Background: Improving the health self-management level of patients with tuberculosis
(TB) is significant for reducing drug resistance, improving the cure rate, and controlling
the prevalence of TB. Mobile health (mHealth) interventions based on behavioral
science theories may be promising to achieve this goal.
Objective: This study aims to explore and conduct an mHealth intervention based on
the Integrated Theory of Health Behavior Change (ITHBC) in patients with pulmonary
TB to increase their ability of self-care management.
Methods: A prospective randomized controlled study was conducted from May to
November 2020. A total of 114 patients who were admitted consecutively to the TB
clinic of Harbin Chest Hospital, China from May 2020 to August 2020 were recruited
by convenience sampling. Patients were divided into the control group and intervention
group, and all received a 3-month intervention. Patients in the intervention group and
the control group received routine medical and nursing care in the TB clinic, including
the supervision of their medications. In addition, pharmacist-assisted mHealth (WeChat)
intervention based on the ITHBC theory about TB management was provided to the
intervention group. The primary outcome was self-management behavior, while the
secondary outcomes were TB awareness, self-efficacy, social support, and degree of
satisfaction with health education. The outcomes were measured using web-based self
designed and standard questionnaires administered at baseline and at the end point of
the study. Intergroup data were assessed using the Mann-Whitney U test, whereas
intragroup data were assessed with the Wilcoxon test (for paired samples).
Results: A total of 112 patients (59 in intervention group and 53 in control group)
completed the study. After the intervention, a statistically significant increase was noted
in the scores of each item of self-care management behaviors compared with the scores
at the baseline (P<.001) in the intervention group. Thescoresofallself-caremanagementbehaviorsofthecontrolgroupwerelowerthanthoseofallself-caremanagementbehaviorsintheinterventiongroup(allP<.05),exceptfortheitem"coveryourmouthandnosewhencoughingorsneezing"(P=.23)anditem"washhandsproperly"(P=.60),whichhadnostatisticallysignificantdifferencefromthoseintheinterventiongroup.Comparedwiththoseatbaseline,TBknowledgeawareness,selfefficacy,socialsupport,anddegreeofsatisfactionwithhealtheducationintheinterventiongroupincreasedsignificantly(P<.001),andtheinterventiongrouphadsignificantlyhigherscoresthanthecontrolgroup(P<.001).Conclusions:mHealthinterventionforTBself-managementbasedonITHBCcoulddeepentheunderstandingofpatientswithTBabouttheirdiseaseandimprovetheirobjectiveinitiativeandself-caremanagementbehaviors,whichwerebeneficialforpromotingcompliancebehaviorandqualityofpreventionandcontrolforpulmonaryTB.