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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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
Springer Verlag
Abstract
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.
Description
Keywords
Lay counsellor, Adherence counselling, Intervention fidelity, Motivational interviewing
Citation
Dewing, S. et al. (2013). 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. AIDS and Behaviour, 17 (9): 2935–2945