Evaluating nurses' implementation of an infant-feeding counseling protocol for HIV-infected mothers: The Ban Study in Lilongwe, Malawi.
A process evaluation of nurses' implementation of an infant-feeding counseling protocol was conducted for the Breastfeeding, Antiretroviral and Nutrition (BAN) Study, a prevention of mother-to-child transmission of HIV clinical trial in Lilongwe, Malawi. Six trained nurses counseled HIV-infected mothers to exclusively breastfeed for 24 weeks postpartum and to stop breastfeeding within an additional four weeks. Implementation data were collected via direct observations of 123 infant feeding counseling sessions (30 antenatal and 93 postnatal) and interviews with each nurse. Analysis included calculating a percent adherence to checklists and conducting a content analysis for the observation and interview data. Nurses were implementing the protocol at an average adherence level of 90% or above. Although not detailed in the protocol, nurses appropriately counseled mothers on their actual or intended formula milk usage after weaning. Results indicate that nurses implemented the protocol as designed. Results will help to interpret the BAN Study's outcomes.
Ferguson
Yvonne Owens
YO
University of North Carolina at Chapel Hill, USA. ferguson.yvonne@gmail.com
Eng
Eugenia
E
Bentley
Margaret
M
Sandelowski
Margarete
M
Steckler
Allan
A
Randall-David
Elizabeth
E
Piwoz
Ellen G
EG
Zulu
Cynthia
C
Chasela
Charles
C
Soko
Alice
A
Tembo
Martin
M
Martinson
Francis
F
Tohill
Beth Carlton
BC
Ahmed
Yusuf
Y
Kazembe
Peter
P
Jamieson
Denise J
DJ
van der Horst
Charles
C
Adair
Linda
L
Ahmed
Yusuf
Y
Ait-Khaled
Mounir
M
Albrecht
Sandra
S
Bangdiwala
Shrikant
S
Bayer
Ronald
R
Bentley
Margaret
M
Bramson
Brian
B
Bobrow
Emily
E
Boyle
Nicola
N
Butera
Sal
S
Chasela
Charles
C
Chavula
Charity
C
Chimerang'ambe
Joseph
J
Chigwenembe
Maggie
M
Chikasema
Maria
M
Chikhungu
Norah
N
Chilongozi
David
D
Chiudzu
Grace
G
Chome
Lenesi
L
Cole
Anne
A
Corbett
Amanda
A
Corneli
Amy
A
Duerr
Ann
A
Eliya
Henry
H
Ellington
Sascha
S
Eron
Joseph
J
Farr
Sherry
S
Ferguson
Yvonne Owens
YO
Fiscus
Susan
S
Galvin
Shannon
S
Guay
Laura
L
Heilig
Chad
C
Hoffman
Irving
I
Hooten
Elizabeth
E
Hosseinipour
Mina
M
Hudgens
Michael
M
Hurst
Stacy
S
Hyde
Lisa
L
Jamieson
Denise
D
Joaki
George
G
Jones
David
D
Kacheche
Zebrone
Z
Kamanga
Esmie
E
Kamanga
Gift
G
Kampani
Coxcilly
C
Kamthunzi
Portia
P
Kamwendo
Deborah
D
Kanyama
Cecilia
C
Kashuba
Angela
A
Kathyola
Damson
D
Kayira
Dumbani
D
Kazembe
Peter
P
Knight
Rodney
R
Kourtis
Athena
A
Krysiak
Robert
R
Kumwenda
Jacob
J
Loeliger
Edde
E
Luhanga
Misheck
M
Madhlopa
Victor
V
Majawa
Maganizo
M
Maida
Alice
A
Marcus
Cheryl
C
Martinson
Francis
F
Thoofer
Navdeep
N
Matika
Chrissie
C
Mayers
Douglas
D
Mayuni
Isabel
I
McDonough
Marita
M
Meme
Joyce
J
Merry
Ceppie
C
Mita
Khama
K
Mkomawanthu
Chimwemwe
C
Mndala
Gertrude
G
Mndala
Ibrahim
I
Moses
Agnes
A
Msika
Albans
A
Msungama
Wezi
W
Mtimuni
Beatrice
B
Muita
Jane
J
Mumba
Noel
N
Musis
Bonface
B
Mwansambo
Charles
C
Mwapasa
Gerald
G
Nkhoma
Jacqueline
J
Pendame
Richard
R
Piwoz
Ellen
E
Raines
Byron
B
Ramdas
Zane
Z
Rublein
John
J
Ryan
Mairin
M
Sanne
Ian
I
Sellers
Christopher
C
Shugars
Diane
D
Sichali
Dorothy
D
Snowden
Wendy
W
Soko
Alice
A
Spensley
Allison
A
Steens
Jean-Marc
JM
Tegha
Gerald
G
Tembo
Martin
M
Thomas
Roshan
R
Tien
Hsiao-Chuan
HC
Tohill
Beth
B
van der Horst
Charles
C
Waalberg
Esther
E
Wiener
Jeffrey
J
Wilfert
Cathy
C
Wiyo
Patricia
P
Zgambo
Onnocent
O
Zimba
Chifundo
C
D000328:Adult; D001942:Breast Feeding; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008295:Malawi; D009723:Nurse-Patient Relations; D010353:Patient Education as Topic / Q000379:methods*; D014886:Weaning