An integrated psycho-social intervention to improve self- efficacy towards treatment uptake and infection prevention among patients and family caregivers. A multi- centric implementation research study

Rationale/ gaps in existing knowledge,

TB elimination goals to achieve 92% treatment success rate by 2025 requires improvement in the treatment uptake self-efficacy of patients to a substantial level.    Psycho -social interventions to improve the treatment self-efficacy and self-management skills to address the multi -dimensional challenges faced by   TB patients are needed to be integrated in the present TB care system

Objectives

To  adapt a self- efficacy driven  intervention     for   improving the  treatment self-efficacy  of TB patients  and family care givers under NTEP program   and to evaluate  its efficacy in comparison to the standard of care  on primary   outcomes: i. improved  TB  treatment self-efficacy  and  secondary outcomes i. improved medication adherence  ii decreased TB stigma & iii. improved infection controls self-management practices

Novelty

The proposed intervention is based on self-efficacy constructs in which the patients and caregivers are intervened to   â€œenable them to execute their own courses of actions, behaviors and self-management skills to effectively deal with challenges and needs of TB disease and treatment.   The elements of the proposed intervention  is    derived from the insights of positively deviant TB patients and their caregivers  who had coped up with TB in the best possible way and have exhibited maximum  self-efficacy. Thus the acceptance and adaptation of proposed intervention is hypothesized as more beneficial as compared to the health care provider driven vertical interventions

Methods

A multi centric hybrid mixed method implementation design  to adapt and evaluate implementation feasibility and efficacy  of delivering a self- efficacy driven intervention   using an implementation research approach.

  Expected outcome.

The proposed self-efficacy driven  intervention of proven efficacious will be the first integrated, theory-driven and evidence-based psycho-social intervention for TB patient that may positively impact self-efficacy and also acceptance and uptake of treatment, self-care and underlying psycho-social issues in a holistic  way. Evidences of efficacy from this study will lead to scaling up of self-efficacy interventions in a pragmatic way under NTEP program which could improve treatment services and outcomes for TB patients in India.