Grants and Research Committee Abstract Annotation – November 2013

By Cate Nicholas 

Article Title: Development and Pilot Testing of a Standardized Training Program for a Patient-Mentoring Intervention to Increase Adherence to Outpatient HIV Care

Review Author(s): Jeffrey A. Cully, Joseph Mignogna, Melinda A. Stanley, Jessica Davila, Jackie Wear, K. Rivet Amico, and Thomas P. Giordano.

Journal: AIDS Patient Care STDS

Published:
March 2012, 26(3): 165-172. doi:10.1089/apc.2011.0248.
Volume: 26 Issue 3: February 29, 2012
Year:
(Online Ahead of Print) January 16, 2012

Introduction
The current study sought to describe and test the feasibility of a standardized peer-mentor training program used for MAPPS (Mentor Approach for Promoting Patient Self-Care), a study designed to increase engagement and attendance at HIV outpatient visits among high-risk HIV inpatients using HIV-positive peer interventionists to deliver a comprehensive behavioral change intervention.

Annotation
Development of MAPPS and its corresponding training program included collaborations with mentors from a standing outpatient mentor program. The final training program included (1) a half-day workshop; (2) practice role-plays; and (3) formal, standardized patient role-plays, using trained actors with “real-time” video observation (and ratings from trainers). Mentor training occurred over a 6-week period and required demonstration of adherence and skill as rated by MAPPS trainers.

Key Findings
 Although time intensive, ultimate certification of mentors suggested the program was both feasible and effective. Survey data indicated mentors thought highly of the training program, while objective rating data from trainers indicated mentors were able to understand and display standards associated with intervention fidelity. Data from the MAPPS training program provide preliminary evidence that peer mentors can be trained to levels necessary to ensure intervention fidelity, even within moderately complex behavioral-change interventions. Although additional research is needed due to limitations of the current study (e.g., limited generalizability due to sample size and limited breadth of clinical training opportunities), data from the current trial suggest that training programs such as MAPPS appear both feasible and effective.

Strengths
This is an example of the expanding role of SP methodology; one where the method is used in the patient advocacy role.  I believe we will see more programs like this where SPs work to educate patients in becoming better health care consumers and improve health literacy.  I think there is a role for the SP community to begin to develop best practices through engaging the patients, family and communities that are touched by the problems addressed through these programs.  As quoted in this study:

Patient mentors provide support, HIV-specific knowledge and knowledge about how to effectively navigate the health care system. In addition, they represent a real-life example of a person who has successfully faced similar life situations and now is living a full and healthy life, overcoming barriers associated with HIV to an improved life. Recent qualitative research, based on the interviews of patient-mentors across the United States, described the numerous supportive activities provided by patient mentors categorized into four domains: informational support (e.g., providing information on how to manage side-effects), emotional support (e.g., instilling hope), affiliation support (e.g., connecting clients with support groups), and instrumental support (e.g., providing assistance to clients in obtaining child care).  Serving as a patient mentor is a formidable challenge, considering that mentors are asked to serve in the role of a supportive and knowledgeable guide charged with motivating and assisting patients who are often skeptical of health care systems. In addition, few patient mentors, especially volunteer patient mentors, have formal training in behavioral-change theory or strategies.”

I would also recommend the following article which highlights the use simulation techniques for a parent education program for children with Type 1 Diabetes. Both articles are good examples of best practices in SP education.

Title: Development and Pilot Testing of a Parent Education Intervention for Type 1 Diabetes: Parent Education through Simulation
Authors: Susan Sullivan Boyle, Carol Bova, Mary Lee and Kimberly Johnson
Journal/ Year: The Diabetes Educator, 2012, 38, Jan 2012

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