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Identifying barriers to and facilitators of tuberculosis contact investigation in Kampala, Uganda: a behavioral approach

Overview of attention for article published in Implementation Science, March 2017
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (78th percentile)
  • Average Attention Score compared to outputs of the same age and source

Mentioned by

policy
1 policy source
twitter
8 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
47 Dimensions

Readers on

mendeley
218 Mendeley
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Title
Identifying barriers to and facilitators of tuberculosis contact investigation in Kampala, Uganda: a behavioral approach
Published in
Implementation Science, March 2017
DOI 10.1186/s13012-017-0561-4
Pubmed ID
Authors

Irene Ayakaka, Sara Ackerman, Joseph M. Ggita, Phoebe Kajubi, David Dowdy, Jessica E. Haberer, Elizabeth Fair, Philip Hopewell, Margaret A. Handley, Adithya Cattamanchi, Achilles Katamba, J. Lucian Davis

Abstract

The World Health Organization recommends routine household tuberculosis contact investigation in high-burden countries but adoption has been limited. We sought to identify barriers to and facilitators of TB contact investigation during its introduction in Kampala, Uganda. We collected cross-sectional qualitative data through focus group discussions and interviews with stakeholders, addressing three core activities of contact investigation: arranging household screening visits through index TB patients, visiting households to screen contacts and refer them to clinics, and evaluating at-risk contacts coming to clinics. We analyzed the data using a validated theory of behavior change, the Capability, Opportunity, and Motivation determine Behavior (COM-B) model, and sought to identify targeted interventions using the related Behavior Change Wheel implementation framework. We led seven focus-group discussions with 61 health-care workers, two with 21 lay health workers (LHWs), and one with four household contacts of newly diagnosed TB patients. We, in addition, performed 32 interviews with household contacts from 14 households of newly diagnosed TB patients. Commonly noted barriers included stigma, limited knowledge about TB among contacts, insufficient time and space in clinics for counselling, mistrust of health-center staff among index patients and contacts, and high travel costs for LHWs and contacts. The most important facilitators identified were the personalized and enabling services provided by LHWs. We identified education, persuasion, enablement, modeling of health-positive behaviors, incentivization, and restructuring of the service environment as relevant intervention functions with potential to alleviate barriers to and enhance facilitators of TB contact investigation. The use of a behavioral theory and a validated implementation framework provided a comprehensive approach for systematically identifying barriers to and facilitators of TB contact investigation. The behavioral determinants identified here may be useful in tailoring interventions to improve implementation of contact investigation in Kampala and other similar urban settings.

Twitter Demographics

The data shown below were collected from the profiles of 8 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 218 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 218 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 52 24%
Researcher 30 14%
Student > Bachelor 23 11%
Student > Ph. D. Student 23 11%
Student > Postgraduate 17 8%
Other 34 16%
Unknown 39 18%
Readers by discipline Count As %
Medicine and Dentistry 79 36%
Nursing and Health Professions 46 21%
Social Sciences 12 6%
Agricultural and Biological Sciences 6 3%
Engineering 5 2%
Other 26 12%
Unknown 44 20%

Attention Score in Context

This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 March 2017.
All research outputs
#2,930,965
of 18,279,189 outputs
Outputs from Implementation Science
#695
of 1,610 outputs
Outputs of similar age
#58,555
of 268,996 outputs
Outputs of similar age from Implementation Science
#6
of 8 outputs
Altmetric has tracked 18,279,189 research outputs across all sources so far. Compared to these this one has done well and is in the 83rd percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,610 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.2. This one has gotten more attention than average, scoring higher than 56% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 268,996 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 78% of its contemporaries.
We're also able to compare this research output to 8 others from the same source and published within six weeks on either side of this one. This one has scored higher than 2 of them.