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Table 4 Selected examples of determinants, theoretical methods, and delivery for the four program components

From: Development of a theory and evidence-based program to promote community treatment of fevers in children under five in a rural district in Southern Ghana: An intervention mapping approach

Determinants (Theory Based Change Methods and Messages)

Program Materials, Practical Applications, and Delivery

Community Introductions (Durbars)

Videotaped Drama

Audiotape

Mobile Van

CHW training and protocol

Health Care Provider Orientation

PARENTS AND CAREGIVERS COMPONENTS

 

Perceived Severity (Role Models, Persuasion, Instruction: fever can be a sign of severe illness – malaria and pneumonia and other illnesses)

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Attitudes (Modeling, arguments, persuasion: Take a child with fever immediately to the CHW. This can keep your child from dying).

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Subjective Norms (Role models, Persuasion: Husbands encourage your wives to take child with fever to CHW promptly)

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Knowledge (Modeling, information: CHWs are friendly)

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Perceived behavioral control/Skills What to do and how to do it (Modeling, information: Sponge child with fever, give paracetamol (if available) and take child immediately to CHW)

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Reinforcement (modeling, vicarious reinforcement, feedback: New drug from CHW is powerful, and it is free. friends and neighbors take child with fever to CHW for treatment)

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COMMUNITY MEMBERS

 

Perceived Severity (Role Models, Persuasion, Instruction: fever can be a sign of severe illness – malaria, pneumonia and other illnesses)

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Attitudes (Modeling, arguments, persuasion: family members and neighbours encourage /support caregivers to take child with fever to CHW)

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Reinforcement (modeling, vicarious reinforcement, persuasion: CHWs work is voluntary, please show appreciation for services)

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COMMUNITY HEALTH WORKERS

 

Reinforcement (Modeling, instruction: Sequence of CHW being appropriate with rewarding behaviour)

 

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Outcome Expectations( modeling, instruction: Caregivers will come to CHW if they are friendly in their approach)

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Subjective norms (Modeling, information: Health Care Providers, project staff and community members recognise the CHW role in the community to be one of respect)

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Skills/Self-efficacy(modeling, information: skills training, information: CHWs are well trained to assess sick child)

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Perceived severity (Modeling, instruction: child with fever can die if action is not taken promptly for fever)

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Knowledge (Modeling, Information: CHW role in the community can help the children stay healthy and survive)

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PROFESSIONAL HEALTH CARE PROVIDERS

 

Attitudes (information, discussion, modeling: The role of CHWs in community management of fevers is important)

     

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Self-efficacy (Information, Modeling: Health care workers are knowledgeable and self-efficacious professionals in working with CHWs in treating child with fever)

     

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Reinforcement (Information, Modeling: Health care workers praise caregivers in responding promptly to referral by CHWs)

     

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Knowledge (information, discussion: Health care workers discuss problems encountered in the work of CHWs that are not resolved during support visits, with project staff)

     

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