ArticlePLOS digital health2026
User engagement in the tuberculosis treatment support tools intervention and its impact on treatment outcomes: A secondary analysis of a pragmatic trial.
Article in PLOS digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Digital adherence technologies (DATs) may improve health behaviors only when users engage, but links between engagement, user factors, and outcomes are unclear. TB Treatment Support Tools (TB-TST) is a DAT with a smartphone app connecting patients to treatment supporters and weekly drug metabolite testing. We evaluated TB-TST app engagement in a pragmatic randomized controlled trial and identified factors associated with adherence and treatment outcomes. Engagement was measured from app interactions by 277 participants over 180-days of TB treatment. Adherence was assessed via daily self-reports and weekly metabolite-test photo submissions. Participants could also message treatment supporters, report side effects, or request help. We modeled time to non-adherence (28 consecutive days without reporting) using survival analysis. Logistic regression tested associations of adherence and engagement with treatment outcomes. A latent engagement score was derived using confirmatory factor analysis (CFA) from medication reports, photo submissions, side-effect reports, messaging, and overall adherence. Participants submitted 24,902 medication reports, 2,926 messages, 2,465 photos, 1235 side effect reports, and 128 help requests. Adherence declined over time (78% at 60 days; 50% at 180 days). Non-adherence was more common among males, participants living at or below the poverty line, those without stable employment, and those treated at certain hospitals. Non-adherence was associated with lower odds of treatment success (OR 0.48, 95% CI: 0.22 - 0.94) and higher odds of loss to follow-up (OR 2.1, 95% CI: 1.03 - 4.7), adjusting for sex, age, education, income, and employment. Higher engagement scores were associated with higher odds of success (OR 2.2 times per standard deviation increase). Engagement with TB-TST was associated with improved TB treatment outcomes. Strategies to increase and sustain engagement, particularly among high-risk groups, may improve adherence and maximize DAT benefits.
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.