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Experienced HIV prevention group facilitators have a unique perspective on sexual risk reduction interventions; however, their views are rarely reported in the research literature. To address this gap, the authors solicited input from four men and four women who served as facilitators in a randomized controlled trial of HIV risk reduction interventions. During focus groups or individual interviews, these facilitators commented on issues related to facilitation training and supervision, key facilitator characteristics, and challenges associated with intervention delivery. Facilitators reported that they valued training that was specific to the HIV context, the opportunity to observe workshops and to facilitate a mock workshop before facilitating themselves, and ongoing peer supervision. They recognized several important facilitator characteristics, including being open and nonjudgmental, being flexible, and being culturally competent. Finally, facilitators mentioned that facilitating workshops was made more difficult by the many psychosocial problems many low-income participants experienced, and that facilitating workshops with men was more difficult than with women. Observations such as these, provided by experienced facilitators, can help to improve intervention training and delivery, and may increase the likelihood that interventions will be adopted in community settings. [ABSTRACT FROM PUBLISHER]

Background: While Motivational Interviewing (MI) is effective in reducing client problem behaviours, including health-related behaviours, there is little evidence about how MI training enhances practitioner skills. Aims: The current pilot study addressed this lack by training two health practitioners (Diabetes Nurse Educators) in MI, and evaluated the effect of MI training on both practitioner and patient behaviour when MI was delivered in a clinical settting, with patients experiencing difficultieswith diabetes self-management. Methods: Comparisons were made between the practitioners' skills in a baseline condition (Patient Education; PE) and after training in Motivational Enhancement Therapy (MET), a four-session form of MI. At the same time, the effects of the two interventions on patient in-session behaviour were compared. Practitioner and patient data were obtained from transcripts of all PE and MET sessions, which were independently coded using Motivational Interviewing Skills Code therapist and client behaviour counts. Results: Compared with their baseline performance, practitioners, when trained to practice MET, behaved in ways consistent with MI, and this appears to have evoked beneficial in-session behaviour from the patients. Conclusions: These results suggest that the MI training was effective. [ABSTRACT FROM AUTHOR]

Abstract: Motivational interviewing is an empirically supported treatment for drug and alcohol problems. Training in this approach is very popular, although previous studies have identified that the acquisition of key skills is challenging and that postworkshop supervision inputs are helpful. This pilot trial investigated the training of adolescent drug treatment practitioners, comparing a group who received immediate training against a delayed training study condition. Training and supervision were found to have no impact upon skill levels as measured by the Motivational Interviewing Treatment Integrity Version 2, with the exception of a very specific effect on motivational interviewing spirit. Motivational interviewing was not easy to learn for these practitioners. Progress made indicates the importance of ongoing supervision, and for high level skill acquisition to occur requires more intensive support of learning from ongoing practice than was used here. [Copyright &y& Elsevier]

Background: Preventable maternal and newborn deaths can be averted through simple evidence-based interventions, such as the use of community health workers (CHWs), also known in Uganda as village health teams. However, the CHW strategy faces implementation challenges regarding training packages, supervision, and motivation. Objectives: This paper explores knowledge levels of CHWs, describes the coverage of home visits, and shares lessons learnt from setting up and implementing the CHW strategy. Methods: The CHWs were trained to conduct four home visits: two during pregnancy and two after delivery. The aim of the visits was to promote birth preparedness and utilization of maternal and newborn health (MNH) services. Mixed methods of data collection were employed. Quantitative data were analyzed using Stata version 13.0 to determine the level and predictors of CHW knowledge of MNH. Qualitative data from 10 key informants and 15 CHW interviews were thematically analyzed to assess the implementation experiences. Results: CHWs’ knowledge of MNH improved from 41.3% to 77.4% after training, and to 79.9% 1 year post-training. However, knowledge of newborn danger signs declined from 85.5% after training to 58.9% 1 year later. The main predictors of CHW knowledge were age (≥ 35 years) and post-primary level of education. The level of coverage of at least one CHW visit to pregnant and newly delivered mothers was 57.3%. Notably, CHW reports complemented the facility-based health information. CHWs formed associations, which improved teamwork, reporting, and general performance, and thus maintained low dropout rates at 3.6%. Challenges included dissatisfaction with the quarterly transport refund of 6 USD and lack of means of transportation such as bicycles. Conclusions: CHWs are an important resource in community-based health information and improving demand for MNH services. However, the CHW training and supervision models require strengthening for improved performance. Local solutions regarding CHW motivation are necessary for sustainability. [ABSTRACT FROM PUBLISHER]