The development and validation of a tool to assess nurse performance in dual protection counseling

ObjectiveTo present preliminary evidence for the reliability and validity of the Dual Protection Counseling Checklist (DPCC), an instrument designed to evaluate nurses’ fidelity to high quality dual protection counseling in a family planning setting.MethodsDuring a trial comparing a dual protection (DP) nurse counseling intervention to standard of care (SOC), client-counselor sessions were audiotaped. Following good inter-rater reliability, 78 audiotaped interviews were coded from the two conditions using the DPCC. We constructed indices from a subset of codes to capture three domains: Promotion of DP (PDP), Relapse prevention counseling (RPC), and Quality of Nurse–Client Interaction (QNCI). The association between scores on these indices and client outcomes was evaluated using logistic regression.ResultsThe DPCC and indices were reliable. Construct validity of indices was supported by greater frequency of target behaviors by the DP nurse. Validity of the QNCI was further supported by its association with clients’ sexual risk reduction 6 months post-counseling.ConclusionThe DPCC and indices hold practical utility for evaluation, monitoring, and supervision of nurse–client counseling sessions.Practice implicationsThe Dual Protection Counseling Checklist provides a user-friendly tool for assessing nurses’ and other providers’ counseling behaviors in dual protection.