Disclaimer: The activities in this document are intended for example purposes only. The actual activities implemented as part of TB program evaluation should 

be identified by TB program officials in collaboration with other stakeholders. The example provided here is not intended to be applied directly to any TB 

program.

1

DTBE Evaluation Plan and Annual Report Example

Program Evaluation Topic/Focus Area:

Identify Factors Related to Patient Completion of Treatment for Latent Tuberculosis Infection

Planned Start Date: October 1, 2020 Planned Completion Date: August 1, 2021

Part A: Evaluation Plan (Please update as necessary when submitting annual report.)

Background, Rationale, and Expected Outcome

Please provide a background, purpose or rationale (what activity or program component are you evaluating, and why have you chosen that

particular activity or program component to evaluate) and expected outcome of your project.

Background and Rationale: 

Scenario: Completing treatment among patients with latent tuberculosis infection (LTBI) is needed to prevent development of active tuberculosis 

(TB) disease; and promote progress towards TB elimination. Despite these important goals, over the past 3 years our program has not been 

making progress towards meeting the 2025 national target of at least 93% of contacts to sputum acid-fast bacilli smear-positive TB patients newly 

diagnosed with LTBI completing treatment. While almost all patients with LTBI begin treatment, a third do not complete treatment. 

Understanding why this occurs will assist in designing interventions that promote completion of treatment among persons with LTBI.

Long Term Goal: Meet the 2025 National Performance Target (93%) of patients with newly diagnosed TB disease who complete treatment within 

12 months among those who are eligible to complete treatment within 12 months.

Expected Outcomes\Short Term Goals

Identify factors affecting success or failure to complete treatment among patients with LTBI. Using this information, the TB program will design 

and implement a plan that addresses these factors.

Objectives

Please provide 1 or more objectives for each goal of the evaluation topic. Objectives should be Specific, Measurable, Achievable, Realistic, and 

Time-bound (SMART). Each objective must have at least 1 Evaluation Question.

1. Identify facilitators, barriers, and potential solutions to barriers expressed by patients in complying with LTBI treatment during October 1,

2020–May 1, 2021.

2. Identify facilitators, barriers, and potential solutions to barriers expressed by public health staff in promoting completion of LTBI treatment 

during October 1, 2020–May 1, 2021.

3. Identify characteristics of patients succeeding or failing to comply with LTBI treatment during October 1, 2020–May 1, 2021.
Disclaimer: The activities in this document are intended for example purposes only. The actual activities implemented as part of TB program evaluation should 

be identified by TB program officials in collaboration with other stakeholders. The example provided here is not intended to be applied directly to any TB 

program.

2

4. Identify public health system factors that might be related to patients succeeding or failing to comply with LTBI treatment and possible 

solutions to barriers during October 1, 2020–May 1, 2021.

Corresponding National Tuberculosis Indicator Project Indicator, if Applicable, or Relation to Scope of Work as Stated in the 

Cooperative Agreement with the Centers for Disease Control and Prevention

Program evaluation should ideally reflect the National Tuberculosis Indicator Project (NTIP). Please specify the NTIP indicator addressed by this 

evaluation. If the evaluation is not linked to an NTIP indicator, please provide an explanation regarding how the evaluation relates to the scope of 

work in your cooperative agreement with the Centers for Disease Control and Prevention (CDC).

Contact Investigations: LTBI Completion of Treatment

Examination of Immigrants and Refugees: Completion of LTBI treatment among contacts of persons with LTBI

Evaluation Plan Questions, Indicators, Analysis, and Timeline

Evaluation Question Measure Data Source Method of Analysis Target

Timeline/Persons

Responsible

1. Each evaluation

question or activity

must correspond to 

an objective

1.1 Each evaluation

question should 

have its own 

deliverable

1.2 Having multiple 

deliverables per 

question is 

permissible

1.1. Each deliverable

needs a data 

source

1.1 Each deliverable 

should have a way 

to be calculated or 

measured

objectively

1.1. How will you 

know your 

deliverable was 

met?

1.1 What is your 

anticipated 

timeline and who 

is responsible for 

different aspects 

of the evaluation?

1. What are 

facilitators, barriers,

and potential 

solutions to barriers 

expressed by 

patients in 

complying with

LTBI treatment?

75% of LTBI 

patients will identify 

facilitators, barriers,

and potential 

solutions to barriers

Medical records of 

LTBI patients 

receiving treatment 

during November 1, 

2020–May 1, 2021

Each patient will be 

asked by nursing staff 

about facilitators,

barriers, and potential 

solutions to barriers

during ≥2 treatment 

sessions

75% of all LTBI 

patients receiving 

treatment during

November 1, 2020–

May 1, 2021, will be

asked to identify

facilitators, barriers,

and potential solutions 

to barriers to 

treatment

Develop questions, a 

database for 

responses, and 

instruct nurses:

October 1–November 

1, 2020

Data collection: 

November 1, 2020–

May 1, 2021

Analysis: May 1–July 

1, 2021

2. What are 

facilitators, barriers,

90% of health care 

staff identify and

Health care staff 

conducting 

Each health care staff 

member will complete 

90% of health care 

staff will identify and 

Develop questions, 

database for 
Disclaimer: The activities in this document are intended for example purposes only. The actual activities implemented as part of TB program evaluation should 

be identified by TB program officials in collaboration with other stakeholders. The example provided here is not intended to be applied directly to any TB 

program.

3

and potential 

solutions to barriers 

expressed by public 

health staff in 

promoting 

completion of LTBI 

treatment?

record facilitators, 

barriers, and 

potential solutions to 

barriers to patient 

adherence with LTBI 

treatment

examinations, 

administering 

medication, or 

overseeing directly 

observed treatment 

(DOT) or electronic 

DOT (eDOT) to LTBI 

patients November 1, 

2020–May 1, 2021

a questionnaire 

regarding facilitators, 

barriers, and possible 

solutions to barriers

during November 1, 

2020–May 1, 2021

record facilitators and 

barriers to providing 

treatment

responses: October 1-

November 1, 2020

Data collection:

November 1, 2020–

May 31, 2021

Analysis: June 1–

August 1, 2021

3. What are patient 

characteristics 

among those 

succeeding or

failing to comply 

with LTBI

treatment?

Using the electronic 

surveillance system, 

review 50% of

patients receiving 

treatment for LTBI 

November 1, 2020–

May 1, 2021, and

record treatment 

adherence and

selected variables

Electronic 

surveillance system

The TB coordinator 

will conduct a review 

by using the electronic 

surveillance system

for a random sample 

of 50% of eligible 

patients (patients 

receiving LTBI 

treatment during

November 1, 2020–

May 1, 2021)

75% of eligible 

patients will have 

variables extracted 

and recorded

Select primary and 

secondary variables:

October 1–November 

1, 2020

Develop database to 

input abstracted data:

November 1–

December 1, 2020

Records review and 

abstraction:

May 1–June 1, 2021

Analysis: June 1–July 

1, 2021

4. What public health 

system factors do 

clinic 

administrative and 

management staff 

express as affecting

whether patients 

succeed or fail to 

complete LTBI 

treatment, and what 

solutions to possible 

barriers to LTBI 

Staff involved in 

clinic administration 

or management will 

participate in a 

structured meeting to 

discuss analyses and 

brainstorm about

related health system 

factors affecting

LTBI treatment 

completion and 

strategies for

Structured meeting Clinic administrative 

and management staff 

will discuss perceived 

facilitators, barriers,

and potential solutions 

to barriers to LTBI 

treatment completion

At least four staff 

involved in clinic 

administration or 

management will 

participate in the 

structured meeting

Develop structured 

meeting questions:

May 1–July 1, 2021

Conduct meeting:

July 1–15, 2021

Write up meeting 

summary:

July 15–August 1, 

2021
Disclaimer: The activities in this document are intended for example purposes only. The actual activities implemented as part of TB program evaluation should 

be identified by TB program officials in collaboration with other stakeholders. The example provided here is not intended to be applied directly to any TB 

program.

4

treatment 

completion are 

expressed?

addressing those 

factors

Part B: Evaluation Findings and Conclusions (This section should be updated with submission of the annual report,

if new findings are available, when the evaluation is complete.)

Is this a final report of a completed evaluation or an interim report of an ongoing evaluation? Final

Evaluation Findings

Evaluation Question or Indicator Outcomes (Listed results are by evaluation question and per NTIP indicator, if 

appropriate.)

Benchmark

Met or Not Met

1. What facilitators, barriers, and possible solutions to barriers were expressed by patients in complying with treatment for 

LTBI?

20 eligible patients; 19 interviewed

Facilitators

Being given a bus pass (expressed by 10 patients); later clinic hours (5 patients); Sunday clinic hours (2 patients)

Barriers

Cannot easily walk to the bus; clinic not open evenings

Possible Solutions to Barriers

eDOT; evening clinic hours

Met — 90% of 

patients asked about 

barriers and 

facilitators

2. What facilitators, barriers, and possible solutions were expressed by public health staff in promoting completion of 

LTBI treatment?

10 eligible staff; 7 interviewed.

Facilitators

Calling patients who are late to remind them (4 nurses); having a regular schedule so that staff can develop a relationship 

with the patients (2 respondents)

Barriers

Constantly being assigned to different areas of the public health clinic so that staff do not develop a relationship with

patients (3 respondents); too little time allotted for visits so that staff are unable to have a meaningful conversation with 

the patient receiving DOT (2 respondents)

Possible Solutions to Barriers

Nursing managers improve consistent assignment of staff, increase time allotted to visits by 5 minutes each, and 

development of prompting questions that can guide health care staff in identifying patients’ barriers to treatment 

completion

Not met — 70% of 

eligible staff 

interviewed instead of 

90% because of staff 

turnover
Disclaimer: The activities in this document are intended for example purposes only. The actual activities implemented as part of TB program evaluation should 

be identified by TB program officials in collaboration with other stakeholders. The example provided here is not intended to be applied directly to any TB 

program.

5

3. What are patient characteristics among those succeeding or failing to adhere with the LTBI treatment regimen?

20 eligible patients; all electronic records reviewed

Characteristics of Adherent Patients (12 Patients)

Ages 30–60 years; ability to speak English fluently; or being US-born

Characteristics of Nonadherentt Patients (8 Patients)

Ages 20–30 years or ≥60 years; being male; not speaking English well; or being homeless for part of the treatment period

Met — all records 

reviewed

4. What public health system factors do clinic administrative and management staff express as affecting whether patients 

succeed or fail to complete LTBI treatment, and what possible solutions to barriers are proposed?

Successful Adherence

Extended clinic hours

Unsusccessful Adherence

Lack of communication with local homeless shelters

Possible Solutions to Barriers

Extend clinic hours; develop association with homeless shelter staff

Met — 5 staff 

participated and 

provided feedback in 

structured meeting

Program Facilitators

What helped facilitate the completion of this evaluation? (This is helpful for other programs who might want to try a similar evaluation.)

Having a timeline and an example to follow

Attending monthly calls with the CDC program evaluation consultant

Organized and up-to-date electronic surveillance records

Program Challenges

What major challenges did you face during this evaluation? (If you did not meet your benchmark, explain why here.)

Not enough time was allotted for the records review and abstraction

Many variables were missing from the records

3 staff were unavailable for interview

Use of Findings

How did you use the findings?

We held a meeting with health care staff and clinic management on August 12, 2021, during which we reviewed all of the findings and discussed 

facilitators, barriers, and possible solutions to barriers. We identified multiple strategies for addressing barriers and expanding facilitators, as 

follows:
Disclaimer: The activities in this document are intended for example purposes only. The actual activities implemented as part of TB program evaluation should 

be identified by TB program officials in collaboration with other stakeholders. The example provided here is not intended to be applied directly to any TB 

program.

6

• Provide a bus pass for all eligible and interested patients (i.e., those expressing difficulty getting to the clinic)

• Extend clinic hours from 5:00 to 6:00 pm each day

• Develop and maintain a contact list of patients and a protocol or follow-up if they are ≥30 minutes late for an appointment

• Decrease shifting of TB staff to other clinic areas during hours when the majority of DOT patients come to the clinic

• Adopt use of culturally and linguistically appropriate materials and use of an alternative language telephone line or other interpreter service

• Establish an association with nearby homeless shelter staff

List of Deliverables and Products, Dissemination Plan

Please provide a list of final deliverables and describe how you plan to disseminate to appropriate stakeholders.

• Include funding for bus passes in the next annual budget (September 2021)

• Revise staffing structure so that the clinic can remain open an additional hour each day (Begins October 2021)

• At next staff meeting, instruct nursing staff to maintain contact sheet for DOT patients and to call them if they are ≥30 minutes late.

• Find and use TB materials in patients’ first language or develop materials in patients’ first language if none are found

• Schedule meeting with director of nearby homeless shelters to discuss areas for collaboration