From research to practice: lay adherence counsellors' fidellity to an evidence-based intervention for promoting adherence to antiretroviral treatment in the Western Cape, South Africa

SOURCE: AIDS and Behavior
OUTPUT TYPE: Journal Article
PUBLICATION YEAR: 2013
TITLE AUTHOR(S): S.Dewing, C.Mathews, A.Cloete, N.Schaay, M.Shah, L.Simbayi, J.Louw
KEYWORDS: ANTIRETROVIRAL THERAPY, COUNSELLING SERVICES, HIV TESTING AND COUNSELLING (HTC), PRIMARY HEALTH CARE, WESTERN CAPE PROVINCE
DEPARTMENT: HIV/AIDS, STIs and TB (HAST)
Print: HSRC Library: shelf number 7790

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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.