Lay Counselors' Ability to Deliver Counseling for Behavior Change
Lay Counselors' Ability to Deliver Counseling for Behavior Change
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DOI：
10.1037/a0034659
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发表时间：
2014-02-01
影响因子：
5.9
通讯作者：
Louw, Johann
中科院分区：
文献类型：
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作者：
Dewing, Sarah;Mathews, Cathy;Louw, Johann
目的：健康选择是一项基于动机访谈（MI）的循证性风险降低干预措施。39名抗逆转录病毒治疗依从性非专业顾问接受了培训，以提供健康选择，帮助他们的病人优化他们的抗逆转录病毒治疗依从性。在35小时的培训后，对辅导员提供干预的能力进行了评估，结果显示，辅导员在8步选项方案的要素方面遇到了困难，未能熟练掌握MI。本研究旨在探讨辅导员进修训练与督导对辅导员介入能力的影响。方法：39名辅导员中有22名在12个月的时间内接受了18小时的复习培训和监督。转录、翻译并分析记录，以确保其与选项方案和MI方法的一致性。使用动机访谈治疗完整性工具和研究人员开发的工具进行分析。结果进行了比较，从最初的35小时的培训后立即评估辅导员的表现的调查结果。结果如下：辅导员改善了他们的交付的一些干预措施，但不是其他人;他们使用的微咨询技能和治疗方法的改善程度，他们密切接近MI的方法。结论：本研究提供的证据表明，正在进行的培训和监督的积极影响，外行卫生工作者的做法。虽然辅导员没有达到完全熟练的选项协议，复习培训和监督提高辅导员的基本咨询沟通技巧和治疗方法，使他们能够提供更好的质量咨询的行为改变。
Objective: Options for Health is an evidence-based sexual risk reduction intervention based on motivational interviewing (MI). Thirty- nine antiretroviral adherence lay counselors were trained to deliver Options for Health to help their patients to optimize their antiretroviral treatment adherence. An evaluation of counselors' ability to deliver the intervention after 35 hr of training revealed that counselors struggled with elements of the 8-step Options protocol and failed to achieve proficiency in MI. The current study aimed to determine the impact of refresher training and supervision on counselors' proficiency in the intervention. Method: Audio-recordings of counseling sessions were collected for 22 of 39 counselors after 18 hr of refresher training and supervision had been delivered over a 12-month period. Recordings were transcribed, translated, and analyzed for fidelity to the Options protocol and the MI approach. Analysis was conducted using the Motivational Interviewing Treatment Integrity Tool and an instrument developed by the researchers. Results were compared to findings from an evaluation of counselors' performance immediately following the initial 35-hr training. Results: Counselors improved their delivery of some intervention steps, but not others; their use of micro-counseling skills and therapeutic approach improved to such an extent that they closely approximated the MI approach. Conclusions: This study contributes evidence for the positive impact of ongoing training and supervision on lay health worker practice. Although counselors did not achieve complete proficiency in the Options protocol, refresher training and supervision improved counselors' basic counseling communication skills and therapeutic approach, enabling them to deliver better quality counseling for behavior change.