Table 4.

Who Can Help to Adapt the Intervention? Stakeholder Findings from Topic Experts Step of ADAPT-ITT

Stakeholder	Likes	Concerns	Recommendations	Modifications made
Alcohol vendors	• Sessions as a couple • Financial literacy and matched savings • Exercises to reduce drinking	• Communication skills could be hard to learn • Privacy/safety of funds • Banks are time-consuming, challenges with deposits and withdrawals	• Include protections for a joint bank account so that one partner cannot steal • Include advice not to bring much money to the beer halls to help curb drinking • Emphasize confidentiality in group sessions • Address issues around transport to bank	1. Added couple financial agreement on bank withdrawals to first session 2. Tailored alcohol content to provide tips from alcohol vendors 3. Added confidential agreement to first session 4. Included mobile banking agents in rural areas to reduce transport costs 5. Mobile money providers are now invited to first session to provide education on services 6. Meal is provided at each group session 7. To address difficulties travelling to banks, we included village bank agents to assist couples in making deposits and withdrawals 8. Facilitators will have formal education and authority to build trust (e.g., teacher or counselor). 9. Included training on bank loans
HIV care providers	• Teaching people how to save and bank independently • Exercises and vignettes around alcohol use • Counseling sessions and relationship activities	• People will borrow to get the match • Difficulties accessing bank services in rural areas • Sessions could be too long	• Include mobile money providers in financial education • Discourage borrowing from friends to get match • Address food insecurity • Address issues around transport to bank
Religious and community leaders	• Match will be a strong incentive • Debt management and loan content • Understanding harms of alcohol • Focus on positive aspect of relationships • Working with couples and involve husbands as saving as often falls on wife	• Concerns about whether people can save in rural areas • People will borrow to get match • Transport to banks is an issue • Banking fees are confusing, missing money from accounts • Mobile money may be preferred over banks	• Recommend bank accounts require dual signatures for withdrawals • Include mobile money representatives • Facilitators should be experts on financial issues • Emphasize confidentiality in group sessions
Financial representatives	• Saving as a couple promotes transparency • Financial skills will give partners tools to solve problems together • Will promote a savings culture • Budget session is important for identifying monthly expenses • Groups will help couples learn from each other	• Concerns about whether people can save in rural areas • Confidentiality in group sessions • People may not be able to save and will borrow from friends	• Mobile banking agents can help • Bank representations should do financial sessions • Divorce rates are high; protections are needed so one partner does not take all the savings and leave • Encourage people to save and not take out high interest loans or borrow from friends
Couples	• Saving will bring couples closer • Difficult to navigate banking system so this will help • Match incentives • Exercises on alcohol reduction • Focus on positive aspects of relationship • Will help with school fees, a big challenge • Good to learn financial skills together (especially men) • People can learn from other in groups	• Couple communication exercises should not focus on one partner’s wrongdoings • Financial literacy sessions could be difficult to understand • Men may struggle more, since budgeting often falls on wife • Some people fear the banks • Will need assistance with opening accounts and banking	• Facilitators should be kind and non-judgmental • Include mobile money providers • Need to promote confidentiality groups • Include a meal at sessions