The Role of Adjunct Trainers in The Role of Adjunct Trainers in STD/HIV Prevention Integration: STD/HIV Prevention Integration:

Utilizing a Utilizing a Training of Trainers Program Training of Trainers Program

to Build Local Capacityto Build Local Capacity

Stacy Vogan, MPH, CHES; Amy Smith, MPH;

Heather Lusk; Alice Gandelman, MPH; Gail Bolan, MD

Presented by

CA STD/HIV Prevention Training Center

BackgroundBackground

As HIV and STD rates continue to As HIV and STD rates continue to increase, so does the demand from Health increase, so does the demand from Health Departments, CBOs and CPGs for skills-Departments, CBOs and CPGs for skills-based, capacity building in the role of based, capacity building in the role of STDs in HIV prevention.STDs in HIV prevention.

To meet this demand, the CA STD/HIV To meet this demand, the CA STD/HIV Prevention Training Center implemented a Prevention Training Center implemented a comprehensive STD TOT program comprehensive STD TOT program October 2003.October 2003.

Program GoalsProgram Goals

To Develop Local Capacity in Partnering To Develop Local Capacity in Partnering Regions IX and X in the role of STDs in Regions IX and X in the role of STDs in HIV preventionHIV prevention– Alaska, Washington, Idaho, Oregon, Alaska, Washington, Idaho, Oregon,

California, Nevada, Arizona, HawaiiCalifornia, Nevada, Arizona, Hawaii

Increase collaboration between STD and Increase collaboration between STD and HIV programs.HIV programs.

Program MethodsProgram Methods

Recruit prospective adjunct trainers to Recruit prospective adjunct trainers to participate in the TOT Program;participate in the TOT Program;

Provide training to adjunct trainers in CA Provide training to adjunct trainers in CA STD/HIV PTC courses;STD/HIV PTC courses;

Provide mentorship and support to adjunct Provide mentorship and support to adjunct trainers.trainers.

RecruitmentRecruitment

CriteriaCriteria– practical field experience in community or public practical field experience in community or public

health settinghealth setting– some training experiencesome training experience– presentation skills - interpreting and delivering presentation skills - interpreting and delivering

informationinformation– facilitation skillsfacilitation skills– can represent or see different perspectivescan represent or see different perspectives– embraces participatory training approachembraces participatory training approach– organized organized – flexibleflexible– committedcommitted

A Six Step ProcessA Six Step Process

Attend specific course as participant

Attend Trainer Skills course

Attend Specific Course Training

Co-facilitate with PTC trainer

Conduct training on own

Follow up & Feedback

Skills TrainingSkills Training Attend specific course as a Attend specific course as a participantparticipant Attend Attend Trainer Skills CourseTrainer Skills Course (Part A) (Part A)

– two way evaluation and decision to continue two way evaluation and decision to continue with TOT program or notwith TOT program or not

Attend Attend Specific Course TrainingSpecific Course Training (Part B) (Part B) Set up training and co-facilitate with PTC trainer Set up training and co-facilitate with PTC trainer

on siteon site Conduct training on ownConduct training on own Follow-up training to share experience and Follow-up training to share experience and

feedback with other adjunct trainersfeedback with other adjunct trainers

Mentorship and SupportMentorship and Support

Throughout TOT structure, on-going Throughout TOT structure, on-going mentorship, support and feedback from mentorship, support and feedback from PTC trainers will occurPTC trainers will occur– co-trainingco-training– observationobservation– written/verbal feedbackwritten/verbal feedback

Evaluation and Quality AssuranceEvaluation and Quality Assurance

Recruitment ProcessRecruitment Process Trainer skills evaluationTrainer skills evaluation

– evaluation of potential adjunct trainer skills (group evaluation of potential adjunct trainer skills (group process, facilitation, stay on task, work effectively with process, facilitation, stay on task, work effectively with co-trainer, etc.)co-trainer, etc.)

– decision as to whether or not to continue programdecision as to whether or not to continue program Evaluation of understanding of course contentEvaluation of understanding of course content Evaluation, feedback and support from ‘Mentor Trainer”Evaluation, feedback and support from ‘Mentor Trainer” Follow-up evaluation and feedback for skills Follow-up evaluation and feedback for skills

development and course improvementdevelopment and course improvement

ResultsResults

Adjunct trainers conducted 28 courses and trained 467 Adjunct trainers conducted 28 courses and trained 467 participants. This is almost 21% of the CA PTC participants. This is almost 21% of the CA PTC Behavioral Intervention trainings and over half (51%) of Behavioral Intervention trainings and over half (51%) of the “STD Overview for Non-clinician” courses during the the “STD Overview for Non-clinician” courses during the same time period.same time period.

Seventy-three percent (73%) of Adjunct Trainers Seventy-three percent (73%) of Adjunct Trainers integrated this course into their work.integrated this course into their work.

Post course evaluations showed acquisition of skills and Post course evaluations showed acquisition of skills and knowledge by participants attending an adjunct trainer knowledge by participants attending an adjunct trainer facilitated courses to be consistent with those of CA PTC facilitated courses to be consistent with those of CA PTC training course evaluations.training course evaluations.

Key Components andKey Components andThings to ConsiderThings to Consider

One point person for contact in One point person for contact in administering agency.administering agency.

Mentorship program was keyMentorship program was key Materials supportMaterials support

ConclusionsConclusions

Conducting a TOT Program can be a Conducting a TOT Program can be a strong capacity building component for strong capacity building component for local agencies and assist them in meeting local agencies and assist them in meeting local training needs.local training needs.