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Table 2 Implementation phase study designs, study objectives, data collection tools, study participants, and timing of data collection

From: Health systems strengthening interventions for perinatal common mental disorders and experiences of domestic violence in Cape Town, South Africa: protocol for a pilot implementation study

Study design Study objectives Data collection tools Participants Timing of data collection
Healthcare worker survey Assess changes in healthcare workers’ knowledge of mental illness and domestic violence and their attitudes towards people with mental health disorders and experiences of domestic violence Self-administered questionnaires: organisational readiness for implementing change [30]; bespoke knowledge questionnaire; mental illness: Clinicians’ Attitudes Scale [31]; Professional Quality of Life Scale [32]; Effort-Reward Imbalance scale [33] All healthcare workers involved in the intervention — CBS trainers, NPO managers, PACK facility trainers, psychiatric nurses, ANC nurses, OTLs, CHWs, health promotion officers, HIV counsellors, nursing assistants Two timepoints — before receiving training and at the end of the implementation phase
Patient survey Assess changes in pregnant women’s knowledge of mental illness and domestic violence and their attitudes towards people with mental health disorders and experiences of domestic violence Self-administered bespoke questionnaire consisting of 16 questions Pregnant women attending MOUs and BANC clinics Two timepoints — before the delivery of health promotion talks and after delivery of the health promotion talks
Observation of health promotion talks Assess uptake, fidelity, penetration, and sustainability of health promotion talks Checklist to be completed by fieldworkers observing the talks   During the delivery of health promotion talks
Cohort study Assess the presence of and risk factors for CMDs and experiences of domestic violence; assess whether the HSS interventions to improve awareness, detection, referral, and treatment resulted in improvement in clinical outcomes Interviewer-administered questionnaires: Edinburgh postnatal depression scale [34]; psychological distress screening tool [12]; bespoke questionnaire to assess domestic violence; Household Food Insecurity and Access Scale [35]; Composite Abuse Scale [36]; WHO Disability Assessment Schedule [37]; Multidimensional Scale of Perceived Social Support [38]; Mother-to-Infant Bonding Scale [39] Pregnant and postnatal women attending antenatal care clinics Three timepoints — (1) when pregnant women are recruited, (2) when participants are 36 weeks pregnant, and (3) 6 weeks after participants have given birth
Patient file reviews Assess changes in detection and referral rates of pregnant women with CMDs and experiences of domestic violence Maternity case record [11] Pregnant and postnatal women attending MOUs and BANC clinics Weekly during the implementation phase
Documentation review Assess coverage of the detection, referral, and treatment interventions Bespoke patient registers and tracking forms ANC nurses and OTLs Daily during the intervention period
Counselling competence Assess fidelity to the structured counselling format and content Enhancing assessment of common therapeutic factors tool [40]; bespoke counselling evaluation form Community health workers (CHWs) During the last 2 months of the intervention
Qualitative assessments Assess the acceptability, appropriateness, satisfaction, and feasibility of the selected HSS interventions Topic guides for key informant interviews and focus group discussions Pregnant and postnatal women involved in the intervention
Healthcare workers involved in the intervention
During the last 3 months of the intervention