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American Journal of Public Health, Vol. 88, Issue 3 442-445, Copyright © 1998 by American Public Health Association

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The influence of program acceptability on the effectiveness of public health policy: a study of directly observed therapy for tuberculosis.

S J Heymann, R Sell and T F Brewer

Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115, USA.

OBJECTIVES: This study examined how patient acceptability influences the effectiveness of directly observed therapy for tuberculosis. METHODS: Decision and sensitivity analyses were used in assessing influences. RESULTS: If mandatory directly observed therapy discourages 6% of initial tuberculosis patients (range: 4% to 10%) from seeking care, then such therapy will be less effective than self-administered therapy. Directly observed therapy is more effective than repeated self-administered therapy for patients failing to complete initial treatment unless 32% (range: 27% to 38%) of patients avoid seeking care. CONCLUSIONS: Patient acceptability must be taken into consideration before selecting public health strategies.


Related articles in AJPH:

Directly observed therapy for tuberculosis.
S Marks, C Nguyen, N Qualls, and Z Taylor
AJPH 1999 89: 600-602. [PDF]  

Does directly observed therapy work?
W J Burman and W el-Sadr
AJPH 1999 89: 600-602. [PDF]  



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Copyright © 1998 by the American Public Health Association