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November 2003, Vol 93, No. 11 | American Journal of Public Health 1871-1877
© 2003 American Public Health Association

ADOLESCENT HEALTH

Increasing Latino Adolescents’ Adherence to Treatment for Latent Tuberculosis Infection: A Controlled Trial

Melbourne F. Hovell, PhD, MPH, Carol L. Sipan, RN, MPH, Elaine J. Blumberg, MA, C. Richard Hofstetter, PhD, Donald Slymen, PhD, Lawrence Friedman, MD, Kathleen Moser, MD, MPH, Norma J. Kelley, BS and Alicia Y. Vera, MPH

Melbourne F. Hovell, Carol L. Sipan, Elaine J. Blumberg, C. Richard Hofstetter, Donald Slymen, Norma J. Kelley, and Alicia Y. Vera are with the Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, San Diego, Calif. C. Richard Hofstetter is also with the Department of Political Science, San Diego State University. Lawrence Friedman is with the Department of Pediatrics, University of California, San Diego. Kathleen Moser is with the Tuberculosis Control Program, County of San Diego.

Correspondence: Requests for reprints should be sent to Elaine J. Blumberg, MA, Center for Behavioral Epidemiology and Community Health, Graduate School of Public Health, San Diego State University, 9245 Sky Park Ct, Suite 230, San Diego, CA 92123 (e-mail: eblumberg{at}projects.sdsu.edu) (Web site: http://www.sci.sdsu.edu/c-beach).

Objectives. We sought to determine the efficacy of coaching Latino adolescents with latent tuberculosis infection to adhere to isoniazid treatment.

Methods. Participants (n = 286) were randomly assigned to adherence coaching, attention control, or usual care groups. Adherence was measured via interviews and validated with urine assays.

Results. Coaching resulted in significant increases in adherence compared with attention and usual care groups. Bicultural adolescents were more likely to be adherent than those most or least acculturated. Age and risk behavior were negatively related to adherence.

Conclusions. Coaching can increase Latino adolescents’ adherence to treatment for latent tuberculosis infection and should contribute to tuberculosis control for adolescents at high risk of contracting the disease.




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