Improving Quality of PrEP Counseling for Adolescent Girls and Young Women in Kenya With Standardized Patient Actors: A Dose-Response Analysis.
Improving Quality of PrEP Counseling for Adolescent Girls and Young Women in Kenya With Standardized Patient Actors: A Dose-Response Analysis.
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DOI：
10.1097/qai.0000000000002814
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发表时间：
2022-01-01
期刊：
影响因子：
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通讯作者：
Kohler P
中科院分区：
文献类型：
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作者：
Larsen A;Abuna F;Owiti G;Kemunto V;Sila J;Wilson KS;Owens T;Pintye J;Richardson BA;Kinuthia J;John-Stewart G;Kohler P
使用标准化患者参与者（SP）进行卫生保健工作者（HCW）培训是一种基于证据的方法，可改善患者与提供者的互动。我们评估了肯尼亚西部HCW中的SP培训是否提高了青春期女孩和年轻女性（AGYW）的PrEP咨询质量。我们在为AGYW提供PrEP咨询的HCW中进行了为期2天的SP培训干预。六名经过培训的SP按照描述常见PrEP寻求场景的脚本与HCW进行角色扮演。SP使用检查表报告和讨论遵守国家PrEP指南，沟通和人际交往技能的领域，每次见面后使用验证的量表。HCW以随机顺序呈现给每个病例。总体和特定领域的平均得分百分比进行了比较之间的第一次和随后的情况下，使用广义线性模型，聚类HCW。在94名HCW中的564例培训病例中，PrEP咨询评分的总体平均质量为83.1（标准差[SD]：10.1）;评分在6次会面的过程中有所改善（p<0.001）。与第一个病例相比，第四个病例的平均得分显著更高（79.1 vs. 85.9，p<0.001）。从第4例到第6例，平均评分趋于稳定（85.2）。虽然HCW表现出较高的基线沟通（95.3）和人际交往能力（83.7），但基线时对PrEP指南的依从性并不理想（57.6）。到第4例时，所有领域的评分均显着增加（p<0.001）。SP培训改善了PrEP咨询整体和人际交往技能，使用指南，并与AGYW沟通的领域，并可能有助于提高AGYW的PrEP咨询质量。
Health care worker (HCW) training using standardized patient actors (SPs) is an evidence-based approach for improving patient-provider interactions. We evaluated whether SP training among HCWs in Western Kenya improved quality of PrEP counseling for adolescent girls and young women (AGYW). We conducted a 2-day SP training intervention among HCWs providing PrEP counseling for AGYW. Six trained SPs role-played one encounter each with HCWs following scripts depicting common PrEP-seeking scenarios. SPs used checklists to report and discuss domains of adherence to national PrEP guidelines, communication, and interpersonal skills using validated scales after each encounter. HCWs presented to each case in random order. Overall and domain-specific mean score percentages were compared between the first and subsequent case encounters using generalized linear models, clustering by HCW. During 564 training cases among 94 HCW, the overall mean quality of PrEP counseling score was 83.1 (standard deviation [SD]:10.1); scores improved over the course of the 6 encounters (p<0.001). Compared to the first case encounter, mean scores for the fourth were significantly higher (79.1 vs. 85.9, p<0.001). Mean scores plateaued from the fourth to the sixth case (85.2). While HCWs demonstrated high baseline communication (95.3) and interpersonal skills (83.7), adherence to PrEP guidelines at baseline was suboptimal (57.6). By the 4th case, scores increased significantly (p<0.001) for all domains. SP training improved PrEP counseling overall and in domains of interpersonal skills, use of guidelines, and communication with AGYW and could be useful in efforts to improve quality of PrEP counseling for AGYW.