Chaisson, Lelia H.Katamba, AchillesHaguma, PriscillaOchom, EmmanuelAyakaka, IreneMugabe, FrankMiller, CecilyVittinghoff, EricDavis, J. LucianHandley, Margaret A.Cattamanchi, Adithya2023-01-192023-01-192015Chaisson LH, Katamba A, Haguma P, Ochom E, Ayakaka I, Mugabe F, et al. (2015) Theory- Informed Interventions to Improve the Quality of Tuberculosis Evaluation at Ugandan Health Centers: A Quasi-Experimental Study. PLoS ONE 10(7): e0132573. doi:10.1371/journal.pone.013257310.1371/journal.pone.0132573https://nru.uncst.go.ug/handle/123456789/7082Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health centers in rural Uganda. Methods We tested components of a multi-faceted intervention to improve adherence to the International Standards for Tuberculosis Care(ISTC): performance feedback and same-day smear microscopy. The strategies were selected based on a qualitative assessment guided by the Theory of Planned Behavior and the PRECEDE model. We collected patient data 6 months before and after the introduction of each intervention component, and compared ISTC adherence in the pre- and post-intervention periods for adults with cough 2 weeks’ duration. Results The performance feedback evaluation included 1,446 adults; 838 (58%) were evaluated during the pre-intervention period and 608 (42%) during the post-intervention period. Performance feedback resulted in a 15% (95%CI +10%to +20%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. The same-day microscopy evaluation included 1,950 adults; 907 (47%) were evaluated during the pre-intervention period and 1,043 (53%) during the post-intervention period. Same-day microscopy was associated with a 14% (95%CI +10%to +18%, p<0.001) increase in the proportion of patients receiving ISTC-adherent care. Conclusions Performance feedback and same-day microscopy should be considered along with ISTC training as part of a multi-faceted intervention to improve the quality of TB evaluation in other high TB burden countries.enTuberculosisUgandan Health CentersQuasi- Experimental StudyArticle