Application of the information-motivation-behavioral-skills model to validate a cognitive and behavioral intervention scale for tuberculosis patients in Jos, Nigeria

Abstract

Psychometric scales can be used to assess the cognition of and behavior toward tuberculosis (TB) disease and anti-TB medicines in TB patients by applying the Information-Motivation-Behavioral-Skills model. This study validated a psychometric scale from the responses of 115 TB patients using principal component (PCA) and reliability analyses. The Cronbach’s-alpha was 0.864. The PCA identified 21 factors, with eigenvalues greater than one. Six factors, with factor loading >0.5 had more than two items loaded to a factor. Twenty-five items validated from six factors suggest that the scale can be used for cognitive and behavioral assessment and interventions in tuberculosis patients.

Applying Psychological and Educational Health Models to Determine the Effect of Cognitive and Behavioral Interventions on Tuberculosis Treatment Outcomes in Plateau State, Nigeria

“…An index score was created using a Likert scale of 1 (strongly disagree) to 5 (strongly agree) for the intervention domains [patients' knowledge of TB disease, their perception of TB disease and anti-TB medicines, their perceived sensitivity to medicines (cognitive), their emotional status, and medication adherence (behavioral)]. 6 A model was built in which the cognitive and behavioral scores were measured at the intensive (month 1), beginning (month 3), and end (month 6) of the continuation phases of data collection. The generalized estimating equation (GEE), a repeated measure regression analysis was used to test if the cognitive and behavioral interventions were significant predictors of treatment success, and whether the different intervention domains were independently related to treatment success.…”

“…Data collected using a structured validated intervention tool included: Patient demographic and clinical characteristics, knowledge of TB disease, perception of TB disease and anti-TB medicines, perceived sensitivity to medicines, emotional status, and medication adherence. 6 Data were collected at the intensive (month 1), beginning (month 3), and end (month 6) of continuation phases of treatment. Baseline demographic and clinical characteristics were compared between the groups.…”

“…This increases the likelihood of treatment success, as modeled by the WHO's Information-Motivation-Behavioural skills model applied in this study. 6,[11][12][13]33 The more knowledgeable TB patients are about their disease, the more likely they will complete their treatment and be cured of TB disease (treatment success). 15,33 Low knowledge level is associated with poor treatment outcomes, as a higher educational level is perceived to reduce ignorance and increase knowledge on drug management and consequences.…”

“…4,5 Treatment outcomes classified as successful and unsuccessful are the major indicators for evaluating TB treatment programs. 6 Non-adherence is a major challenge to global TB control because it increases the risk of treatment failure, relapse, and the emergence of drug-resistant TB which are unsuccessful treatment outcomes. 7,8 Educational interventions have been shown to decrease non-adherence and improve successful treatment outcomes.…”

“…20 The IMB model was applied in the development of the structured intervention tool used for Medication Education and Adherence Counseling (MEAC); the intervention administered to tuberculosis patients. 6 The relationship between the IMB model and tuberculosis treatment outcomes is explained in the conceptual model in Figure 2 where the IMB model equips the patient with the necessary skill for informed decisions to take his/her medicines correctly (adherence). The medicines are then absorbed and distributed to systemic circulation where their concentration can be measured and translated to adherence measurement.…”