TABLE 5-1 Best-Practice Domains and Recommendations of the National Institutes of Health’s Behavior Change Consortium

Goals Strategies
Domain: Provider training
  • Standardize training for all provider types
  • Ensure the acquisition of provider skills
  • Identify and have processes to minimize “competency drift” in provider skills
  • Accommodate differences in providers’ backgrounds with respect to skill expectations and roles
  • Use standardized training manuals, materials, resources, field guides, structured practice and role playing; standardized patients; same instructors/supervisors; video training
  • Observe implementation of interventions with standardized patients or role playing; score providers according to a checklist; conduct debriefings; administer written pre- and posttraining examinations; certify skills during and after training
  • Conduct booster sessions; conduct in vivo observations scored against a standard checklist; supervise; obtain provider self-reports; conduct patient exit interviews or obtain feedback
  • Have certified or established professional supervisors for provider training; monitor patient dropouts and treatment effectiveness
Domain: Delivery of treatment
  • Control for provider variability
  • Reduce ineffective variation within treatments
  • Ensure adherence to evidence-based treatment protocols
  • Assess patient perceptions of providers through questionnaires, and give feedback to providers; audiotape sessions, and have different supervisors review; monitor patient complaints; have providers work with all treatment populations served
  • Use scripted protocols, treatment manual; have supervisors rate audiotapes, videotapes
  • Audiotape or videotape encounters, and review with providers; randomly monitor audio or videotapes for adherence to protocols; have providers complete a checklist of intervention components
Domain: Receipt of treatment and enactment of treatment skills
  • Ensure patients’ comprehension and acquisition of skills
  • Ensure patients’ ability to perform new skills
  • Have providers review participants’ homework, self-monitoring logs; assess, measure participants’ performance; have structured interviews with patients; use questionnaires; use hypothetical scenarios to test patients
  • Collect patient self-monitoring, self-report data; use behavioral outcome measures

SOURCE: Adapted from Bellg et al., 2004.

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