Pham Ngoc Thach Hospital, Ho Chi Minh City, Viet Nam.
Friends for International TB Relief, Hanoi, Viet Nam.
PLoS One. 2021 May 7;16(5):e0250644. doi: 10.1371/journal.pone.0250644. eCollection 2021.
The World Health Organization recently recommended Video Observed Therapy (VOT) as one option for monitoring tuberculosis (TB) treatment adherence. There is evidence that private sector TB treatment has substandard treatment follow-up, which could be improved using VOT. However, acceptability of VOT in the private sector has not yet been evaluated.
We conducted a cross-sectional survey employing a theoretical framework for healthcare intervention acceptability to measure private provider perceptions of VOT across seven constructs in three cities of Viet Nam: Ha Noi, Ho Chi Minh City, and Hai Phong. We investigated the differences in private providers' attitudes and perceptions of VOT using mixed ordinal models to test for significant differences in responses between groups of providers stratified by their willingness to use VOT.
A total of 79 private providers completed the survey. Sixty-two providers (75%) indicated they would use VOT if given the opportunity. Between private providers who would and would not use VOT, there were statistically significant differences (p≤0.001) in the providers' beliefs that VOT would help identify side effects faster and in their confidence to monitor treatment and provide differentiated care with VOT. There were also significant differences in providers' beliefs that VOT would save them time and money, address problems faced by their patients, benefit their practice and patients, and be relevant for all their patients.
Private providers who completed the survey have positive views towards using VOT and specific subpopulations acknowledge the value of integrating VOT into their practice. Future VOT implementation in the private sector should focus on emphasizing the benefits and relevance of VOT during recruitment and provide programmatic support for implementing differentiated care with the technology.
世界卫生组织最近推荐视频观察治疗（VOT）作为监测结核病（TB）治疗依从性的一种选择。有证据表明，私营部门的结核病治疗后续服务质量不达标，而 VOT 可以改善这一情况。然而，私营部门对 VOT 的接受程度尚未得到评估。
我们采用医疗干预措施接受度的理论框架进行了一项横断面调查，以衡量越南三个城市（河内、胡志明市和海防）的私营提供者对 VOT 的看法，共涉及七个方面。我们采用混合有序模型调查了私营提供者对 VOT 的态度和看法的差异，以测试按是否愿意使用 VOT 分层的提供者群体之间的反应差异是否具有统计学意义。
共有 79 名私营提供者完成了调查。62 名提供者（75%）表示，如果有机会，他们将使用 VOT。在愿意和不愿意使用 VOT 的私营提供者之间，存在统计学上的显著差异（p≤0.001），体现在提供者认为 VOT 可以更快地发现副作用、更有信心监测治疗以及通过 VOT 提供差异化护理等方面。在 VOT 可以节省他们的时间和金钱、解决患者面临的问题、有益于他们的实践和患者以及对所有患者都相关等方面，提供者的信念也存在显著差异。
完成调查的私营提供者对使用 VOT 持积极态度，特定的亚人群承认将 VOT 纳入其实践的价值。未来在私营部门实施 VOT 应注重在招募过程中强调 VOT 的益处和相关性，并为利用该技术提供差异化护理提供方案支持。
