Abstract / Summary
Tuberculosis remains a major global health challenge, and poor medication adherence contributes to treatment failure, progression of disease, and transmission. This study evaluated the association between an educational program based on the Information–Motivation–Behavioral Skills model and self-reported medication adherence among pulmonary tuberculosis patients. This quasi-experimental pilot study utilized a two-cluster, city-level allocation design, with one city assigned to the intervention group and one to the control group.A total of 160 patients were enrolled from designated tuberculosis centers. The intervention group received three structured Information–Motivation–Behavioral Skills model-based educational sessions. The primary outcome was the continuous MMAS-8 adherence score; categorical adherence levels were assessed as a secondary outcome. Data were analyzed using descriptive statistics and individual-level tests, and supplemented by sensitivity analyses examining assumed clustering effects. Following the intervention, mean scores for all Information–Motivation–Behavioral Skills model constructs and the MMAS-8 adherence score increased in the intervention group ( p < 0.001), whereas no significant changes were observed in the control group ( p > 0.05). Post-intervention adherence was higher in the intervention group ( p = 0.001). However, sensitivity analyses showed that these differences were not robust to moderate intraclass correlation assumptions (ICC ≥ 0.05). The educational program was associated with improved self-reported adherence in the intervention group, but the two-cluster allocation design and reliance on self-reported measures limit causal inference. Findings should be interpreted as preliminary and hypothesis-generating. Not applicable.