A randomized trial co-authored by UW School of Nursing Professor Pamela Kohler evaluated the effectiveness of using patient actors to role-play counseling for PrEP (pre-exposure prophylaxis) services provided to adolescent girls and young women in Kenya – a population disproportionately affected by HIV in the region.
After a two-day training intervention that included adolescent health, PrEP guidelines, values clarification and communication skills, intervention providers role-played with trained actors. Control facilities received standard national training.
“It was important to have a safe space to practice discussions about HIV with young women, so that providers could feel more confident with sensitive topics and ensure that their personal values weren’t negatively affecting young people seeking care,” said Kohler. “The providers were exceptionally receptive to feedback from the actors and their peers.”
At the end of the study, both the intervention and control facilities were assessed using what you might know as “secret shopping” or “mystery shopping.” Trained actors presented to clinics portraying young women requesting PrEP services according to case scripts, then documented their care experiences with study staff. The actors didn’t know whether the facilities they attended had received the training, and the providers did not know they were caring for actors.
The difference in quality of service was substantial.
Providers who had worked with the actors scored better for both adherence to national guidelines and communication skills. The mean quality score was 58.4% at control sites compared with 73.6% at sites where providers had worked with the actors.
That kind of impact could have far-reaching implications for improving HIV prevention not only for adolescent girls and young women in the region but also globally and for other underserved populations in need of PrEP or other health services.
Read the full study, “Patient actor training improves PrEP delivery for adolescent girls and young women in Kenya: a cluster randomized trial.”