From Research to Practice: Lay Adherence Counsellors?Fidelity to an Evidence-Based Intervention for Promoting Adherence to Antiretroviral Treatment in the Western Cape, South Africa

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• 作者：Sarah Dewing (1)
  Cathy Mathews (1) (2) (6)
  Allanise Cloete (3)
  Nikki Schaay (4)
  Madhvi Shah (5)
  Leickness Simbayi (3) (6)
  Johann Louw (7)
  
• 关键词：Lay counsellor ; Adherence counselling ; Intervention fidelity ; Motivational interviewing
• 刊名：AIDS and Behavior
• 出版年：2013
• 出版时间：November 2013
• 年：2013
• 卷：17
• 期：9
• 页码：2935-2945
• 全文大小：
• 作者单位：Sarah Dewing (1)
  Cathy Mathews (1) (2) (6)
  Allanise Cloete (3)
  Nikki Schaay (4)
  Madhvi Shah (5)
  Leickness Simbayi (3) (6)
  Johann Louw (7)
  
  1. Health Systems Research Unit, Medical Research Council of South Africa, PO Box 19070, Tygerberg, 7505, South Africa
  2. School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
  6. Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
  3. HIV/AIDS, STIs and TB Research Programme, Human Sciences Research Council, Pretoria, South Africa
  4. School of Public Health, University of the Western Cape, Cape Town, South Africa
  5. School of Medicine, Marshall University, Huntington, WV, USA
  7. Department of Psychology, University of Cape Town, Cape Town, South Africa
  
• ISSN：1573-3254

文摘

In the Western Cape, lay counsellors are tasked with supporting antiretroviral (ARV) adherence in public healthcare clinics. Thirty-nine counsellors in 21 Cape Town clinics were trained in Options for Health (Options), an evidence-based intervention based on motivational interviewing (MI). We evaluated counsellors?ability to deliver Options for addressing poor adherence following 5?days training. Audio-recordings of counselling sessions collected following training were transcribed and translated into English. Thirty-five transcripts of sessions conducted by 35 counsellors were analysed for fidelity to the Options protocol, and using the Motivational Interviewing Treatment and Integrity (MITI) code. Counsellors struggled with some of the strategies associated with MI, such as assessing readiness-to-change and facilitating change talk. Overall, counsellors failed to achieve proficiency in the approach of MI according to the MITI. Counsellors were able to negotiate realistic plans for addressing patients?barriers to adherence. Further efforts aimed at strengthening the ARV adherence counselling programme are needed.