attitudes toward ISTC, having the required skills, perceived attitudes of their peers toward ISTC and belief in their ability to follow ISTC. Second, we conducted a formative assessment to gather data on these factors as well as health system barriers to TB evaluation. Finally, we selected intervention components that targeted pre-disposing, enabling, and reinforcing factors, as recommended by the PRECEDE model, and that were considered feasible and sustainable by key stakeholders.
Table 1.
Bivariate analysis of intervention impact on presumed TB patient evaluation at 6 health centers.
Table 2.
Multivariate analysis of intervention impact on presumed TB patient evaluation at 6 health centers.
Table 3.
Between-site variation in impact of interventions on ISTC-adherent care at 6 health centers.