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Updated: Oct 3, 2026

An Automated Culture System for Use in Preclinical Testing of Host-Directed Therapies for Tuberculosis
Published on: August 16, 2021
Bridging Programmatic Gap in Post-TB Treatment Prevention: Applying the COM-B Model and Behavior Change Wheel to
Jonathan Izudi1,2, Christine Sekaggya-Wiltshire3,4, Andrew D Kerkhoff5
1Directorate of Graduate Training, Research and Innovation, Muni University, Arua, Uganda.
Abstract:
Uganda's National Tuberculosis and Leprosy Program (NTP) recommends tuberculosis preventive therapy (TPT) immediately after TB treatment completion (hereafter post-TB treatment TPT or PTT-TPT) for people with retreatment TB, as they are at high risk for recurrent/drug-resistant TB. However, uptake of PTT-TPT is limited. To examine determinants of uptake, identify program-relevant strategies, and improve implementation, we applied a behavioral framework. We used the COM-B model (Capability-Opportunity-Motivation Behavior) to conceptualize the behavioral and health system determinants and the Behavior Change Wheel (BCW) to map the determinants to potential programmatic actions. The COM-B model showed that the low uptake of PTT-TPT reflects interacting limitations in healthcare provider capability, opportunity, and motivation. Based on the BCW, interventions aligned with behavioral drivers could help the NTP and similar settings to integrate PTT-TPT prevention more effectively within routine TB care. In conclusion, addressing the behavioral determinants of PTT-TPT may strengthen uptake.
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