Table 4 Overview of the provider training fidelity strategies and monitoring plan for HeLTI SA
Goal | NIH description | Strategies used in HeLTI SA | Fidelity monitoring tools for HeLTI SA |
|---|---|---|---|
Standardize training | Ensure that training is conducted similarly for different providers | - To ensure providers meet similar a priori criteria and detailed job descriptions are used to recruit health helpers. - Health helpers are trained following their recruitment, in small groups [4, 5], by a core group of trainers. - A detailed training manual with materials is used for training. - HCS training includes role-playing, and the training team was trained by a developer. | - Training session includes a before/after evaluation of skills. - Regular debriefs are held with HHs. |
Ensure provider skill acquisition | Train providers to well-defined performance criteria | - Follow-up training on HCS was provided for the HeLTI SA trainers. - Regular problem-solving and debriefing sessions in the form of team meetings. - Certification is not necessary in the South African setting | - Criteria for intervention adherence (Additional file 1) are used to evaluate the intervention and control sessions, generating a score. - Training session includes a before/after evaluation of skills. |
Minimize “drift” in provider skills | Ensure that provider skills do not decay over time | - Refresher training for HCS is provided at a standardized time since recruitment. - The project coordinator and researcher are available to provide support and assistance with questions, emergencies, or triggered safety protocols. - Weekly debrief sessions are held, during which questions and concerns can be addressed. | - Observations and review of the recorded sessions are included as a part of the intervention process evaluation. - Qualitative methods are used as part of the process evaluation to assess the participants’ and health helpers’ perceptions of intervention delivery. |
Accommodate provider differences | Ensure an adequate level of training in providers of differing skill levels, experiences, or professional backgrounds. | - Consistency in the delivery of intervention components is encouraged and trained. - Strengths of different providers are shared within teams to enhance delivery. | - Observations and review of the recorded sessions are included as a part of the intervention process evaluation. |