Assessing peer advisor intervention fidelity using video skits in a peer support implementation trial.

Area of Science:

• Community Health
• Health Behavior Interventions
• Diabetes Management

Background:

• Assessing intervention fidelity in community-based programs with lay health workers, or community health workers (CHWs), is challenging due to unobserved peer-client interactions.
• Rural populations with low literacy present unique contexts for health interventions, requiring culturally appropriate assessment tools.

Purpose of the Study:

• To develop and evaluate a video assessment tool measuring participant perceptions of peer-client interactions in a diabetes intervention.
• To examine the association between the video assessment tool and traditional questionnaire-derived measures of counseling style and goal setting.

Main Methods:

• A community-based randomized controlled trial in rural Alabama was used.
• A video assessment tool with four skits (directive vs. nondirective counseling, specific vs. general goals) was developed.
• 102 participants evaluated their peer advisor's similarity to the skits and completed questionnaire-derived measures.

Main Results:

• 44% of participants identified their peer advisor as using a nondirective counseling style based on the video skits.
• 42% of participants identified their peer advisor as setting specific goals based on the video skits.
• No statistically significant relationship was found between video skit selection and questionnaire-derived measures.

Conclusions:

• The video assessment tool was feasible for evaluating participant perceptions of CHW interactions.
• Discrepancies between video and questionnaire assessments suggest different insights are captured.
• Further validation is needed to understand and reconcile differences between these assessment methods.