The document discusses lessons learned from a capacity building assistance program for community organizations and health departments implementing HIV prevention programs for Black communities. It provides an overview of the program and Harm Reduction Coalition's approach to capacity building. It identifies needs of community-based organizations, barriers to effective capacity building, and lessons learned. Key lessons include the importance of collaboration, open communication, addressing staff turnover, and empowering organizations to lead to sustainable programs.

1. A model Capacity
Building Assistance
(CBA) Program
Lessons Learned Building the
Capacity of Community Based
Organizations and Health
Departments implementing HIV
interventions for Black Communities
Camille Abrahams Emeagwali, M.S.
Harm Reduction Coalition November 2, 2010

2. Roadmap for Today’s
Presentation
 Overview
 CBA then…CBA now
 Multiple Layers of Impact and Change
 HRC’s Approach to CBA
 Methodology to Develop Best Practices
 Process of CBA Service Provision (in HIV Prevention)
 Cornerstones for Effective CBA
 Essential Tools for Evaluating CBA
 Findings
 Needs of CBOs
 Barriers to Effective and Sustainable CBA
 Lessons Learned
 Future Direction of Capacity Building
2

3. Harm Reduction Coalition
 Founded in 1994 to work with individuals and communities at risk
for HIV infection due to drug use and high-risk sexual behaviors.
 Committed to reducing drug-related harm by initiating and
promoting local, regional and national harm reduction education,
interventions and community organizing
 Offer specific expertise in how to best incorporate the principles of
health and safety promotion for drug users.
3

4. History of HRC’s Capacity
Building
 HRC’s Training Institute (NY & CA) has
been in existence since the inception of the
organization (1994)
 Since 1994, HRC has provided training and
technical assistance in the areas of:
 Syringe access services
 Hepatitis C prevention and education
 Overdose prevention
 HIV prevention
4

5. Overview of AACBI
In 2004, the Harm Reduction Coalition (HRC)
received a 5-year grant from the CDC to be a
Focus Area 2 CBA Provider for CBOs and health
departments (HDs) working with African
Americans communities in the North Region.
The African American Capacity Building Initiative
(AACBI), a program of HRC, was a dynamic
initiative aimed at reducing the infection and
transmission rates of HIV/AIDS within African
American communities.
5

6. History of HRC’s Capacity
Building
 2004-2009: African American Capacity Building
Initiative (AACBI)
 CDC-funded CBA provider serving African-American
serving CBOs & HDs in the North Region
 DEBI Expertise: d-up!, POL, Safety Counts,
VOICES/VOCES
 2008: Published lessons learned & best practices in
Journal of HIV/AIDS & Social Services
 2008: Formation of the Forgotten Population Project
6

7. Guiding Principles of CBA at
AACBI/HRC
NKYINKYIM ("twisting" )
symbol of initiative, dynamism
and versatility
NYANSAPO ("wisdom knot") symbol of
wisdom, ingenuity, intelligence and
patience. This symbol conveys the idea
that "a wise person has the capacity to
choose the best means to attain a goal.
7

8. History of HRC’s Capacity
Building
 2008 to present: Institute@ HRC
 Skills and Knowledge on Overdose Prevention (SKOOP)
 Drug Overdose Prevention Education (DOPE)
 LGBT Program
 HIV Prevention Capacity Building Initiative
8

9. 9

10. Overview of HRC’s HIV Prevention
Capacity Building Initiative
 CBA for CBOs
 CBA for Syringe Access Mobilization
10

11. CBA for CBOs
 Organizational Infrastructure and Program
Sustainability
 Evidence-based Interventions and Public
Health Strategies
 d-up! Defend Yourself!
 Safety Counts
 VOICES/VOCES
 NIA (New!)
 SHIELD (New!)
11
 Monitoring and Evaluation 11

12. CBA for Syringe Access
Mobilization
 A PLACE for Syringe Access
 Adaptation of Community Mobilization Model –
Mobilizing for Action through Planning and
Partnerships (MAPP)
 Social Marketing Campaigns
 Community-level Evidence-based
Interventions
 Community PROMISE
 Popular Opinion Leader (POL)
12

13. Multiple Layers of CBA
Impact…
Staff
Team
Executive Management
Organization
Board
Community
Movement
** For the purpose of today’s discussion, I will focus on Organizations.
This layer of impact also encompasses staff, teams and executive
management. Board development is also intricately involved at this 13
level as well.

14. Multiple Layers of Change
Leadership
Development
Staff
Team
Development
Development
Movement
Board Building
Development
Organizational Community 14
Development Development

15. HRC’s Approach to CBA
CBA Service Provision (in HIV prevention)
Key Characteristics for Effective CBA
Essential Tools for Evaluating CBA

16. Methodology to Develop Best
Practices
 Formal/informal interviews with AACBI staff
 Interviews and focus groups with CBA consumers
 Review of case files that included action plans,
detailed progress notes, Consumer Satisfaction
Surveys, CBA completion forms, and
communications between AACBI and CBA
consumers
 Interview/observe other CBA providers
 Literature Review
16

17. Introduction
In order for comprehensive HIV prevention services
and strategies to be successful, community based
organizations and their frontline staff must have
the necessary skills and resources to respond
efficiently and effectively to this epidemic.
Thus, CBOs must have the capacity to engage
successfully in HIV prevention efforts, particularly
those efforts involving the implementation of HIV
prevention interventions that have proven to be
effective.
17

18. Capacity Building Assistance (CBA)
HIV prevention capacity building is a process by
which individuals, organizations, and communities
develop abilities to enhance and sustain HIV
prevention efforts.
The goal of capacity building is to foster self-
sufficiency and the self-sustaining ability to
improve HIV prevention programs, processes, and
outcomes.
18
18

19. Process of CBA Service
Provision (in HIV Prevention)
1. Frame the Problem
 Define and fully understand the issue(s)
 Tool: Initial Needs Assessment
2. Capacity Inventory
 Stage the Consumer’s Readiness for CBA
 Identify resources/assets of staff, team, management,
organization, etc.
 Tool: Organizational Assessment
3. Comprehensive Analysis of CBO’s Challenges & Threats
 Identify intermediate and long-term challenges, barriers and
threats to resources, assets, and expected outcomes
19

20. Process of CBA Service
Provision (in HIV Prevention)
1. Formalize Partnership between CBO & CBA
 Tool: MOA
2. Action Planning
 Develop an approach to address the problem/issue
 Refine approach based on CBO feedback
3. CBA Service Delivery
20

21. CBA Delivery Strategies
 Trainings
 To increase knowledge, skills and ability
 Technical assistance/consultation
 the provision and/or facilitation of culturally relevant and
expert programmatic, scientific, and technical advice
(mentoring/coaching) and support
 Examples include coaching and mentoring
 Information Dissemination
 distribution and sharing of relevant and current information
through print materials, presentations, websites, and mass
media
21

22. Process of CBA Service
Provision (in HIV Prevention)
1. Evaluate CBA Service Provision (Process) and
Ability of CBO (outcome)
Essential Tools for Evaluating CBA
 Needs Assessment
 Immediate Need (Problem Diagnosis and Expected Outcomes)
 Staff/Organization/Board Assessment (Asset/Resource
Inventory). What can we build on?
 Intermediate and Long-Term Needs
 Reflective Tool: 3/6/12 month follow up
 How well are consumers applying their new/enhanced capacity?
 Have unintended and/or negative consequences been
addressed?
22

23. Process of CBA Service
Provision (in HIV Prevention)
1. Recommend Additional CBA Services, if
necessary
 Ask, “what can we do to build or advance the good
work that the CBA consumer is doing?”
 Tool: Letter of Recommendations
2. Additional CBA Services
23

24. Cornerstones for Effective
CBA
 Cultural Competence – All CBA is local
 Local, culturally relevant consultant; Community Advisory Board
 Needs Driven CBA: initial, organizational, other needs
 “Stage” Consumer for CBA Readiness; identify their
assets/resources; Meet Them Where They’re At
 CBA Provider/CBA Recipient Team Approach
 Infuse Best Practices from Subject Matter Experts (SMEs)
 Continuous Program Improvement
 Evaluate work; improve CBA tools; follow up with CBO to
determine if effectiveness is maintained
24

25. Findings
Passion + Commitment does
NOT equal capacity

26. Broad CBA Needs Identified by
HRC
 Organizational Infrastructure
 Culturally and Linguistically Appropriate
Services and Settings
 Demonstrated Competence In Foundational
Skills and Knowledge
Specific to AIDS Service Organizations?
26
26

27. Barriers to Effective and
Sustainable CBA
 High staff turnover – in CBOs and CBA
providers
 CBO’s lack of or poor experience with CBA
Reputation is everything
 Insufficient commitment from CBO
management
27

28. HRC’s Lessons Learned Providing
CBA to CBOs/HDs : 2004-2009
 A team-based approach helps to ensure effective
and efficient service delivery (lesson #1)
 Relationship building and open communication is
essential (lesson #3)
 Staff turnover results in loss of institutional
memory and momentum (lesson #9)
28
28

29. HRC’s Lessons Learned Providing
CBA to CBOs/HDs : 2004-2009
 Empowered CBA consumers lead to sustainable
programs (lesson #11)
 CBOs should work with CBA and technical
assistance providers during the pre-implementation
and implementation phases (lesson #5)
 A coordinated effort among CBA providers is
needed to effect change on a national level (lesson
#7)
29
29

30. Conclusions:
Many of the lessons centered on the need for
open communication and collaboration
between CBA providers, CBA consumers,
CDC program officers, and CDC program
consultants in order to ensure efficient and
effective capacity building.
30

31. Conclusions:
The overarching theme across the lessons
learned is that providing capacity building
assistance has its rewards, but it is not
without its challenges.
31

32. Future Direction of Capacity
Building
 Capacity Building as a “field”
 Strategic Giving and Capacity Building
 Innovative strategies to Promote the
Sustainability of Capacity Building Efforts
 Measure the Long-Term Impact of Capacity
Building
32

33. “If you have some power, then your
job is to empower someone else”
Toni Morrison

34. Contact Info.
Camille Abrahams Emeagwali, M.S.
Harm Reduction Coalition
abrahams@harmreduction.org
212.213.6376