Effects of Information, Motivation and Behavioral Skills Model with Video-Observed Therapy program among New Pulmonary Tuberculosis Patients in Nonthaburi Province


  • Suchanwat Somsorn Faculty of Public Health, Mahidol University
  • Panan Pichayapinyo Faculty of Public Health, Mahidol University
  • Sunee Lagampan Faculty of Public Health, Mahidol University


Video-Observed Therapy, pulmonary tuberculosis



Introduction: Pulmonary tuberculosis (TB) is still one of the major health problems in Thailand.  Knowledge and self-care behavior among these TB patients, especially in new cases, are important to help patients recover from the disease. And these can effectively prevent the spread of disease.  

Research objectives: This quasi-experimental study aimed to evaluate an effect of the information, motivation, and behavioral skills model with video-observed therapy (VOT) program in new patients with pulmonary TB.  Sixty-six patients were randomly assigned into an experimental group (n=33) and a comparison group (n = 33).) Inclusion criteria were patients: (a) aged 20 to 60 years old with Acid-Fast Bacilli (AFB) positive result; and (b) who registered in a TB clinic located in Nonthaburi province. The experimental group received a routine care combined with 8-week intervention educational session, including infection control, drug adherence, and side-effect management. Also, they were provided with VOT and weekly sending  info graphic message. The comparison group received only a routine care.  Data were collected using  a set of self-administered questionnaires such as individual knowledge of TB, self-care behavior, and sputum test result.  Data were analyzed using Chi-square test, Repeated Measure ANOVA, and independent t-test.

Results:  Findings revealed that among the participants in the experimental group, TB knowledge, and self-care behaviour were found to be significantly improved between baseline and follow-up (8- and 12-week) (p < .05). At follow-up, between-group significant differences were also found on TB knowledge, and self-care behaviour (p < .05).

At follow-up, the sputum test among the participants in the experimental group at   8- and 12-week were more significantly improved than those at baseline (p<.05). However, there was not significantly different on testing result between groups at the end of the study.

Conclusion: At follow-up, Information, motivation, and behavioral skills model with VOT program mutually increased more TB knowledge, and self-care behaviour of the experimental group than at baseline. When conducted between-group analyses with follow-up data, we found that the experimental group showed more significant improvements on TB knowledge, and self-care behaviour than the comparison group. At follow-up the experimental group also reported the better sputum test results than at baseline. Nonetheless, the sputum test results of the experimental group were not significantly different from the comparison group.

Implications for practice: Instead of using DOT, healthcare workers should use VOT in pulmonary TB patients during the COVID-19 outbreak. It can prevent the spread of COVID-19 and reduce the medical care cost of TB.


Download data is not yet available.


World Health Organization. Global TB report 2019. Geneva, Switzerland: WHO; 2019.

Bureau of Tuberculosis. National tuberculosis control programme guideline, Thailand, 2018. Bangkok: Aksorn graphic and design publishing house; 2018. (in Thai)

Bureau of Epidemiology. 506 Report: Tuberculosis [Internet]. 2018 [cited 2019 Apr 28]. Available from: http://www.boe.moph.go.th/boedb/surdata/index.php. (in Thai)

Bureau of Tuberculosis. TB data center [Internet]. 2019 [cited 2019 Aug 9] Available from: (in Thai)

Muture BN, Keraka MN, Kimuu PK, Kabiru EW, Ombeka VO, Oguya F. Factors associated with default from treatment among tuberculosis patients in Nairobi province, Kenya: a case control study. BMC public health 2011; 11: 696.

Luka MI, Idris SH, Patrick N, Raymond D, Ndadilnasiya EW, Moses OA, et al. Factors associated with interruption of treatment among pulmonary tuberculosis patients in Plateau State, Nigeria, 2011. Pan Afr Med J 2014; 17(78): 78.

World Health Organization. Global tuberculosis programme. Treatment of tuberculosis. Geneva: WHO; 1998.

Prasomphol B. The effect of a counseling program using brief motivation interviewing on knowledge about tuberculosis and medication adherence among patients with pulmonary tuberculosis. [master’ thesis]. Bangkok: Mahidol University; 2011. (in Thai)

Posawang C. Directly observed treatment to promote anti tuberculosis adherence. [master’ thesis]. Bangkok: Mahidol University; 2016. (in Thai)

World Health Organization. Treatment of tuberculosis guidelines for treatment of drug-susceptible tuberculosis and patient care 2017. Geneva: WHO; 2017.

Chuck C, Robinson E, Macaraig M, Alexander M, Burzynski J. Enhancing management of tuberculosis treatment with video directly observed therapy in New York City. Int J Tuberc Lung Dis 2016; 20(5): 588–593.

Garfein RS, Collins K, Munoz F, Moser K, Cerecer-Callu P, Raab F, et al. Feasibility of tuberculosis treatment monitoring by video directly observed therapy: a binational pilot study. Int J Tuberc Lung Dis 2015; 19(9): 1057–1064.

Rujirawiwattanakul Y. Tuberculosis case interview, Bangyai hospital. Nonthaburi: Bangyai hospital; 2020. (in Thai)

Mukarsa S, Sumpowthong K. Effects of a health promotion program by applying the theory of empowerment in new smear positive pulmonary tuberculosis patients. J Med Health Sci 2019; 24(1): 13-27. (in Thai)

Pasurakul S, Keeratiyutawong P, Masingboon K. Effects of a self-regulation program and social support on attitude toward treatment, self-care behavior and tuberculosis treatment success rate in pulmonary tuberculosis patients. The Journal of Faculty of Nursing Burapha University 2013; 20(4): 57-67. (in Thai)

Fisher JD, Fisher WA, Shuper PA. The information-motivation-behavioral skill model of HIV preventive behavior. In Emerging theories in health promotion practice and research. (2nd ed.), San Francisco: Jessey-Bass; 2009.

Fisher JD, Fisher WA, Byan AD, Mishovich SJ. Information-Motivation-Behavioral Skill model-based HIV risk behavior change interception for inner-city high school youth. Health Psychol Res 2002; 21(2): 177-186.

Nanthachan N, Kasatpibal N, Viseskul N. Effect of information provision, motivation, and skill development on antiretroviral adherence among youths living with HIV. Nursing Journal 2016; 42(3): 72-83. (in Thai)

Rattanayotin J, Vanijja V. Designing and developing android application for medication reminder to improve treatment efficiency of stroke patient. Pathumwan Academic Journal 2018; 7(20): 29–44. (in Thai)

Jankaew U, Kespichayawattana J. The effect of information and motivation behavioral skill development program on dyspnea of elderly with chronic obstructive pulmonary disease. Journal of health and nursing research 2020; 36(1): 84-97. (in Thai)

Holzman SB, Zenilman A, Shah M. Advancing patient-centered care in tuberculosis management: A Mixed-methods appraisal of video directly observed therapy. Open Forum Infect Dis 2018; 5(4): 1-8.

Rattanasuwan P. TB Treatment: DOT vs. VOT. Journal of Bamrasnaradura Infectious Diseases Institute 2019; 12(1): 57-64. (in Thai)

Bureau of Tuberculosis. Tuberculosis control programme guideline in the situation of the coronavirus 2019 outbreak. Bangkok: Bureau of Tuberculosis; 2020. (in Thai)



How to Cite

Somsorn ส, Pichayapinyo ป, Lagampan ส. Effects of Information, Motivation and Behavioral Skills Model with Video-Observed Therapy program among New Pulmonary Tuberculosis Patients in Nonthaburi Province. JHNR [Internet]. 2022 Apr. 1 [cited 2022 Jun. 26];38(1):241-53. Available from: https://he01.tci-thaijo.org/index.php/bcnbangkok/article/view/246987



Research articles