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Psychosocial interventions to improve tuberculosis preventive treatment uptake and psychosocial outcomes: a systematic review
Open accessAbstract
Despite its importance in global TB elimination, tuberculosis preventive treatment (TPT) remains underutilized. Psychosocial barriers significantly contribute to this issue. This systematic review aims primarily to synthesize psychosocial interventions to improve the initiation of TPT. We analyzed psychosocial outcomes as secondary objectives when relevant data were available. This review included studies indexed in PubMed, Scopus, and PsycInfo until August 25, 2025. Original studies addressing psychosocial interventions for people with latent tuberculosis infection (LTBI) indicated for TPT were included in this review. The risk of bias was assessed via the Crowe Critical Appraisal Tool (CCAT). A narrative synthesis summarized the characteristics of interventions, including the format of delivery, settings, intervention providers, psychosocial content, duration, and outcomes. Among the 1725 identified studies, nine (14,428 participants) met the inclusion criteria. The CCAT classification was moderate to high quality, with strengths in clearly articulated study rationales but weaknesses in study design. Most studies were from upper-middle-income countries with a high burden of TB; none were from Asia. Health education is a core component, often incorporating culturally adapted survivor testimonials to reduce stigma and increase motivation. Interventions were mostly community-based and led by multidisciplinary healthcare professionals and community workers. TPT initiation improved in all included studies, with risk differences ranging from 10-52%. This review emphasizes the potential of psychosocial interventions in supporting behavior change and increasing TPT initiation. Methodological limitations and a lack of research in high-burden Asian contexts restrict the current evidence. Future studies should focus on developing rigorous, contextually appropriate strategies for scalable psychosocial interventions that are effective and sustainable.
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A scoping review is timely because the End TB Strategy and the WHO mhGAP framework have explicitly called for integration of mental health and psychosocial care into TB programs, while the number of primary trials and qualitative studies in this area has expanded substantially over the past five years.
“A scoping review is particularly timely now because the End TB Strategy [13] and the WHO mhGAP framework [17] have explicitly called for the integration of mental health and psychosocial care into TB programs, while the number of primary trials and qualitative studies in this area has expanded substantially over the past five years [18,19,20,21].”
From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [20]
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Experimental — accuracy not yet measuredTheory-informed intervention design may strengthen psychosocial programs by linking strategies to modifiable determinants of behavior.
“The apparent usefulness of established behavioral frameworks—including the Health Belief Model [29,32], Motivational Enhancement Therapy drawing on stages-of-change principles [28], and the Capability, Opportunity, Motivation, and Behavior (COM-B) model and Behavior Change Technique Taxonomy [20]—suggests that theory-informed intervention design may strengthen psychosocial programs by linking”
From Psychosocial Interventions for Improving Treatment Adherence in Tuberculosis Patients: A Scoping Review of Evidence-Based Approaches. (2026) · cites this paper as [20]
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Rayyan-a web and mobile app for systematic reviews.
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“Similarly, BCT 15.1 (Verbal Persuasion about Capability) and BCT 6.3 (Social/Environmental Conse-quences) contributed to strengthening self-ef fi cacy, altering perceptions of stigma, reframing LTBI as a manageable condition, and making the treatment journey more relatable 34,39,40 .”
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“Structural and psychological support further strengthened the initiation of TPT. BCT 3.2 (Social Support, practical) addressed structural barriers through socioeconomic support, home visits, and accompaniment to health facilities, thereby enhancing physical opportunity 37,44 .”
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“These techniques enhanced psychological capability via treatment literacy while simultaneously reinforcing re fl ective motivation by highlighting the bene fi ts of TPT 9,40,43 .”
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“Despite evidence of its cost-effectiveness and impact on key indicators, the implementation and scale-up of TPT in resource-limited settings has been slow [15,17,18], and while it is increasingly available to PLHIV in high-burden settings, uptake remains low [5,19,20].”
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Metadata
- Authors
- Parwitha, I. A. A., Djunaidy, V. D., Alfian, S. D., Setyowibowo, H., & Pradipta, I. S.
- Affiliations
- Universitas Katolik Widya Mandala Surabaya (ID)
- Padjadjaran University (ID)
- Corresponding author
- Pradipta, Ivan S.
- Venue
- npj Primary Care Respiratory Medicine
- Published
- 2025-09-29
- Volume
- 35
- Issue
- 1
- Pages
- 40-40
- ISSN
- 2055-1010 (ISSN-L)
- PMC
- PMC12480859
- OpenAlex
- W4414601694
- Cited by
- 4
- References
- 44
- Citations by year
- 2026: 3 · 2025: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Primary Care Respiratory Medicine (publishedVersion, cc-by-sa)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Ministry of Higher Education, Science, and Technology of the Republic of Indonesia (1584/UN6.3.1/PT.00/2025)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › HIV, TB, and STIs Epidemiology
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Keywords
- tuberculosis prophylaxis, latent tuberculosis infection, psychosocial interventions, treatment uptake, health education, stigma reduction, community-based intervention, behavior change, tuberculosis elimination
- MeSH terms
- Psychosocial Intervention, Humans, Patient Acceptance of Health Care, Tuberculosis, Latent Tuberculosis, Social Stigma
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