assessing community readiness and implementing culturally appropriate interventions within...
TRANSCRIPT
Assessing Community Readiness and Implementing Culturally Appropriate
Interventions within Aboriginal Communities
Training of Trainers
Purpose
To provide Community Trainers with the knowledge and skills to train community facilitators who in turn will be able to:• assess their community’s readiness to address risk reduction;• determine culturally appropriate prevention and intervention
approaches;• implement the approaches to effectively reduce risk and reduce
vulnerability for HIV infection; and, • provide wise practices that demonstrate successful application of
the community readiness model for risk reduction and features various case studies outlining lessons learned.
Agenda
Pre-Training Questionnaire
Module 1: The Issue: The Need for Culturally Appropriate Interventions in Aboriginal communities
Module 2: Community PlanningModule 3: Community Readiness ModelModule 4: Conducting Your Community Readiness AssessmentModule 5: Moving From Assessment to Action Planning
Evaluating Your Risk Reduction Action Plan
Final Questions/Answers
Post-Training Questionnaire
Workshop Reflections and Closing
Additional Agenda
The training is one day
There are 6 Modules:Module 1 – 4 are designed to inform them about the community readiness model and how to conduct the assessment
Module 5 will give them knowledge and skills to engage the community in a workshop – presenting their community readiness results (including definition of readiness) and to develop their strategies/action plan.
Additional Agenda
A Reflection process after the conclusion of each module – to provide an opportunity for participants to share their thoughts about the process, ask questions, or table any concerns.
Before Module 1: complete a “confidential” Pre-Training Questionnaire.
After the completion of the Modules : information on evaluation will be shared, question period Post-Training Questionnaire.
Module 1 (ex.1): The Issue
Aboriginal people are overrepresented in the HIV epidemic in Canada.
1979 to Dec 2008: 21,300 AIDS cases reported: 16,824 (79%) included information on ethnicity.
690 were reported to be Aboriginal people.
Aboriginal people only make up 3.8% of the population.
Module 1 (ex.1): The Issue
In 2008, PHAC surveillance data demonstrated that:
Aboriginal people make up a growing % of HIV+ test reports and reported AIDS cases;
Injecting drug use is a key mode of transmission especially for women (Aboriginal female cases: 64.4% - 53.7% for Aboriginal male cases);
Aboriginal youth are diagnosed at a younger age than non-Aboriginal youth.
Module 1 (ex.1): The Issue
Walk with Me Pathway To Health: That the number of people with HCV in Canada is increasing at a
steady rate;
PHAC - major mode of contracting HCV is sharing of contaminated needles /other needle works among injection drug users; and,
Estimates indicate more than 1500 HIV+ Aboriginal people are co-infected with HCV - presents other health management and outcome complications.
Module 1 (ex.2): The Issue
Exercise Explain - Risk Factors vs. Risky Behaviours
Brainstorm: “What are some risk factors for infection, and risky
behaviours that people engage in that place them at high risk for HIV and/or HCV infection?”
Module 1 (ex.3): The Issue
ExerciseTarget populations with escalated risk?
Brainstorm:
“Which specific populations are experiencing escalated rates of infection?”
“What is the issue that leads to higher risk?”
Module 1 (ex.4): The Issue
ExerciseAbstinence-based approaches are more common in Aboriginal communities, but culturally appropriate intervention approaches are also needed to reduce the risk.
Brainstorm:“Why are risk reduction intervention approaches needed? To either compliment or replace abstinence-based approaches?”
Module 2: Community Planning
Where they are
Where do they want
to be
How do they want
to get there
Module 2: Community Planning“Walk with Me Pathway to Health”
Module 3: Community Readiness Model
Definition: Model for community change; Integrates its culture, resources and level of readiness; Brings community together, builds cooperation and increases its
capacity for prevention and intervention; Recognizes community uniqueness different stages of willingness
and ability; Readiness is “the degree to which a community is prepared to
take action on an issue”. Risk reduction to prevent HIV /HCV infection.
Module 3: Community Readiness Model
Risk reduction
Module 3: Community Readiness Model
Dimensions:A. Community Efforts
B. Community Knowledge of the Efforts
C. Leadership
D. Community Climate
E. Community Knowledge about the Issue
F. Resources Related to the Issue
Module 3: Community Readiness Model
Stages of Readiness1. No Awareness 2. Denial / Resistance3. Vague Awareness4. Preplanning5. Preparation6. Initiation7. Stabilization8. Confirmation/ Expansion9. High Level of Community Ownership
Module 1 -2-3: Reflections
Experience: What did you learn from the module(s)? What did you need to know in order to prepare for community
readiness? Identify:
How was the experience significant to you? What do you understand better about yourself? Your role?
Analyze: What helped you to learn? What do you feel about what you learned?
Generalize: How will you apply what you learned to being a Facilitator of
Community Readiness? Is there anything that you would change about the process?
Module 4: Conducting Your Community Readiness Assessment
Three Steps to conducting interviews:1. Prepare and plan;2. Conduct; and,3. Score.
To prepare: Identify who you want to interview; Have a thorough understanding of the questions;
and, Contact interviewees and arrange interview.
Module 4: Conducting Your Community Readiness Assessment
Exercise: Brainstorm and list key respondents ….. “ Who are some potential key respondents in your
community?” (Ask yourselves … are they connected to the issue? Are any of them “gatekeepers” in the community – respected, well connected people?)
Once listed“Explain why these respondents are appropriate for this issue.”
Module 4: Conducting Your Community Readiness Assessment
Read the Interview Questions and Discuss; A – Community Efforts (Programs, Activities, Policies, etc.) B – Community knowledge of efforts - In your community, how much of a
concern is providing services that reduce risk and risky behavior associated to HIV and AIDS an HCV infection?
C – Leadership - For the “leaders” in your community, how much of a concern is reducing risk?
D – Community Climate - Are there ever any circumstances in which members of your community might think that denying services to individuals who are “under the influence or who practice other risky behaviours should be tolerated? Please explain.
E - Knowledge about the issue – How knowledgeable are community members about risk reduction. Please explain. (such as: dynamics, signs symptoms, statistics, effects on family and friends, etc.)
F – Resources for prevention efforts (time, money, people, space, etc.) On a scale from 1-10, what is the level of expertise and training among those working on providing services to reduce risk? With 1 being “very low” and 10 being “very high”. Please explain.
Module 4: Conducting Your Community Readiness Assessment
Practice Interviewing and Recording
1. Score the interviews2. Using the Anchored Scoring sheet guide and
recording on the Assessment Scoring Sheet, create a score for each of the six dimensions. Remember interviews are scored by dimensions not by individual questions.
Module 4: Conducting Your Community Readiness Assessment
Scoring Process
Presentation, Exercise and Samples of Risk Reduction Strategies
Module 5: Moving from Assessment to Action Planning
“WORKSHOP tool CRM presentation”
Module 4: Reflections
Experience: What did you learn from the module(s)? What did you need to know in order to prepare for community
readiness? Identify:
How was the experience significant to you? What do you understand better about yourself? Your role?
Analyze: What helped you to learn? What do you feel about what you learned?
Generalize: How will you apply what you learned to being a Facilitator of Community Readiness? Is there anything that you would change about the process?
Module 5: Moving from Assessment to Action Planning
Exercise - “Brainstorming Intervention Strategies”
STRENGTHS “What strengths does a community have that will help reduce
the risk of HIV and/or HCV infection?”
CONCERN “What are the concerns or obstacles to implementing strategies
focused on reducing the risk?”
RESOURCES “What are our resources that support strategies for reducing the
risk for HIV and HCV infection?”
Module 5: Moving from Assessment to Action Planning
Module 5: Reflections
Experience: What did you learn from the module(s)? What did you need to know in order to prepare for community
readiness?Identify: How was the experience significant to you? What do you understand better about yourself? Your role?Analyze: What helped you to learn? What do you feel about what you learned?Generalize: How will you apply what you learned to being a Facilitator of
Community Readiness? Is there anything that you would change about the process?
Evaluation
Logic Model Illustrates how and why a program or strategy works Shows, “…how all the program goals, activities, and expected
outcomes link together” (Shackman, 2010).
Goals Goals describe future expected outcomes or states. They provide programmatic direction - focusing on ends
rather than means. For example, your goal may be to reduce the spread of HIV
and HCV in your community by delivering programs and services that effectively reduce and/or change risky behaviours.
Evaluation
ObjectivesObjectives are clear, realistic, specific, measurable, and time-limited, statements of action which when completed will move towards goal achievement. Objectives tell how to meet a goal.
For example, objectives may be:To raise community awareness about risky
behaviours that may lead to HIV infection;To reduce risk by promoting safer sex practices.
EvaluationInputs
What are the resources that will go into accomplishing your goal? Resources can be funds, people, capital items, etc.
ActivitiesActivities include services, products, and more. They serve your goal and are clearly linked to the objectives.
Example:Objective
To raise community awareness about risky behaviours that may lead to HIV infection..
Activities Series of workshops Information brochures about HIV and HCV.
Evaluation
OutcomesOutcomes are the preferred consequences of achieving the set out goals.Short term outcomesIntermediate outcomesLong Term outcomesQuantitative measures - measured in numbers. Qualitative measure are descriptive, cannot me counted.
Closing
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