Table 2.

Changes made in MoMent study design based on formative research findings

	Original Study Design	Formative Findings	Adjusted Study Design
1	MMs to interact with WLHIV clients only at facility and at client homes	Due to stigma, WLHIV and their families may not want to receive home visits from MMs, who lived in the same communities and were often known to be HIV-positive	MMs to provide services at facility and at a variety of community locations including home, religious centers, markets and agreed-upon locations. Documented phone calls also count toward MM interactions
2	Branded attire for MMs to wear at facility and/or in the community	Even if MMs wanted to wear identifying attire, clients and their families preferred them not to, due to intense community stigma	MMs are not to wear branded or any other distinguishing attire for their work activities
3	MMs to be trained with study curriculum without receiving documentation of training	MMs took their jobs very seriously and were motivated as both patients and service providers in the PMTCT program	Each study-trained MM provided a formal certificate upon completion of training to foster belonging in the PMTCT program and recognition from health workers and clients
4	MMs were required to be able to read and write English at least at 5th grade level to participate, due to documentation needs	Ability to communicate effectively with WLHIV clients in their first language was more important for MMs’ impact than being able to read and write English	MM training was conducted in both English and Hausa, the dominant local language. English literacy was made a desirable but not required MM skill. MMs lacking this skill were assisted in documentation by English-literate MM supervisors
5	MMs to be paid through the health facility’s PMTCT operational procedures, which could experience administrative delays	Fair and consistent compensation was critical to MM motivation and performance	MM stipends (~ $50 monthly) paid directly to them via personal bank accounts or through local chapters of peer WLHIV associations

WLHIV women living with HIV, MM mentor mother, PMTCT prevention of mother-to-child transmission of HIV