{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:58:10Z","timestamp":1790776690256,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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.<\/jats:p>","DOI":"10.1093\/ofid\/ofag601","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T19:17:32Z","timestamp":1789672652000},"source":"Crossref","is-referenced-by-count":0,"title":["Bridging Programmatic Gap in Post-TB Treatment Prevention: Applying the COM-B Model and Behavior Change Wheel to Improve the Uptake of TB Preventive Therapy"],"prefix":"10.1093","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9065-0389","authenticated-orcid":false,"given":"Jonathan","family":"Izudi","sequence":"first","affiliation":[{"name":"Directorate of Graduate Training, Research and Innovation, Muni University , Arua ,","place":["Uganda"]},{"name":"Department of Community Health, Mbarara University of Science and Technology , Mbarara ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9247-2950","authenticated-orcid":false,"given":"Christine","family":"Sekaggya-Wiltshire","sequence":"additional","affiliation":[{"name":"Makerere University Infectious Diseases Institute Department of Research, , Kampala ,","place":["Uganda"]},{"name":"Mulago National Referral and Specialized Hospital Department of Internal Medicine, , Kampala ,","place":["Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5023-6658","authenticated-orcid":false,"given":"Andrew D","family":"Kerkhoff","sequence":"additional","affiliation":[{"name":"Center for Tuberculosis, Institute for Global Health Sciences, University of California San Francisco , San Francisco, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6553-2601","authenticated-orcid":false,"given":"Adithya","family":"Cattamanchi","sequence":"additional","affiliation":[{"name":"Center for Tuberculosis, Institute for Global Health Sciences, University of California San Francisco , San Francisco, California ,","place":["USA"]},{"name":"Division of Pulmonary Diseases and Critical Care Medicine, University of California Irvine , Irvine, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"2026093009165348400_ofag601-B1","doi-asserted-by":"crossref","first-page":"e1080","DOI":"10.1016\/S2214-109X(17)30372-8","article-title":"Effect of isoniazid preventive therapy on risk of death in west African, HIV-infected adults with high CD4 cell counts: long-term follow-up of the temprano ANRS 12136 trial","volume":"5","author":"Badje","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2026093009165348400_ofag601-B2","doi-asserted-by":"crossref","first-page":"e0330208","DOI":"10.1371\/journal.pone.0330208","article-title":"Effectiveness of tuberculosis preventive treatment on disease incidence among people living with HIV\/AIDS: a systematic review and meta-analysis","volume":"20","author":"Silva J\u00fanior","year":"2025","journal-title":"PLoS One"},{"key":"2026093009165348400_ofag601-B3","volume-title":"WHO Operational handbook on tuberculosis. Module 1: prevention - tuberculosis preventive treatment","author":"World Health Organization","year":"2024","edition":"2nd ed"},{"key":"2026093009165348400_ofag601-B4","volume-title":"Consolidated guidelines for the prevention and treatment of HIV and AIDS in Uganda","author":"Republic of Uganda","year":"2022"},{"key":"2026093009165348400_ofag601-B5","doi-asserted-by":"crossref","first-page":"4","DOI":"10.5588\/pha.22.0047","article-title":"Increase in rifampicin resistance among people previously treated for TB","volume":"13","author":"Izudi","year":"2023","journal-title":"Public Health Action"},{"key":"2026093009165348400_ofag601-B6","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/tmi.13489","article-title":"Rifampicin resistance among Mycobacterium tuberculosis-infected individuals using GeneXpert MTB\/RIF ultra: a hospital-based study","volume":"26","author":"Kouemo Motse","year":"2021","journal-title":"Trop Med Int 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Mozambique","volume":"32","author":"Templin","year":"2026","journal-title":"Emerg Infect Dis"},{"key":"2026093009165348400_ofag601-B10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5588\/pha.20.0005","article-title":"Tuberculosis preventive therapy uptake barriers: what are the low-lying fruits to surmount this?","volume":"10","author":"Masini","year":"2020","journal-title":"Public Health Action"},{"key":"2026093009165348400_ofag601-B11","doi-asserted-by":"crossref","first-page":"e002802","DOI":"10.1136\/bmjresp-2024-002802","article-title":"Health system-related barriers and facilitators to tuberculosis preventive treatment: a qualitative case study comparing implementation in the Republic of Moldova and Georgia","volume":"12","author":"Mkrtchyan","year":"2025","journal-title":"BMJ Open Respir Res"},{"key":"2026093009165348400_ofag601-B12","doi-asserted-by":"crossref","first-page":"303","DOI":"10.3390\/tropicalmed10110303","article-title":"Tuberculosis preventive treatment 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