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Background: Levels of adherence to recommended protocols in an intervention trial can affect outcomes and confound the results. To broaden the evidence about the selection and utility of adherence measures in varying contexts, we describe the level of adherence to the Mycotoxin Mitigation Trial (MMT) randomized intervention using caregiver-reported survey questions and compare inferences of adherence between multi-module surveys and interactive 24 h dietary recalls based on our program theory. Methods: The MMT was a two-arm cluster-randomized trial conducted in 52 health facilities (clusters) in central Tanzania. Surveys were conducted with all trial participants at three time points and dietary recalls were conducted in a cohort at 12 mo. Results: The 12 mo survey was conducted with 2112 caregivers and the 18 mo survey was conducted with 2527 caregivers. A cohort of participants (n = 282, 20 clusters) was selected for dietary recalls, balanced by arm. Reported feeding of blended porridge flours, whether MMT-provided or own-sourced, was high at 12 and 18 mo, between 73 and 95%, with only slight differences between the surveys and recalls. Inferences were similar for continuation of breastfeeding, feeding frequency, and dietary diversity. Only the amount of porridge fed the previous day differed statistically by method, with higher amounts reported in the recalls compared to the survey. Conclusions: Detailed analysis of reported behaviors, based on the MMT program theory, supports high adherence to the recommended trial behaviors. Survey data and 24 h dietary recalls were convergent for almost all indicators, strengthening the trial’s conclusions and allowing for either method to be selected for similar research. 

Abstract ObjectiveTo understand the perspectives of home health aides (HHAs) toward their own health and health behaviors, and how their job impacts both. Data Sources and Study SettingInterviews were conducted with 28 HHAs from 16 unique home care agencies from August 2021 to January 2022. The study was conducted in partnership with the 1199SEIU Training and Employment Fund, a labor‐management fund of the largest health care union in the US. Study DesignA qualitative study with English and Spanish‐speaking HHAs. Interviews were conducted using a semi‐structured topic guide, informed by Pender's Health Promotion Model and the National Institute for Occupational Safety and Health's Total Worker Health Model. To be eligible, HHAs had to be currently employed by a home care agency in New York, NY. Data Collection/Extraction MethodsInterviews were recorded, professionally transcribed, and analyzed thematically. Principal FindingsThe 28 HHAs had a mean age of 47.6 years (SD 11.1), 39% were non‐Hispanic Black, 43% were Hispanic, and they had a mean of 14.1 years (SD 7.8) of job experience. Five themes emerged; HHAs were: (1) Healthy enough to work, but were managing their own chronic conditions while working; (2) Motivated to be healthy, in part driven by their desire to care for others; (3) Worked closely with sick patients, which influenced their perceptions of health; (4) Experienced occupational and patient‐level barriers to practicing healthy behaviors; (5) Sought support and resources to improve their health and wellbeing. ConclusionsHHAs have numerous health challenges, many of which are influenced by their job. Culturally and occupationally tailored interventions may mitigate the barriers that HHAs experience to achieve optimal health.