The TAM assessment focused on all field-based activities conducted by the CCG pairs from the time they left the clinic for household visits to the time they returned to the clinic. Our study team developed a standardized time reporting form based on reviews of CCG activity reports, discussions with CCGs, and direct on-site observations during a preceding pilot phase (January to March 2018). All participating CCG staff were trained to self-report TAM data during the study period. During each observation day, one member of the CCG pair recorded start and end times for each discrete activity (categorized based on a pre-defined set of activity codes shown in Table S1.1 in S1 Appendix ) carried out by their peer in the field [16 (link), 17 (link)]. Times and activities were recorded in a continuous and consecutive manner with no time gaps between activities [17 (link)].
TAM data were collected in two distinct ways: at the household level and at the daily level. Household visit TAM forms captured the type and duration of activities performed within each household visit. Daily TAM forms captured information about the total time spent performing field work each day, the number of households visited, how much time was spent at patient households, how much time was spent traveling, and reasons for unsuccessful household visits. Both TAM forms were completed concurrently with each other, so data between forms could be linked. Direct activities were those that involved CCG service provision at households, namely household registrations, follow-up visits and other contact investigations (for TB and other diseases, such as maternal and child health and HIV). Indirect activities included travel from the clinic to the household, from one household to another, and back to the clinic.
Each CCG pair was asked to complete both TAM forms at least three working days per calendar month during the study period, for an anticipated 264 form submissions. All submissions were voluntary and CCG pairs were not given specific days to collect data (i.e. submission and date selection was random). Completed paper-based forms were collected weekly by two trained study research assistants for data validation and were recorded into a Microsoft Excel database. The data validation process involved assessing the quality of each TAM form, based on the completeness and adherence to the time and activity reporting guidelines provided, with poor-quality forms excluded. Poor-quality forms were defined as forms that were not informative for TAM activities, such as forms with time gaps or missing information and those with suspicious patterns like all activities lasting for an equal duration. Feedback and quality reports were given to all CCG pairs to help improve quality of data collection over the study duration. Any data discrepancies were resolved by two independent reviewers reviewing the original data. Person-time–both in total and broken down per day, household visit, and patient interaction–were calculated and assessed for both clinics separately.
TAM data were collected in two distinct ways: at the household level and at the daily level. Household visit TAM forms captured the type and duration of activities performed within each household visit. Daily TAM forms captured information about the total time spent performing field work each day, the number of households visited, how much time was spent at patient households, how much time was spent traveling, and reasons for unsuccessful household visits. Both TAM forms were completed concurrently with each other, so data between forms could be linked. Direct activities were those that involved CCG service provision at households, namely household registrations, follow-up visits and other contact investigations (for TB and other diseases, such as maternal and child health and HIV). Indirect activities included travel from the clinic to the household, from one household to another, and back to the clinic.
Each CCG pair was asked to complete both TAM forms at least three working days per calendar month during the study period, for an anticipated 264 form submissions. All submissions were voluntary and CCG pairs were not given specific days to collect data (i.e. submission and date selection was random). Completed paper-based forms were collected weekly by two trained study research assistants for data validation and were recorded into a Microsoft Excel database. The data validation process involved assessing the quality of each TAM form, based on the completeness and adherence to the time and activity reporting guidelines provided, with poor-quality forms excluded. Poor-quality forms were defined as forms that were not informative for TAM activities, such as forms with time gaps or missing information and those with suspicious patterns like all activities lasting for an equal duration. Feedback and quality reports were given to all CCG pairs to help improve quality of data collection over the study duration. Any data discrepancies were resolved by two independent reviewers reviewing the original data. Person-time–both in total and broken down per day, household visit, and patient interaction–were calculated and assessed for both clinics separately.
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