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Free Content A clinical trial of a financial incentive to go to the tuberculosis clinic for isoniazid after release from jail

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Abstract:

Setting: Screening for active tuberculosis (TB) and providing isoniazid (INH) preventive therapy in jails are important control measures. In San Francisco, however, historical data showed that 62% of inmates were released before completing preventive therapy, and of those only 3% attended the TB Clinic for follow-up.

Objective and Design: A randomized clinical trial to compare a $5 cash incentive plus standardized TB education with standardized TB education alone in encouraging released inmates to make a first visit to the clinic.

Results: Of 79 persons enrolled in the trial, 77.2% were released before INH completion. Rates of first visit were not significantly different for those receiving $5 plus standardized education (25.8%) versus standardized education alone (23.3%), but were higher than rates seen in historical data for inmates not receiving standardized education. Age was an important predictor of completion of a first visit (odds ratio 1.09, 95% confidence interval 1.02–1.16, P = 0.017). Other variables predicting adherence included intent to adhere, more previous time in jail, stable housing, and being partnered versus alone, although these were not statistically significant.

Conclusion: Standardized education may be important in improving follow-up after release. Further work on the role of a financial incentive in this population is needed.

Keywords: correctional health care; tuberculosis prevention

Document Type: Regular Paper

Affiliations: 1: Department of Community Health Systems, University of California, San Francisco, California, USA 2: Department of Medicine, University of California, San Francisco, California, USA 3: San Francisco City and County Public Health Department, San Francisco, California, USA

Publication date: June 1, 1998

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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