{
  "abstract": "Aim The International Guide for Monitoring Child Development (GMCD) is a monitoring and intervention package for supporting early childhood development (ECD) and addressing developmental difficulties. As part of a clinical trial task-shifting the GMCD to community health workers (CHWs) in Guatemala, we aimed to evaluate CHWs’ fidelity to the GMCD protocol.Methods We trained CHWs from non-governmental organizations over six days in the use of the GMCD. We collected sociodemographic data. To evaluate fidelity, we created a checklist containing 34 rules that should be followed for optimal implementation. The checklist was broken down into 3 sections, rules that apply before the GMCD implementation, during and after. The fidelity evaluation was carried out during the CHW’s first implementation after training. We performed a lineal regression analysis to investigate the correlation between CHW education level and fidelity.Results Of 50 trained CHWs, we evaluated 36. The overall fidelity of the GMCD protocol was 72%. Fidelity before the intervention was 85%, 73% during and 61% after. Simple lineal regression analysis showed no statistically significant differences in CHWs fidelity and educational level (p=0.64)Conclusions We found that CHWs had acceptable fidelity to the GMCD rules after training and that education did not have a significant impact on fidelity. Furthermore, our results suggest that rules in the after section may need additional focus in the training. Our analysis demonstrates that CHWs can implement the GMCD with satisfactory fidelity which could be an avenue to expanding ECD services in low- and middle-income countries.",
  "authors": [
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Tecpán, Guatemala"
      ],
      "name": "Karyn Choy"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Tecpán, Guatemala"
      ],
      "name": "Sara Hernández"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Tecpán, Guatemala"
      ],
      "name": "Magdalena Guarchaj"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Acibadem Maslak Private Hospital, Istanbul, Turkey"
      ],
      "name": "Revan Mustafa"
    },
    {
      "affiliations": [
        "Developmental-Behavioral Pediatrics Division, Department of Pediatrics, Faculty of Medicine, Ankara University, Ankara, Turkey"
      ],
      "name": "Ilgi Ertem"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Tecpán, Guatemala"
      ],
      "name": "Scott Tschida"
    },
    {
      "affiliations": [
        "Center for Indigenous Health Research, Maya Health Alliance, Tecpán, Guatemala",
        "Division of Global Health Equity, Brigham and Women’s Hospital, Boston, USA",
        "Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA"
      ],
      "name": "Peter Rohloff"
    }
  ],
  "title": "185 Evaluation of the fidelity of community health workers to the international guide for monitoring child development (GMCD) in Guatemala",
  "uid": "f0af4928-9be6-5449-bc35-1437cf04a3f4"
}