4TC Day One Summary

4TC Meeting: Summary of Day One Breakout Discussions: 

4TC Meeting: Summary of Day One Breakout Discussions HIV Prevention Strategies Emerging Priority Areas (Part 1)

Overarching Issues and Strategies: 

Overarching Issues and Strategies

Training Needs: 

Training Needs Assessment is critical for determining need and guiding development of training plans Training materials/resources need to be created or adapted for use across systems, but must also have the flexibility to be tailored to specific audiences Training and TA should not be separate (and should include information, skill building, and capacity building) Cultural competency and legal issues cut across all areas

Benefits of Co-Training: 

Benefits of Co-Training Wider audiences = wider impact Ability to provide more training events Offer trainer and participant variety Enhance networking among participants, trainers, and systems Maximize efforts and resources Avoid duplication Deliver consistent messages Enhance credibility

Areas for 4TC Collaboration: 

Areas for 4TC Collaboration Coordinate and Enhance Materials and Resources Create a Regional 4TC toolkit/compendium and/or national clearinghouse of all TC materials Create a shared 4TC module list with detailed information about materials trainers, target audience, contact person, etc. Modify existing materials to be in line with new guidelines and to state specifications Develop regional toolkits Analyze and utilize the data that’s been generated regarding interventions

Areas for 4TC Collaboration : 

Areas for 4TC Collaboration Enhance Collaboration at Training Center Level Increase communication across TCs Learn what others are doing to reduce duplication of efforts Share workplans and calendars Provide cross-training opportunities Enhance Collaboration at Federal Level Increase funds for regional collaboration to develop curriculum or materials that can be used by all TCs Provide all agencies that collaborate with full credit, consistent objectives, and clear guidelines Invite additional Training Centers into partnership

HIV Prevention: 

HIV Prevention

Barriers to Training – Across Care Settings: 

Barriers to Training – Across Care Settings Lack of “normalized” HIV testing - thinking HIV is different Structural barriers such as funding, confidentiality, treatment, bias/stigma Established relationships between agencies and hard-to-change structures Fear, especially of giving positive results Lack of information regarding referrals and resources Need for clear, consistent guidelines

Training Needs – Across Care Settings: 

Training Needs – Across Care Settings Topics Testing and providing results under state laws Rapid testing – all aspects Giving positive results Counseling skills Working with males in family planning settings Cultural/linguistic issues Stigma Confidentiality concerns Referrals for care Capacity building

Training Needs – Within Medical Care Settings: 

Training Needs – Within Medical Care Settings Materials/Resources Scripts for addressing HIV prevention with clients Pocket guides Implementation guidance Sample policies and forms Quality assurance practices

Target Audience – Within Medical Care Settings: 

Target Audience – Within Medical Care Settings Emergency Departments In-patient care Primary care Community health centers Health departments Prison/jail/juvenile justice Publicly funded programs: family planning, HIV, addictions, STDs Veterans Affairs

Target Audience – Outside of Medical Care Settings: 

Target Audience – Outside of Medical Care Settings School settings and universities Referral networks Community networks of care Health fairs, state fairs, Native Pow Wows Homeless shelters Domestic violence shelters Long term care settings Research settings Faith-based organizations Community-based organizations Legal services organizations Advocacy groups Outreach workers Vans Bath houses Bars

Existing Materials/Resources – Across Care Settings: 

Existing Materials/Resources – Across Care Settings AETC Developing new test guidelines pocket guide for clinicians Cultural competency (NM AETC) Rapid testing in labor and delivery (PA AETC) Rapid testing in community health settings (NW AETC) ASI module regarding risk assessment (PTC/AETC) PTC STD/HIV/Substance use/TB Partnerships for Health for AIDS clinics Rapid testing courses with focus on technology and behavioral unit on counseling and prevention change Stigma training and disclosure training (CA PTC)

Existing Materials/Resources – Across Care Settings: 

Existing Materials/Resources – Across Care Settings RTC HIV prevention and encouraging testing SiHLE. project Peer-driven, evidence-based interventions for young African American women – SISTA, WILLOW Cultural competency/systems-based intervention (CHT) Positive sexuality (RTC/Region IX) ATTC Tool kit for substance abuse counselors Distance education program Other National Minority AIDS Council curriculum on stigma with marginalized populations National Partner Counseling and Referral Services training

Training Gaps – Across Medical Care Settings: 

Training Gaps – Across Medical Care Settings Training on guidelines regarding state laws, referrals, and resources Specific curriculum on HIV prevention for use across systems Additional cross-system resources (e.g., SAMHSA/CDC tips/taps) Strategies for collaboration at regional and state levels How to partner with Department of Health How to collaborate with others to provide programs/services How to get to the decision makers

HIV Prevention-Specific Areas for 4TC Collaboration: 

HIV Prevention-Specific Areas for 4TC Collaboration Move forward with guidelines and support for non-traditional HIV counseling and testing Assess and modify existing toolkits Identify resources and materials used or created locally and disseminate regionally to all TCs Update and share workplans, assessment tools, and reports/data Maintain listservs and continue discussions in region Consider commitment to regional collaborative trainings

Examples of HIV Prevention-Specific Regional Workplan Strategies: 

Examples of HIV Prevention-Specific Regional Workplan Strategies Train on “normalizing” HIV testing Integrate HIV testing into existing trainings providers are already attending Link training to programs funded to do HIV counseling and testing/rapid tests Collaborate with Departments of Health to develop rapid testing training Develop regional toolkits Create “storyboard” of guidance – state-specific and population/service specific

Adolescents: 

Adolescents

Training Needs: 

Training Needs Legal Issues Rights and entitlements Informed consent Mandatory reporting Reproductive Health Topics Effective pregnancy prevention A-B-C approach to HIV prevention HIV care for adolescents HIV and STD training/awareness for pediatricians

Training Needs : 

Training Needs Working with Adolescents Teen behavior and developmental issues Cultural competency Substance use and mental health issues Involvement of families Organizational Capacity Capacity assessment and organizational development Selection and adaptation of materials Access to evidence-based practices and lessons learned

Target Audience: 

Target Audience Primary care Public health Mental health Substance abuse Schools Juvenile justice Homelessness Employment Foster care Family planning Rape crisis Systems

Target Audience: 

Target Audience Organizations Community-based organizations Faith-based organizations Parent-teacher organizations/associations Individuals Pediatricians Peer and adolescent counselors Educators Case managers Outreach workers Those working with migrant youth

Existing Materials/Resources: 

Existing Materials/Resources AETC National AETC Resource Center workgroup products HIV and adolescent experts (FL AETC) Work with Boston Happens, a multi-agency coalition focusing on adolescents (NE AETC) Legal issues Pocket guide ATTC Conference materials Adolescent competencies document RTC OPA adolescent related priorities training materials manual Patient materials curricula Online training web site NY/NJ Public Health Training Network

Training Gaps: 

Training Gaps Training and Workforce Issues Lack of training curricula specific to adolescent issues Lack of curricula designed for pediatric providers, family medicine, and OB/GYN Surplus of adolescent trainers but lack of those trained clinically and behaviorally on HIV Difficulty reaching rural providers Topical Issues Legal and ethical issues of treatment of adolescents Rural vs. urban issues Methamphetamine and other drug use Training on peer models Training about trauma

Adolescent-Specific Areas for 4TC Collaboration: 

Adolescent-Specific Areas for 4TC Collaboration Invite 4TC partners to planning for yearly adolescent conference Create a 4TC on-line course on adolescents addressing each TC focus area Cross-train RTC adolescent trainers on clinical and behavioral HIV/STD and cross-train HIV/STD trainers on adolescent issues Create or modify an HIV/STD risk assessment tool specifically for adolescents and provide training to providers on how to use it and discuss risk and options

Examples of Adolescent-Specific Regional Workplan Strategies: 

Examples of Adolescent-Specific Regional Workplan Strategies Integrate Adolescent Issues Into The Current Workplan Meeting #1 in Baltimore, MD on Nov. 28th to plan joint work products Meeting #2 in Fairfax, VA to continue/follow up Develop Capacity of 4TC Collaborators And Faculty Adolescent taught by RTC HIV taught by AETC STD/HIV taught by PTC Behavioral taught by PTC Substance abuse taught by ATTC

The Internet: 

The Internet

Opportunities and Barriers Related to Training: 

Opportunities and Barriers Related to Training Opportunities Variety of modalities that can be expanded to other disciplines Potentially increase accessibility (e.g., in rural areas) Potentially change behaviors of providers regarding their services to clients Ability to track who is accessing resources, follow up, and evaluate impact Barriers Tools/technology might not be available People who already know TCs are more likely to access related internet-based resources Generation gap – younger more comfortable Potential resistance Requires culture change Some agencies cannot provide information directly to patients so the internet topic may be irrelevant

Training Needs: 

Training Needs Sample Provider Training Topics Basic internet use (including security, ethics, etc.) How other providers are using internet to reach their clients/patients Distance-based technologies for training Can we show efficacy from web-based interventions? Hot topics Various models (e.g., distance learning, chat rooms, WebEx) FAQs – responding to emerging questions via the web

Target Audience: 

Target Audience Medical, clinical, and health educators Outreach workers Case managers Administrators Health Departments Sources of health care – NPs, RNs, MDs, etc. Clients

Existing Materials/Resources: 

Existing Materials/Resources AETC National Resource Center - CD ROM, online prevention with positives HIV web study (NW AETC) Hepatitis Web study (PTC/NW AETC) CDC rapid testing guidelines (NW AETC) ATTC – webinars (NE ATTC) PTC National Network of STD Prevention Training Center STD case series and STD practitioner manual (Seattle PTC) Video’s/demonstrations of wet prep (Seattle PTC) Ask/screen/intervene on-line TOT (Seattle PTC) RTC – web-based orientation to family planning Partner Counseling and Referral Services-related internet training

Training Gaps: 

Training Gaps It is not known how many sites are using internet for training purposes A good needs and feasibility study will need to be conducted before we can understand use of the internet for training purposes within the 4TCs At this point, at least one group is not convinced this is a training priority for the centers

Internet-Specific Areas for 4TC Collaboration: 

Internet-Specific Areas for 4TC Collaboration Create National on-line links of all training centers Share knowledge and evaluation results of each others web-based programs Utilize technology for collaborative events (e.g., planning tool, shared schedules, Web-based registration process, WebEx for case management conference) Standardize data collection

Examples of Internet-Specific Regional Workplan Strategies: 

Examples of Internet-Specific Regional Workplan Strategies Address in regional workplan 1-2 years from now Utilize quarterly meetings to discuss internet activities Identify technology-specific topics/look for gaps/plan together Enhance communication by jointly marketing and promoting courses Develop provider chat rooms