Table 2.

PMTCT practice items related to determinants of adoption.

Determinants of adoption	Definition	Related PMTCT practice category	Hypothesized outcomes
Relative advantage	The new practice is perceived as better than the one that preceded it	Newborn antiretroviral (ARV) treatment	Adoption of the practice related to newborn ARV treatment is expected to be positive due to presence of ARVs at all sites due to relationship with donor agency
		Breastfeeding	Earlier recommendation was the avoidance of breastfeeding. The expectation of the study is that the recommendation to breastfeed is not perceived to be better than avoiding breastfeeding. Adoption is not expected
Compatibility	The practice works well with existing practices and structures	Maternal and newborn ARV treatment	Adoption is expected due to availability of ARVs at all sites
		Universal precautions	Adoption of the practice is not expected due to research evidence of limited material resources, including gowns and gloves
Complexity	The practice is simple and well defined	Breastfeeding	Multiple changes in recommendations over the last decade, varying from avoiding breastfeeding to providing breastfeeding. Adoption is not expected
Trialability and observability	The practice is offered in the clinical setting and nurses have opportunities to observe the practice being delivered in their institution	Maternal intrapartum treatment	Due to centralization of HIV treatment in tertiary settings, nurses in primary and secondary settings had no opportunities to trial or observe care of HIV-positive pregnant women. Adoption of the practice is not expected to be implemented in primary and secondary sites