A Qualitative Study Exploring Stakeholder Perceptions of Video Directly Observed Therapy for Monitoring Tuberculosis Treatment in the US-Mexico Border Region
María Luisa Zúñiga, PhD1, Kelly Collins, PhD2, Fátima Muñoz, MD, MPH2, Kathleen Moser, MD, MPH3, Gudelia Rangel, PhD4, Jazmine Cuevas-Mota, MPH2, Maureen Clark, BA2, Jose Luis Burgos, MD, MPH2, Richard S. Garfein, PhD, MPH2
1San Diego State University, School of Social Work, 5500 Campanile Drive, San Diego, CA, USA; 2Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; 3San Diego County Health and Human Services Agency, San Diego, CA, USA; 4Comisión de Salud Fronteriza, Sección México-Secretaria de Salud, Tijuana, Baja California, México
Corresponding Author: firstname.lastname@example.org
Journal MTM 5:2:12–23, 2016
Background: Tuberculosis (TB) incidence in the U.S.-Mexico border region exceeds both countries’ national rates. The four U.S. states bordering Mexico account for nearly 40% of total U.S. TB cases. TB treatment monitoring using directly observed therapy (DOT) is a globally-accepted practice; however, it is resource intensive for providers and patients.
Aims: To determine whether Video DOT (VDOT)—a process whereby patients record themselves taking their medication by mobile phone and sending the videos to their TB care provider for observation—could be used to remotely monitor TB treatment adherence.
Methods: We conducted five focus groups with TB patients and four with TB care providers in San Diego, California, U.S. and Tijuana, B.C., Mexico.
Results: VDOT consistently received broad support: U.S. patients valued greater autonomy and Mexican patients valued improved privacy. Groups agreed technology would not be a barrier, but emphasized need for adequate patient training.
Conclusion: Patients and providers in both countries found VDOT conceptually feasible and acceptable.