Leveraging Patients' Social Networks to Overcome Tuberculosis Under-detection in India
This study will estimate the effect of financial incentives on leveraging social networks of existing tuberculosis (TB) patients to improve outreach and detection. Strategies to improve outreach and detection are vital, because while highly effective treatment is available, the disease infects about 9 million people worldwide and at least one third of those infected are not in treatment (WHO 2012a).
Financial incentives may overcome stigma and other costs that current patients face in referring others for testing and treatment. Combining incentives with patient-to-patient referrals represents both a scientific advance, and a contribution with the potential to change and enhance current practices in TB detection.
In collaboration with Operation ASHA, an Indian NGO that operates 190 community-based DOTS (“Directly Observed Treatment Short Course”) centers in India, we propose to conduct a randomized controlled trial to compare the effectiveness of different types of incentives to current patients and prospective patients.
This proposal is for a seed grant to fund pilot activities to (1) validate and refine our research protocol, test our treatments and determine their effect size, and (2) work with Operation ASHA to develop the necessary procedures and infrastructure to implement the full scale study.
Findings from our proposed work will lead to the development of an NIH grant proposal for the full-scale intervention. A crucial strength of this proposal is the multi-disciplinary nature of the research team which combines expertise in conducting RCTs studying the effects of incentives and networks with extensive experience in TB clinical trials in resource-constrained settings.
Jason Edward Farley PhD, MSN, MPH, Nursing, Community Public Health