TB Treatment Support Tools: Refinement and Evaluation of an Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes - Insurance News | InsuranceNewsNet

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January 22, 2020 Newswires
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TB Treatment Support Tools: Refinement and Evaluation of an Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes

Insurance Daily News

2020 JAN 22 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Staff editors report on the newly launched clinical trial, NCT04221789, which has the following summary description: “The overall goal of this study is to conduct a Randomized Clinical Trial (RCT) to evaluate a tuberculosis treatment support tool (TB-TST), a cellular phone app developed using user-centered design principles and a paper-based drug metabolite urine test strip modified for home use for testing the presence of isoniazid drug metabolites in urine to directly monitor adherence to treatment, to improve treatment outcomes for patients with TB receiving self-administered treatment (SAT). Poor medication adherence to TB regimens, along with challenges in monitoring patients and returning them to treatment, are important contributing factors to poor outcomes and the development of drug resistance. With advances and proliferation of mobile technology platforms, there is substantial interest in the possible use of mobile health (mHealth) interventions to address these challenges. Of the mHealth approaches under investigation for TB adherence monitoring, drug metabolite testing has been identified as the most promising, ethical, and accurate, and the least intrusive and stigmatizing strategy compared to other mobile solutions, yet its potential remains largely unexplored. Additionally, mobile applications (apps) may provide personalized treatment supervision, increase patients’ self-management and improve patient-provider communication by offering more advanced functionalities for patient support and monitoring. The existing version of the TB-TST app offers education on TB and its treatment, communication with a care-coordinator, tracks treatment adherence (both by self-reporting and direct metabolite test strip images), self-reports treatment side-effects, and retains patient’s “diary” notes. This proposal builds on preliminary work to: 1) Refine the TB-TST intervention based on pilot study findings and apply principles of user-centered design; 2) Evaluate the impact of the TB-TST on treatment outcomes compared to usual care; 3) Assess patient and provider perceptions of the facilitators and barriers to implementation of the TB-TST and synthesize lessons learned with stakeholders and policy makers. Primary outcome will be treatment success. Secondary outcomes will include: treatment default rates, self-reported adherence, technology use and usability. Findings have broader implications not only for TB adherence but disease management more generally and will improve our understanding of how to support patients facing challenging treatment regimens”

As a matter of record, on January 9, 2020, NewsRx staff editors report that the available information provided by Institute for Clinical Effectiveness and Health Policy on this trial include:

Tracking Information

Trial Identifier NCT04221789
First Submitted Date January 6, 2020
First Posted Date January 8, 2020
Results First Submitted Date Not Provided
Results First Posted Date Not Provided
Last Update Submitted Date January 6, 2020
Last Update Posted Date January 8, 2020
Primary Completion Date December 31, 2023
Start Date July 2020
Current Primary Outcome Measures •Treatment success [ Time Frame: 6 months ] -- Completion of treatment and or cure
•Treatment default [ Time Frame: 6 months ] -- Abandonment of treatment for at least 2 months
Current Secondary Outcome Measures Not Provided
Other Outcome Measures Not Provided
Change History Complete list of historical revisions of study NCT04221789

Descriptive Information

Brief Title TB Treatment Support Tool Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes
Official Title TB Treatment Support Tools: Refinement and Evaluation of an Interactive Mobile App and Direct Adherence Monitoring on TB Treatment Outcomes
Brief Summary The overall goal of this study is to conduct a Randomized Clinical Trial (RCT) to evaluate a tuberculosis treatment support tool (TB-TST), a cellular phone app developed using user-centered design principles and a paper-based drug metabolite urine test strip modified for home use for testing the presence of isoniazid drug metabolites in urine to directly monitor adherence to treatment, to improve treatment outcomes for patients with TB receiving self-administered treatment (SAT). Poor medication adherence to TB regimens, along with challenges in monitoring patients and returning them to treatment, are important contributing factors to poor outcomes and the development of drug resistance. With advances and proliferation of mobile technology platforms, there is substantial interest in the possible use of mobile health (mHealth) interventions to address these challenges. Of the mHealth approaches under investigation for TB adherence monitoring, drug metabolite testing has been identified as the most promising, ethical, and accurate, and the least intrusive and stigmatizing strategy compared to other mobile solutions, yet its potential remains largely unexplored. Additionally, mobile applications (apps) may provide personalized treatment supervision, increase patients’ self-management and improve patient-provider communication by offering more advanced functionalities for patient support and monitoring. The existing version of the TB-TST app offers education on TB and its treatment, communication with a care-coordinator, tracks treatment adherence (both by self-reporting and direct metabolite test strip images), self-reports treatment side-effects, and retains patient’s “diary” notes. This proposal builds on preliminary work to: 1) Refine the TB-TST intervention based on pilot study findings and apply principles of user-centered design; 2) Evaluate the impact of the TB-TST on treatment outcomes compared to usual care; 3) Assess patient and provider perceptions of the facilitators and barriers to implementation of the TB-TST and synthesize lessons learned with stakeholders and policy makers. Primary outcome will be treatment success. Secondary outcomes will include: treatment default rates, self-reported adherence, technology use and usability. Findings have broader implications not only for TB adherence but disease management more generally and will improve our understanding of how to support patients facing challenging treatment regimens
Detailed Description Tuberculosis remains one of the top ten causes of death globally despite it being largely curable. Patients face many challenges to adhere to treatment and mobile health (mHealth) interventions may address these challenges and support patients to complete their treatment. We will improve an interactive intervention based on the combined input from patients and TB experts and evaluate the intervention’s impact on treatment outcomes in a randomized clinical trial. Findings have broader implications not only for TB adherence but disease management more generally and will improve our understanding of how to support patients in challenging treatment regimens.
Study Type Interventional
Study Phase N/A
Study Design Allocation: Randomized
Intervention Model: Parallel Assignment
Primary Purpose: Treatment
Masking: Single
Masking Description: Data analysts will not be aware of group allocation
Condition Tuberculosis
Treatment Adherence
Intervention •Other: TB treatment assistant
phone app
Study Arms •Experimental: intervention: TB treatment assistant
Patients receiving instructions to use phone application
Interventions:
⚬Other: TB treatment assistant
Publications* *Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline
World Health Organization. The top 10 causes of death worldwide. Geneva, 2017.
World Health Organization. Global Tuberculosis Report, 2018.
World Health Organization. Tuberculosis: fact sheet no. 104, Reviewed March 2016, 2016.
All Party Parliamentary Group on Global TB. The price of a pandemic:counting the cost of MDR-TB, 2015.
World Health Organization. End TB Strategy. 2015.
World Health Organization. Digital Health for the End TB Strategy: An Agenda for Action Geneva, Switzerland, 2015.
World Health Organization. Digital health for the End TB strategy: progress since 2015 and future perspectives. Geneva: World Health Organization, 2017.
PubMed Link - DiStefano MJ, Schmidt H. mHealth for Tuberculosis Treatment Adherence: A Framework to Guide Ethical Planning, Implementation, and Evaluation. Glob Health Sci Pract. 2016 Jun 27;4(2):211-21. doi: 10.9745/GHSP-D-16-00018. Print 2016 Jun 20.
PubMed Link - Schnall R, Bakken S, Brown Iii W, Carballo-Dieguez A, Iribarren S. Usabilty Evaluation of a Prototype Mobile App for Health Management for Persons Living with HIV. Stud Health Technol Inform. 2016;225:481-5.
PubMed Link - Guerra RL, Conde MB, Efron A, Loredo C, Bastos G, Chaisson RE, Golub JE. Point-of-care Arkansas method for measuring adherence to treatment with isoniazid. Respir Med. 2010 May;104(5):754-7. doi: 10.1016/j.rmed.2010.02.001. Epub 2010 Mar 3.
PubMed Link - Schraufnagel DE, Stoner R, Whiting E, Snukst-Torbeck G, Werhane MJ. Testing for isoniazid. An evaluation of the Arkansas method. Chest. 1990 Aug;98(2):314-6.
PubMed Link - Kilburn JO, Beam RE, David HL, Sanchez E, Corpe RF, Dunn W. Reagent-impregnated paper strip for detection of metabolic products of isoniazid in urine. Am Rev Respir Dis. 1972 Dec;106(6):923-4.
World Health Organization. Global Tuberculosis Report, 2016. Geneva: World Health Organization, 2016.
PubMed Link - Fisher JD, Amico KR, Fisher WA, Harman JJ. The information-motivation-behavioral skills model of antiretroviral adherence and its applications. Curr HIV/AIDS Rep. 2008 Nov;5(4):193-203. Review.
PubMed Link - Schnall R, Rojas M, Bakken S, Brown W, Carballo-Dieguez A, Carry M, Gelaude D, Mosley JP, Travers J. A user-centered model for designing consumer mobile health (mHealth) applications (apps). J Biomed Inform. 2016 Apr;60:243-51. doi: 10.1016/j.jbi.2016.02.002. Epub 2016 Feb 20.
Center for Desease Control and Prevention. Tuberculosis Data and Statistics, 2018.
PubMed Link - Maartens G, Wilkinson RJ. Tuberculosis. Lancet. 2007 Dec 15;370(9604):2030-43. Review.
PubMed Link - Osterberg L, Blaschke T. Adherence to medication. N Engl J Med. 2005 Aug 4;353(5):487-97. Review.
PubMed Link - Ray TK, Sharma N, Singh MM, Ingle GK. Economic burden of tuberculosis in patients attending DOT centres in Delhi. J Commun Dis. 2005 Jun;37(2):93-8.
PubMed Link - Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglione MC, Dye C. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med. 2003 May 12;163(9):1009-21. Review.
PubMed Link - Iribarren SJ, Rubinstein F, Discacciati V, Pearce PF. Listening to Those at the Frontline: Patient and Healthcare Personnel Perspectives on Tuberculosis Treatment Barriers and Facilitators in High TB Burden Regions of Argentina. Tuberc Res Treat. 2014;2014:135823. doi: 10.1155/2014/135823. Epub 2014 Sep 28.
PubMed Link - Hirpa S, Medhin G, Girma B, Melese M, Mekonen A, Suarez P, Ameni G. Determinants of multidrug-resistant tuberculosis in patients who underwent first-line treatment in Addis Ababa: a case control study. BMC Public Health. 2013 Aug 28;13:782. doi: 10.1186/1471-2458-13-782.
PubMed Link - Mitchison DA. How drug resistance emerges as a result of poor compliance during short course chemotherapy for tuberculosis. Int J Tuberc Lung Dis. 1998 Jan;2(1):10-5.
Center for Desease Control and Prevention. The costly burden of drug-resistant TB in the U.S., 2017.
World Health Organization. Global Plan to End TB: The Paradigm Shift 2016-2020. Geneva, Switzerland, 2015.
World Health Organization. What is DOTS? A guide to understanding the WHO-recommended TB control strategy known as DOTS, 1999.
PubMed Link - Karumbi J, Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev. 2015 May 29;(5):CD003343. doi: 10.1002/14651858.CD003343.pub4. Review.
PubMed Link - Pope DS, Chaisson RE. TB treatment: as simple as DOT? Int J Tuberc Lung Dis. 2003 Jul;7(7):611-5.
PubMed Link - Volmink J, Garner P. Directly observed therapy for treating tuberculosis. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003343. Review. Update in: Cochrane Database Syst Rev. 2007;(4):CD003343.
Tuberculosis Coalition for Technical Assistance. International Standards for Tuberculosis Care (ISTC). Diagnosis, Treatment, Public Health. 2nd ed. The Hague, 2009.
World Health Organization. Global Tuberculosis Report 2015. Geneva, Switzerland: WHO, 2015.
Instituto Nacional de Enfermedades Respiratorias
World Health Organization. TB country profile Argentina, 2017. 2018. http://www.who.int/tb/country/data/profiles/en/
United Nations. Sustainable Development Goals. 2015. http://www.un.org/sustainabledevelopment/sustainable-development-goals/
International telecommunication Union. The World in 2016: ICT Facts & Figures. 2016. http://www.itu.int/en/ITU-D/Statistics/Documents/facts/ICTFactsFigures2016.pdf
PubMed Link - Hoffman JA, Cunningham JR, Suleh AJ, Sundsmo A, Dekker D, Vago F, Munly K, Igonya EK, Hunt-Glassman J. Mobile direct observation treatment for tuberculosis patients: a technical feasibility pilot using mobile phones in Nairobi, Kenya. Am J Prev Med. 2010 Jul;39(1):78-80. doi: 10.1016/j.amepre.2010.02.018. Epub 2010 May 26.
PubMed Link - Wade VA, Karnon J, Eliott JA, Hiller JE. Home videophones improve direct observation in tuberculosis treatment: a mixed methods evaluation. PLoS One. 2012;7(11):e50155. doi: 10.1371/journal.pone.0050155. Epub 2012 Nov 30.
PubMed Link - Belknap R, Weis S, Brookens A, Au-Yeung KY, Moon G, DiCarlo L, Reves R. Feasibility of an ingestible sensor-based system for monitoring adherence to tuberculosis therapy. PLoS One. 2013;8(1):e53373. doi: 10.1371/journal.pone.0053373. Epub 2013 Jan 7.
PubMed Link - Soobratty MR, Whitfield R, Subramaniam K, Grove G, Carver A, O’Donovan GV, Wu HH, Lee OY, Swaminathan R, Cope GF, Milburn HJ. Point-of-care urine test for assessing adherence to isoniazid treatment for tuberculosis. Eur Respir J. 2014 May;43(5):1519-22. doi: 10.1183/09031936.00132613. Epub 2014 Jan 16.
Singer E. TB Drug Compliance. Paper drug test and text messaging could help thwart the most deadly strains of tuberculosis. 2009. https://www.technologyreview.com/s/412203/tb-drug-compliance/
PubMed Link - Meissner PE, Musoke P, Okwera A, Bunn JE, Coulter JB. The value of urine testing for verifying adherence to anti-tuberculosis chemotherapy in children and adults in Uganda. Int J Tuberc Lung Dis. 2002 Oct;6(10):903-8.
PubMed Link - Iribarren SJ, Sward KA, Beck SL, Pearce PF, Thurston D, Chirico C. Qualitative evaluation of a text messaging intervention to support patients with active tuberculosis: implementation considerations. JMIR Mhealth Uhealth. 2015 Feb 27;3(1):e21. doi: 10.2196/mhealth.3971.
PubMed Link - Iribarren S, Beck S, Pearce PF, Chirico C, Etchevarria M, Cardinale D, Rubinstein F. TextTB: A Mixed Method Pilot Study Evaluating Acceptance, Feasibility, and Exploring Initial Efficacy of a Text Messaging Intervention to Support TB Treatment Adherence. Tuberc Res Treat. 2013;2013:349394. doi: 10.1155/2013/349394. Epub 2013 Dec 12.
PubMed Link - Iribarren SJ, Beck SL, Pearce PF, Chirico C, Etchevarria M, Rubinstein F. MHEALTH INTERVENTION DEVELOPMENT TO SUPPORT PATIENTS WITH ACTIVE TUBERCULOSIS. J Mob Technol Med. 2014;3(2):16-27.
Rubinstein F, Iribarren, SJ. Effectiveness of different usual regimens treatment delivery strategies on Tuberculosis treatment success and default rates in Argentina: A Prospective Cohort Study (under review). 2017.
Rubinstein F, Bernachea, M.P., Klein, K, Zurbrigk, F, Iribarren, S, Chirico, C, Gibbons, L,. TB treatment strategies and risk of default: a quasi-experimental study The International Journal of Tuberculosis and Lung Disease; 2016; Liverpool, UK; 2016.
PubMed Link - Fisher JD, Fisher WA, Amico KR, Harman JJ. An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychol. 2006 Jul;25(4):462-73.
PubMed Link - Munro S, Lewin S, Swart T, Volmink J. A review of health behaviour theories: how useful are these for developing interventions to promote long-term medication adherence for TB and HIV/AIDS? BMC Public Health. 2007 Jun 11;7:104. Review.
McReynolds J, Crane, H, Berry, D, Lober, WB. Open Source Computerized Patient Reported Outcomes: Research and Practice across Three Domains. AMIA; 2013; Washington DC; 2013.
PubMed Link - Mandel JC, Kreda DA, Mandl KD, Kohane IS, Ramoni RB. SMART on FHIR: a standards-based, interoperable apps platform for electronic health records. J Am Med Inform Assoc. 2016 Sep;23(5):899-908. doi: 10.1093/jamia/ocv189. Epub 2016 Feb 17.
PubMed Link - Banos O, Villalonga C, Garcia R, Saez A, Damas M, Holgado-Terriza JA, Lee S, Pomares H, Rojas I. Design, implementation and validation of a novel open framework for agile development of mobile health applications. Biomed Eng Online. 2015;14 Suppl 2:S6. doi: 10.1186/1475-925X-14-S2-S6. Epub 2015 Aug 13.
PubMed Link - Flood D, Chary A, Austad K, Diaz AK, Garcia P, Martinez B, Canu WL, Rohloff P. Insights into Global Health Practice from the Agile Software Development Movement. Glob Health Action. 2016 Apr 29;9:29836. doi: 10.3402/gha.v9.29836. eCollection 2016.
PubMed Link - Ngwatu BK, Nsengiyumva NP, Oxlade O, Mappin-Kasirer B, Nguyen NL, Jaramillo E, Falzon D, Schwartzman K; Collaborative group on the impact of digital technologies on TB. The impact of digital health technologies on tuberculosis treatment: a systematic review. Eur Respir J. 2018 Jan 11;51(1). pii: 1701596. doi: 10.1183/13993003.01596-2017. Print 2018 Jan.
PubMed Link - Alipanah N, Jarlsberg L, Miller C, Linh NN, Falzon D, Jaramillo E, Nahid P. Adherence interventions and outcomes of tuberculosis treatment: A systematic review and meta-analysis of trials and observational studies. PLoS Med. 2018 Jul 3;15(7):e1002595. doi: 10.1371/journal.pmed.1002595. eCollection 2018 Jul.
PubMed Link - Iribarren S, Schnall R. Call for Increased Patient Support Focus: Review and Evaluation of Mobile Apps for Tuberculosis Prevention and Treatment. Stud Health Technol Inform. 2016;225:936-7.
eMarketer. Smartphone uptake is on the rise in Argentina. 4G is becoming more common. Aug 4, 2016 2016. https://www.emarketer.com/Article/Smartphone-Uptake-on-Rise-Argentina/1014300 (accessed Aug 17 2018).
PubMed Link - Atun R, Weil DE, Eang MT, Mwakyusa D. Health-system strengthening and tuberculosis control. Lancet. 2010 Jun 19;375(9732):2169-78. doi: 10.1016/S0140-6736(10)60493-X. Epub 2010 May 18. Review.
PubMed Link - Lonnroth K, Jaramillo E, Williams BG, Dye C, Raviglione M. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med. 2009 Jun;68(12):2240-6. doi: 10.1016/j.socscimed.2009.03.041. Epub 2009 Apr 23. Review.
Volpp K. A healthcare revolution: Behavioral economics for behavior change and preventive medicine. NIH Office of Behavioral and Social Sciences Research; 2015.
PubMed Link - Masterson Creber RM, Maurer MS, Reading M, Hiraldo G, Hickey KT, Iribarren S. Review and Analysis of Existing Mobile Phone Apps to Support Heart Failure Symptom Monitoring and Self-Care Management Using the Mobile Application Rating Scale (MARS). JMIR Mhealth Uhealth. 2016 Jun 14;4(2):e74. doi: 10.2196/mhealth.5882.
PubMed Link - Berry DL, Hong F, Halpenny B, Partridge A, Fox E, Fann JR, Wolpin S, Lober WB, Bush N, Parvathaneni U, Amtmann D, Ford R. The electronic self report assessment and intervention for cancer: promoting patient verbal reporting of symptom and quality of life issues in a randomized controlled trial. BMC Cancer. 2014 Jul 12;14:513. doi: 10.1186/1471-2407-14-513.
PubMed Link - Evans HL, Lober WB. A Pilot Use of Patient-Generated Wound Data to Improve Postdischarge Surgical Site Infection Monitoring. JAMA Surg. 2017 Jun 1;152(6):595-596. doi: 10.1001/jamasurg.2017.0568. Review.
PubMed Link - Fredericksen RJ, Tufano J, Ralston J, McReynolds J, Stewart M, Lober WB, Mayer KH, Mathews WC, Mugavero MJ, Crane PK, Crane HM. Provider perceptions of the value of same-day, electronic patient-reported measures for use in clinical HIV care. AIDS Care. 2016 Nov;28(11):1428-33. doi: 10.1080/09540121.2016.1189501. Epub 2016 May 29.
Chirico C, Kuriger A, Etchevarria M, Casamajor L, Morcillo N. Is the DOTS strategy a useful tool to fight against Tuberculosis in a median incidence area of Buenos Aires Province? Int J Tuberc Lung Dis 2005.
PubMed Link - Chirico C, Kuriger A, Fernandez H, Morcillo N. [Tuberculosis in the V Sanitary Zone of Buenos Aires Province. Analysis of its trends between 1984 and 1996]. Medicina (B Aires). 1999;59(4):332-8. Spanish.
Chirico C, Sanjurjo M, Iribarren S, Zerbini E, Echevarrria M. Tuberculosis infantil: estudio de tendencia en la region sanitaria v de la provincia de buenos aires, anos 2000-2014. Medicina Infantil 2016; XXIII: 217-23.
PubMed Link - Chirico C, Sanjurjo M, Iribarren S, Appendino A, Zerbini E, Etchevarria M. [Trends of tuberculosis in the Fifth Health Region, Buenos Aires Province, years 2000-2011]. Medicina (B Aires). 2015;75(3):147-54. Spanish.
mPOWEr - University of Washington. mPOWEr. 2016. http://mpowercare.org/ (accessed Sept 4 2016).
PubMed Link - Stoyanov SR, Hides L, Kavanagh DJ, Zelenko O, Tjondronegoro D, Mani M. Mobile app rating scale: a new tool for assessing the quality of health mobile apps. JMIR Mhealth Uhealth. 2015 Mar 11;3(1):e27. doi: 10.2196/mhealth.3422.
Akraa S, Tran Tama, A, Shena, H, Tang, Y, Tang, B.Z, Li, J, Walker, S. A smartphone-based point-of-care quantitative urinalysis device for chronic kidney disease patients. Journal of Network and Computer Applications 2018; 115(2018): 59-69.
PubMed Link - Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009 Apr;42(2):377-81. doi: 10.1016/j.jbi.2008.08.010. Epub 2008 Sep 30.
Statista. Smartphone users as share of the population in Argentina from 2015 to 2022. 2018. https://www.statista.com/statistics/621034/smartphone-user-penetration-in-argentina/
Instituto Nacional de Enfermedades Respiratorias. Programa Nacional de Control de la tuberculosis. Normas tecnicas (National Tuberculosis Program. Technical standards), 2002.
PubMed Link - Knobel H, Alonso J, Casado JL, Collazos J, Gonzalez J, Ruiz I, Kindelan JM, Carmona A, Juega J, Ocampo A; GEEMA Study Group. Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS. 2002 Mar 8;16(4):605-13.
World Health Organization. Treatment for Tuberculosis: Guidelines (4rd Edition) WHO/HTM/TB/2009.420, 2010.
Guest G, Namey, E, Taylor, J, Eley, N & McKenna, K. Comparing focus groups and individual interviews: findings from a randomized study. International Journal of Social Research Methodology 2017; 20(6): 693-708.
PubMed Link - Mani M, Kavanagh DJ, Hides L, Stoyanov SR. Review and Evaluation of Mindfulness-Based iPhone Apps. JMIR Mhealth Uhealth. 2015 Aug 19;3(3):e82. doi: 10.2196/mhealth.4328.
Lincoln Y, Guba E. Naturalistic Inquiry. Newbury Park, CA: Sage Publications; 1985.
Creswell JW, Klassen, A. C., Plano-Clark, V. L., Smith, K. C., for Office of Behavioral and Social Sciences Research. Best practices for mixed method research in the health sciences. Washington, DC: NIH National Institutes of Health, 2011.
Johnson RB, Onwuegbuzie AJ. Mixed methods research: A research paradigm whose time has come Educational Researcher 2004; 33(7): 14-26.
Thomas DR. A General Inductive Approach for Analyzing Qualitative Evaluation Data. American Journal of Evaluation 2006; 27(2): 237-46.

Recruitment Information

Recruitment Status Not yet recruiting
Estimated Enrollment 400
Estimated Completion Date June 2024
Primary Completion Date December 31, 2023 (Final data collection date for primary outcome measure)
Eligibility Inclusion Criteria: There is no planned exclusion of women or minorities. Participants will include men and women of all racial and ethnic backgrounds who meet the inclusion criteria. Participants who are Spanish-speaking will be actively recruited. It is estimated that the sample will have a larger number of men than women based on national reports of TB cases. In the recent TB country report, around 60% of cases were male and 40% were female.1 Per National Population Census (2010): 46.2% of the population of Argentina was concentrated in the Province of Buenos Aires and Autonomous City of Buenos Aires; 51.3% of the population were female and 48.7% male; 2.4% self-classified as indigenous or native South American; 0.5% of households reported at least one household member of African descent; and 4.5% were classified as immigrants (predominantly from Paraguay, Bolivia, Chile, and Peru).2 The 2010 census was the first to inquire about the status of African descent. Exclusion Criteria: Children will not be included in the proposed research because the scientific literature demonstrates that the content of health-related messaging needs to be differentiated for the different target age groups and children would need different content than adults.1,2 The initial intervention’s educational messages are not tailored for children or adolescence younger than 18 with active TB. If the intervention is found to be efficacious, future studies will include designing age appropriate educational messages for children younger than 18 and for the caregivers of children younger than 18 to identify their unique needs during management of the disease and treatment. Active TB in children is a significant problem and it is often more difficult to diagnose. It is usually the case that a child with active TB has an adult in the household with the active disease. Therefore, targeting adults will likely affect the transmission to TB to children. In addition, TB medication for children differs slightly than that for adults.
Sex/Gender Sexes Eligible for Study: All
Ages 18 years to 60 years
Accepts Healthy Volunteers No
Contacts Primary contact: Fernando A Rubinstein, MD MPH, +54 11 47778767, [email protected]
Backup contact: Sarah Iribarren, RN PhD, 206 543 5211, [email protected]
Listed Location Countries Not Provided
Removed Location Countries

Administrative Information

NCT Number NCT04221789
Other Study ID Numbers 12112019
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product Not Provided
Plan to Share Data No
Plan to Share Data (IPD) Description Not Provided
Responsible Party Institute for Clinical Effectiveness and Health Policy
Collaborators University of Washington
Investigators Principal Investigator: Fernando A Rubinstein, MD MPH, Institute for Clinical Effectiveness and Health Policy
Information Provided By Institute for Clinical Effectiveness and Health Policy
Verification Date January 2020

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