A clinical trial of a financial incentive to go to the tuberculosis clinic for isoniazid after release from jail.
METHODS
Screening for active tuberculosis (TB) and providing isoniazid (INH) preventive therapy in jails are important control measures. In San Francisco, however, historical data showed that 62% of inmates were released before completing preventive therapy, and of those only 3% attended the TB Clinic for follow-up.


OBJECTIVE
A randomized clinical trial to compare a $5 cash incentive plus standardized TB education with standardized TB education alone in encouraging released inmates to make a first visit to the clinic.


RESULTS
Of 79 persons enrolled in the trial, 77.2% were released before INH completion. Rates of first visit were not significantly different for those receiving +5 plus standardized education (25.8%) versus standardized education alone (23.3%), but were higher than rates seen in historical data for inmates not receiving standardized education. Age was an important predictor of completion of a first visit (odds ratio 1.09, 95% confidence interval 1.02-1.16, P = 0.017). Other variables predicting adherence included intent to adhere, more previous time in jail, stable housing, and being partnered versus alone, although these were not statistically significant.


CONCLUSIONS
Standardized education may be important in improving follow-up after release. Further work on the role of a financial incentive in this population is needed.
White
M C
MC
Department of Community Health Systems, University of California, San Francisco 94143-0608, USA. mcwhite@itsa.ucsf.edu
Tulsky
J P
JP
Reilly
P
P
McIntosh
H W
HW
Hoynes
T M
TM
Goldenson
J
J
D000328:Adult; D000554:Ambulatory Care Facilities; D000995:Antitubercular Agents / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use*; D008297:Male; D008403:Mass Screening; D009042:Motivation; D010349:Patient Compliance; D010353:Patient Education as Topic; D011329:Prisoners; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control*
D000995:Antitubercular Agents; D007538:Isoniazid