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Volume 24, Number 10—October 2018

Research

Tuberculosis Treatment Monitoring by Video Directly Observed Therapy in 5 Health Districts, California, USA

Richard S. GarfeinComments to Author , Lin Liu, Jazmine Cuevas-Mota, Kelly Collins, Fatima Muñoz, Donald G. Catanzaro, Kathleen Moser, Julie Higashi, Teeb Al-Samarrai, Paula Kriner, Julie Vaishampayan, Javier Cepeda, Michelle A. Bulterys, Natasha K. Martin, Phillip Rios, and Fredric Raab
Author affiliations: University of California San Diego, La Jolla, California, USA (R.S. Garfein, L. Liu, J. Cuevas-Mota, K. Collins, F. Muñoz, J. Cepeda, M.A. Bulterys, N.K. Martin, P. Rios, F. Raab); University of Arkansas, Fayetteville, Arkansas, USA (D.G. Catanzaro); San Diego County Health and Human Services Agency, San Diego, California, USA (K. Moser); San Francisco Department of Public Health, San Francisco, California, USA (J. Higashi); Santa Clara County Public Health Department, San Jose, California, USA (T. Al-Samarrai); Imperial County Public Health Department, El Centro, California, USA (P. Kriner); San Joaquin Public Health Services, Stockton, California, USA (J. Vaishampayan)

Main Article

Table 3

Bivariate analysis of FEDO by participant characteristics and perceptions of VDOT in a study assessing VDOT for monitoring tuberculosis treatment, by selected characteristics, 5 California health districts, 2015–2016*

Characteristic
 No. patients
 FEDO, median (SD)
 p value†
Demographic and socioeconomic
Site type
Urban county 248 92.8 (13.3) 0.51
Rural county 26 94.2 (15.4)
Age, y, correlation coefficient 272 −0.03 0.63
Months on treatment, correlation coefficient 272 −0.14 0.02
Education
<Primary school 26 88.4 (13.7) 0.17
High school 105 93.0 (14.5)
Some college or technical school 67 93.9 (13.2)
>Bachelor’s degree 71 94.2 (11.9)
Sex
M 167 92.8 (12.7) 0.70
F 105 93.4 (14.8)
Race or ethnicity
Asian 154 95.0 (10.8) <0.001
Caucasian or white 19 95.6 (15.4)
Hispanic or Latino 82 86.8 (16.3)
Other‡ 17 87.0 (11.4)
Country of birth
United States 47 90.3 (17.2) <0.001
Mexico 44 84.7 (16.0)
Other§ 181 94.5 (10.7)
Annual household income, $ (USD)
<10,000 110 92.7 (13.6) 0.04
10,000–30,000 74 90.8 (14.8)
30,000–50,000 26 92.0 (10.4)
>50,000 39 96.3 (9.8)
Insured at baseline
Yes 229 93.4 (13.6) 0.28
No 42 89.9 (13.4)
Owned cell phone at baseline
Yes 247 93.0 (12.9) 0.49
No 26 93.1 (18.3)
Owned smartphone at baseline
Yes 196 92.8 (13.2) 0.84
No
 76
 93.6 (14.5)
Tuberculosis risk factors
Ever smoked cigarettes
Yes 116 92.3 (12.3) 0.26
No 157 93.6 (14.4)
Marijuana use in previous 6 mo
Yes 18 88.1 (19.3) 0.01
No
 252
 93.2 (13.0)
Tuberculosis and treatment perceptions
Did you share your VDOT experience with family members?
Yes 156 92.9 (14.1) 0.80
No 58 93.1 (13.0)
  Did you share your VDOT experience with friends, neighbors, classmates, or coworkers?
Yes 73 93.4 (13.7) 0.48
No 141 92.7 (13.9)
Were you concerned someone would see you using the VDOT cell phone?
Yes 73 93.3 (14.9) 0.89
No 141 92.6 (13.2)
  Did you ever fail to record a video because you were worried someone was watching you?
Yes 18 89.2 (10.3) 0.28
No 196 93.1 (14.1)
Confidentiality of VDOT vs. DOT?
More 146 92.9 (14.4) 0.92
Less 5 92.7 (12.5)
Same 59 93.0 (12.7)
VDOT experience
Overall, how easy/difficult did you find the VDOT process?
Very easy 174 93.6 (12.4) 0.001
Somewhat easy 32 91.7 (14.6)
Somewhat or very difficult 9 66.9 (19.8)
  If you had to redo tuberculosis treatment, would you choose VDOT or in-person DOT?
VDOT 192 93.2 (13.9)
In-person DOT 6 91.3 (13.3) 0.55
No preference 16 92.1 (12.9)
Would you recommend VDOT to other tuberculosis patients?
Yes 202 92.7 (13.9) 0.42
No 8 94.8 (9.8)
How often did you take tuberculosis while medication away from home?
Never or rarely 120 94.2 (12.3) 0.04
Less than half or half the time 48 93.4 (13.8)
Most of the time or every time 46 88.9 (16.4)
How often did you have problems using the VDOT application?
Never 82 95.1 (13.7) 0.001
Rarely 99 92.8 (10.3)
Less than half the time 23 88.2 (12.3)
Half the time or more 10 74.3 (25.7)
How often did poor reception cause you problems uploading videos?
Never 65 95.8 (15.6) 0.01
Rarely 103 92.4 (11.5)
Less than half the time 24 89.6 (8.7)
Half the time or more 20 84.9 (19.3)

*DOT, directly observed therapy; FEDO, fraction of expected doses observed = number of complete doses observed through VDOT divided by the number of doses expected; VDOT, video directly observed therapy.
†p values based on Wilcoxon rank sum test, Kruskal-Wallis test, or Spearmen correlation coefficient.
‡Other race groups were African American (n = 3), American Indian (n = 2), Pacific Islander (n = 1), and mixed and other races (n = 11).
§Other countries were predominately in Asia.

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Page created: September 16, 2018
Page updated: September 16, 2018
Page reviewed: September 16, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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