Effects of a Behavioral Treatment Package on Adherence to Tuberculosis Medicaiton Regimens

Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

James G. Hollandsworth

Advisor Department



The research was designed to measure the effects of a behavioral treatment package on adherence to tuberculosis medications. The behavioral treatment package combined cueing, contracting, self-monitoring, and social reinforcement strategies. Subjects consisted of a public health population of tuberculosis patients. The behavioral treatment experimental group and attention-placebo control group included newly diagnosed (inception cohort) patients and ongoing patients. Pill count, sputum cultures, urine assays, and two self-report questionnaires were utilized to gather data. The physiological measures, sputum cultures and urine assays, and self-report questionnaires were utilized descriptively. The pill count percentages were statistically analyzed by a two-way analysis of variance. Research findings yielded month 1 significance for the main effect of the behavioral treatment package. Month 2, 3, and follow-up yielded nonsignificant results. However, corroboration of descriptive data encourages attention to the behavioral adherence strategies. The organizational changes introduced by the research protocol and the ceiling effect of high adherence rates may have attenuated the behavioral treatment package results. Significance was also found month 1 for the time factor of earlier intervention. The earlier intervention effect was moderated by the nonsignificant month 2, 3, and follow-up results and the absence of corroborating data. The findings of the present study encourage inclusion of behavioral adherence strategies in medical treatment protocols. Future adherence research directed to the assessment of the independent contributions of treatment package components and organizational changes is recommended.