Pilot evaluation of a standardized patient actor training intervention to improve HIV care for adolescents and young adults in Kenya

ABSTRACT

Poor retention in HIV care remains a major problem for Adolescents and Young Adults (AYA). A Standardized Patient (SP) clinical training intervention was developed to improve healthcare worker (HCW) “adolescent-friendly” competencies in Kenya. Professional actors were trained to portray HIV-infected AYA according to standardized scripts. HCWs completed a 2-day SP training that included didactic sessions, 7 video-recorded SP encounters, and group debriefing. AYA health experts rated HCWs by reviewing the video recordings. All HCWs (10/10) reported high satisfaction with the intervention and overall improvement in self-rated competency in caring for HIV-infected AYA. Cases were reported to be realistic and relevant by between 7 and 10 of 10 HCWs. The case on disclosure and adherence was rated as most challenging in communication and making medical decisions by HCWs. Areas identified by SPs for improvement by HCWs included allowing patients time to ask questions, and enabling SP to share sensitive information. The overall ICC by experts was low 0.27 (95% CI: −0.79 to 0.95), however, ICCs in assessment of HIV disclosure 0.78 (95% CI: 0.17–0.98), and sexual behavior 0.97 (95% CI: 0.89–0.99) were high. This intervention was acceptable for Kenyan HCWs and improved self-rated competency in caring for HIV-infected AYA.

KEYWORDS:

• Adolescents
• HIV
• healthcare worker competency
• adolescent-friendly services
• standardized patient actors

Acknowledgements

We wish to thank the participants and KNH as well as acknowledge the contributions of our Community Advisory Board and the National AIDS/STI Control Program in reviewing the study materials.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability

Datasets analysed for this manuscript are available upon request.

Additional information

Funding

This work was supported by National Institutes of Health under grant R01 HD085807.