Video Observed Therapy System to Improve Monitoring of Tuberculosis Treatment in Thailand during the COVID-19 Pandemic: A mixed methods study (Preprint)
BACKGROUND A directly observed therapy (DOT) program for monitoring tuberculosis (TB) treatment in Thailand is not sustainable, especially during the COVID-19 pandemic. The current video observed therapy (VOT) system called TH VOT was developed and measured usability in a small area of Thailand before upscaling. OBJECTIVE To examine the usability score of the TH VOT system based on the users’ experience and measure the users’ accountability using a mixed method study. METHODS The VOT was implemented in Na Yong district, a small district in Trang province, Southern Thailand. A mixed-method study was conducted. The quantitative data were firstly collected with the TH VOT session records and six dimensions of the user experience questionnaire (UEQ). The scores of the UEQ were compared with the good level of the UEQ general benchmark. Then, the score of each dimension was magnified by the qualitative data, which contained the reflections and suggestions from three groups of users: the observer, the healthy volunteer as a simulated patient, and the TB patients. The qualitative data were thematically analyzed based on those six dimensions. Finally, the quantitative data records in the TH VOT system were retrieved and analyzed to measure the accountability levels as the compliance percentage of the observer users and patient users. RESULTS Overall, the user experience scores of attractiveness, dependability, and novelty indicated good usability, but the scores of perspicuity, efficiency, and stimulation reflected the areas for improvement. The usability of the TB patients was not different from people uninfected with TB. The observers requested a smartphone app for reviewing the videos. Both the observers and patients needed an appropriate online notification system. The video session records showed 85.71% and 61.67% of the compliance in the patients and the observers, respectively. CONCLUSIONS The TH VOT system was usable for the patients more than for the observers. Furthermore, the accountabilities of both the patients and TB staff should be improved. Online notification and proper management would also be further needed to solve these problems.