DOI : https://doi.org/10.56338/mppki.v9i10.10172

Association of Structured Self-Talk Intervention Assignment with Short-Term Tuberculosis Medication Adherence: A Sequential Quantitative Study

Tiwik Eriskawati (1), Chatarina Umbul Wahyuni (2), Joko Prasetyo (3), Agustin Widyowati (4)
(1) Doctor of Public Health Program, Universitas STRADA Indonesia, Jawa Timur
(2) Doctor of Public Health Program, Universitas STRADA Indonesia, Jawa Timur
(3) Doctor of Public Health Program, Universitas STRADA Indonesia, Jawa Timur
(4) Doctor of Public Health Program, Universitas STRADA Indonesia, Jawa Timur
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Eriskawati, T., Chatarina Umbul Wahyuni, Joko Prasetyo, & Agustin Widyowati. (2026). Association of Structured Self-Talk Intervention Assignment with Short-Term Tuberculosis Medication Adherence: A Sequential Quantitative Study . Media Publikasi Promosi Kesehatan Indonesia, 9(10), 1779–1792. https://doi.org/10.56338/mppki.v9i10.10172
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Introduction: Tuberculosis (TB) treatment requires sustained medication use, but adherence can be influenced by cognitive, psychosocial, and healthcare-related factors. Evidence on structured self-talk for supporting TB medication adherence remains limited. This study examined factors associated with adherence and whether assignment to the structured self-talk intervention was associated with short-term improvement in self-reported adherence.


Methods: A sequential quantitative design was used. Phase I included 117 patients with pulmonary TB in a cross-sectional study assessing TB knowledge, access to health facilities, self-efficacy, and family support. Phase II used a quasi-experimental pretest–posttest control-group design with 68 patients. Participants were allocated according to clinic attendance schedules. The structured self-talk intervention involved twice-weekly practice for 4 weeks. Phase I data were analysed using Spearman's rank correlation and binary logistic regression. Between-group changes in the study-specific modified 11-item medication adherence scores in Phase II were compared using the Mann–Whitney U test; ANCOVA was used for the adjusted analysis.


Results: In Phase I, TB knowledge, access to health facilities, self-efficacy, and family support were positively associated with medication adherence in bivariate analyses (all p < 0.001). After adjustment, only self-efficacy (OR = 2.34; 95% CI: 1.41–3.89) and family support (OR = 3.97; 95% CI: 2.16–7.31) remained significantly associated with good adherence. In Phase II, the primary non-parametric between-group analysis showed a Hodges–Lehmann location shift of 3.00 points (95% CI: 2.00–4.00; p < 0.001). ANCOVA yielded an adjusted between-group coefficient of 3.08 points for the post-intervention study-specific modified 11-item medication adherence score (95% CI: 1.85–4.31; p < 0.001).


Conclusion: Cognitive, psychosocial, and contextual factors were associated with TB medication adherence. Assignment to the structured self-talk intervention was associated with greater short-term improvement in self-reported adherence. However, interpretation should consider the non-randomised design, self-reported outcome measurement, and short follow-up period. Randomised studies with longer follow-up and objective adherence measures are warranted.

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