Participant perspectives on incentives for TB preventative therapy adherence and reduced alcohol use: A qualitative study

• DOI: 10.1371/journal.pgph.0002472
• Publication Date: 2024-04-24T17:27:31Z
• Authors: Ayesha Appa; Amanda P. Miller; Robin Fatch; Allen Kekibiina; Brian Beesiga; Julian Adong; Nneka Emenyonu; Kara Marson; Monica Getahun; Moses Kamya; Winnie Muyindike; Michael McDonell; Harsha Thirumurthy; Judith A. Hahn; Gabriel Chamie; Carol S. Camlin
• Keywords: Contingency management

Economic incentives to promote health behavior change are highly efficacious for substance use disorders as well increased medication adherence. Knowledge about participants’ experiences with and perceptions of is needed understand their mechanisms action optimize future incentive-based interventions. The Drinkers’ Intervention Prevent Tuberculosis (DIPT) trial enrolled people HIV (PWH) in Uganda latent tuberculosis unhealthy alcohol a 2x2 factorial that incentivized recent abstinence isoniazid (INH) adherence on monthly urine testing while INH preventive therapy. We interviewed 32 DIPT study participants across arms explore perspectives this intervention. Participants described 1) satisfaction sufficient size allowed them purchase items improved quality life, 2) multiple ways which were motivating, from gamification “winning” through support pre-existing desire improve suggesting variable effects extrinsic intrinsic motivation, 3) finding value learning results clinical monitoring. To build effective incentive programs both reduced antimicrobial adherence, we recommend carefully selecting magnitude harnessing motivation reward target behavior. In addition these participant-described strengths, incorporating monitoring related the program provide more information may also contribute health-related empowerment.