Structured behavioral intervention to increase children's adherence to treatment for latent tuberculosis infection

SETTING: San Diego, California public health department tuberculosis clinic. OBJECTIVE: To evaluate the effectiveness of a behavioral intervention (the Treasure Chest) that employed the behavior modification techniques of self-monitoring and positive reinforcement to increase adherence to therapy for latent tuberculosis infection (LTBI) in children. DESIGN: A retrospective study utilizing a historical comparison group. The treatment adherence of children who attended San Diego County TB Control Program (SDCTBCP) clinics with positive tuberculin skin tests who were started on LTBI treatment prior to Treasure Chest program implementation (n = 841) was compared to that of SDCTBCP children enrolled in the Treasure Chest program (n = 741). RESULTS: Logistic regression analysis demonstrated that children who participated in the Treasure Chest program were 2.4 times more likely to complete therapy than those who did not receive the intervention. CONCLUSION: The Treasure Chest intervention is effective in increasing adherence to LTBI therapy in children.