Evaluation of the Tsima community mobilization intervention to improve engagement in HIV testing and care in South Africa: study protocol for a cluster randomized trial

Lippman, Sheri A.; Pettifor, Audrey; Rebombo, Dumisani; Julien, Aimée; Wagner, Ryan G.; Kang Dufour, Mi-Suk; Kabudula, Chodziwadziwa Whiteson; Neilands, Torsten B.; Twine, Rhian; Gottert, Ann; Gómez-Olivé, F. Xavier; Tollman, Stephen M.; Sanne, Ian; Peacock, Dean; Kahn, Kathleen

doi:10.1186/s13012-016-0541-0

Implementation Science

Table 1 Intervention activities addressing social barriers to treatment as prevention, mapped onto community mobilization domains

From: Evaluation of the Tsima community mobilization intervention to improve engagement in HIV testing and care in South Africa: study protocol for a cluster randomized trial

	Social barriers to TasP
CM domains	Stigma related to testing, care, and treatment	Increased knowledge (diminish fears) about testing and treatment	Gender norms around testing and treatment	Social support around testing and treatment
Building shared concerns and community consciousness	2-Day intensive and single session workshops -focus on community stigma around testing/treatment Door to door outreach Digital stories and film screening Engaging with clinic staff	Street theater-focused on barriers to testing/treatment Digital stories and films on testing and care experiences Door to door outreach Educational events	2-Day and intensive and single session workshops on gender norms and the benefits/barriers to men engaging in testing and care Street theater addressing gender norms	2-Day intensive and single session group workshops-focused on community barriers to testing and treatment Door to door outreach *Digital stories screening
Engaging leadership and stakeholders (includes traditional leaders, religious leaders, clinic leaders, other community stakeholders)	Engaging leaders around importance of TasP and barriers in community Intensive workshops with leaders on HIV stigma, testing/treatment *Pursuing leadership commitments to achieving village testing and treatment targets (goal setting)	Engaging leaders around importance of TasP and barriers in community Monthly 1-day small group workshops focused on benefits of testing and treatment in community	Engaging leaders around the importance of men engaging in health care Seek support from leadership to enter places of work, taverns, places where men congregate	Identifying home based care support groups in CAT development Engaging leaders in creating support networks for testing and treatment as a community benefit *Goal setting with leadership
Orgs/networks (includes NGOs, CBOs, CATs, other family or community groups/networks)	*Working with the key groups to openly support and include testing and treatment in their work in the communities	Working with key groups to understand how testing and care can improve community well-being Message dissemination through networks.	Working with the key groups (employers, small businesses, sport teams, etc..) to support engagement of men in testing/care Dialogues with church leaders addressing support for male testing/care	Identifying home-based care groups and PLWH in CAT development Partnering with support and treatment networks *Founding community support groups
Collective action	Murals that address stigma related to testing and treatment Events to support testing campaigns/treatment access *Encouraging Tsima members and affiliates to HIV test together	Soccer tournaments that highlight importance of testing and treatment Events to support testing campaigns/treatment access *Home education (open house) events for networks/groups	Community events/forums that address gender norms and accessing HIV care Murals that address gender norms and HIV care	Community events conducted by CATS, PLWH, and home-based care groups to increase community support around TaSP Encouraging Tsima members and affiliates to HIV test together
Social cohesion	Visible community support (events/forums) to reduce stigma–working with PLWH Community events to dialogue around how stigma affects the community and how communities can respond	Identifying home based care groups and PLWH in CAT development–providing safe space for discussion and support Events to support stronger care and treatment networks	Dialogues with men’s groups or associations–addressing male support for testing/care. Building CATs with men, including men LWH	Work with home-based care and CATS to establish PLWH support networks Extend networks and activities to families *Join CATs, local leaders, and clinic staff in testing and treatment strategies.

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ISSN: 1748-5908

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	Social barriers to TasP
CM domains	Stigma related to testing, care, and treatment	Increased knowledge (diminish fears) about testing and treatment	Gender norms around testing and treatment	Social support around testing and treatment
Building shared concerns and community consciousness	2-Day intensive and single session workshops -focus on community stigma around testing/treatment Door to door outreach Digital stories and film screening Engaging with clinic staff	Street theater-focused on barriers to testing/treatment Digital stories and films on testing and care experiences Door to door outreach Educational events	2-Day and intensive and single session workshops on gender norms and the benefits/barriers to men engaging in testing and care Street theater addressing gender norms	2-Day intensive and single session group workshops-focused on community barriers to testing and treatment Door to door outreach *Digital stories screening
Engaging leadership and stakeholders (includes traditional leaders, religious leaders, clinic leaders, other community stakeholders)	Engaging leaders around importance of TasP and barriers in community Intensive workshops with leaders on HIV stigma, testing/treatment *Pursuing leadership commitments to achieving village testing and treatment targets (goal setting)	Engaging leaders around importance of TasP and barriers in community Monthly 1-day small group workshops focused on benefits of testing and treatment in community	Engaging leaders around the importance of men engaging in health care Seek support from leadership to enter places of work, taverns, places where men congregate	Identifying home based care support groups in CAT development Engaging leaders in creating support networks for testing and treatment as a community benefit *Goal setting with leadership
Orgs/networks (includes NGOs, CBOs, CATs, other family or community groups/networks)	*Working with the key groups to openly support and include testing and treatment in their work in the communities	Working with key groups to understand how testing and care can improve community well-being Message dissemination through networks.	Working with the key groups (employers, small businesses, sport teams, etc..) to support engagement of men in testing/care Dialogues with church leaders addressing support for male testing/care	Identifying home-based care groups and PLWH in CAT development Partnering with support and treatment networks *Founding community support groups
Collective action	Murals that address stigma related to testing and treatment Events to support testing campaigns/treatment access *Encouraging Tsima members and affiliates to HIV test together	Soccer tournaments that highlight importance of testing and treatment Events to support testing campaigns/treatment access *Home education (open house) events for networks/groups	Community events/forums that address gender norms and accessing HIV care Murals that address gender norms and HIV care	Community events conducted by CATS, PLWH, and home-based care groups to increase community support around TaSP Encouraging Tsima members and affiliates to HIV test together
Social cohesion	Visible community support (events/forums) to reduce stigma–working with PLWH Community events to dialogue around how stigma affects the community and how communities can respond	Identifying home based care groups and PLWH in CAT development–providing safe space for discussion and support Events to support stronger care and treatment networks	Dialogues with men’s groups or associations–addressing male support for testing/care. Building CATs with men, including men LWH	Work with home-based care and CATS to establish PLWH support networks Extend networks and activities to families *Join CATs, local leaders, and clinic staff in testing and treatment strategies.