Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103800

Linda L. McCreary, PhD, RN¹, Kathleen F. Norr, MA, PhD¹, Chrissie P. N. Kaponda, PhD, RNM², Ursula Kafulafula, MS, RNM², and Diana N. Jere, MS, RNM². (1) College of Nursing (M/C 802), University of Illinois at Chicago, 845 S. Damen Avenue, Chicago, IL 60612-7350, 312-355-3446, mccreary@uic.edu, (2) Kamuzu College of Nursing, University of Malawi, Private Bag # 1, Lilongwe, Malawi

An HIV-prevention peer group intervention based on the social learning model is being introduced for rural health workers, adults and adolescents in Malawi. Peer groups based on social learning are effective in changing HIV risk behaviors, but no evidence based process evaluation guidelines exist. Peer group interventions differ from didactic learning because they integrate factual content with participatory learning and skill building. Most Malawians are educated in authoritarian classrooms; thus, the peer group approach is novel. To implement a six-session intervention using health workers and community members as volunteer peer group co-leaders, it is essential to build peer leaders' participatory group facilitation skills as well as factual knowledge. We identified specific content and group process elements in the sessions, e.g., participant engagement and expressions of comfort-discomfort. Collaborating with trainers and peer leaders, we developed an observation guide including descriptors for each element. Several iterations of the observation guide were required to achieve ease and reliability of administration. Observers were trained to achieve inter-rater reliability using the guide. The observation guide has been implemented successfully with 29 groups. Observing the groups across the six sessions documents the peer leaders' effectiveness and increased group engagement and participation over time. Documenting peer group process is important for development of volunteers and validating intervention fidelity. Process evaluation builds the evidence base for peer group interventions by documenting the effectiveness of volunteer health workers and community members as peer leaders and the participatory process that occurs in the peer group intervention.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Discuss differences between didactic learning and peer group educational approaches.
• Describe the development of an observation tool for process evaluation of a community based peer education intervention for HIV prevention.
• Identify behavioral indicators of group process associated with an effective peer group HIV prevention intervention.

Keywords: International Health, HIV Interventions

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation