A model of capacity building assistance (cba)


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Lessons Learned Building the Capacity of Community Based Organizations and Health Departments implementing HIV interventions for Black Communities

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  • The African American Capacity Building Initiative (AACBI) is proud to be a program of the 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. Because injection and other drug users in the African American community are at significant risk of HIV infection and transmission, the Harm Reduction Coalition saw the need to work with those groups that were already working to provide HIV prevention interventions to African Americans and to aid them in their work, while offering its specific expertise in how to best incorporate the principles of health and safety promotion for drug users. The harm reduction movement started decades ago in Western Europe and was introduced to the US in the late 1970s/early 1980s when the HIV epidemic began to spread like wildfire, especially among IDUs. Current & former drug users started HRC to promote the health & human rights of drug users
  • HRC’s HIV Prevention Capacity Building Initiative is a CDC-funded project Our funding period is September 1, 2009 to March 31, 2014
  • Capacity building involves a variety of delivery mechanisms: technology transfer technical/capacity-building assistance training skills building information dissemination technology transfer – the process by which innovations are diffused among HIV prevention providers to improve how intervention effectiveness and scientific research is translated into programs and practice. technical assistance – the provision and/or facilitation of culturally relevant and expert programmatic, scientific, and technical advice (mentoring/coaching) and support. CBB members provide assistance to grantees in areas such as organizational infrastructure development, program implementation, adaptation and tailoring of behavioral interventions, and evaluation. training – curricula development, delivery of curricula and coordination of training activities to increase the knowledge, skills and abilities of trainers, educators and service providers. Training focuses on the delivery of effective HIV prevention interventions and strategies, such as: prevention counseling partner counseling, testing and referral services (PCRS) prevention case management (PCM) and implementation of rapid testing. Training activities also include facilitation skills, recruitment strategies, adaptation and tailoring guidance that increases knowledge, skills, and abilities required to implement HIV prevention interventions, and programs and services. Trainings are provided directly to service providers for implementation or to educators/trainers in a Train-the-Trainer (TOT) format for further dissemination. Facilitation of trainings is provided in English and Spanish. information dissemination – distribution and sharing of relevant and current HIV prevention information (reviewed by peer materials review committees prior to dissemination) through print materials, presentations, websites, and mass media.
  • #5: CDC Recommendations: Areas to Assess To Determine Readines s organizational environment, governance, and programmatic infrastructure (the agency culture and characteristics that are needed to support an EBI) workforce and professional development (knowledge, skills, and abilities of the people who implement an EBI) resources and support (practical assets needed to implement an EBI); motivational forces and readiness (reasons that an EBI will meet the needs of the target population as well as staff enthusiasm to provide high-quality services); learning from experience (changes that occur in people, agencies, and interventions during implementation as provided by feedback and evaluation); and adjusting to the external environment (adjusting to the cultural, social, economic, political, legal, and environmental factors that are within agency control and influence their capacity to implement an EBI).
  • A model of capacity building assistance (cba)

    1. 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 CommunitiesCamille Abrahams Emeagwali, M.S.Harm Reduction Coalition November 2, 2010
    2. 2. Roadmap for Today’sPresentation 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. 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. 4. History of HRC’s CapacityBuilding 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. 5. Overview of AACBIIn 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. 6. History of HRC’s CapacityBuilding 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. 7. Guiding Principles of CBA atAACBI/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. 8. History of HRC’s CapacityBuilding 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. 9
    10. 10. Overview of HRC’s HIV PreventionCapacity Building Initiative CBA for CBOs CBA for Syringe Access Mobilization 10
    11. 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. 12. CBA for Syringe AccessMobilization 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. 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 executivemanagement. Board development is also intricately involved at this 13level as well.
    14. 14. Multiple Layers of Change Leadership DevelopmentStaff TeamDevelopment Development Movement Board Building Development Organizational Community 14 Development Development
    15. 15. HRC’s Approach to CBA CBA Service Provision (in HIV prevention) Key Characteristics for Effective CBA Essential Tools for Evaluating CBA
    16. 16. Methodology to Develop BestPractices 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. 17. IntroductionIn order for comprehensive HIV prevention servicesand strategies to be successful, community basedorganizations and their frontline staff must havethe necessary skills and resources to respondefficiently and effectively to this epidemic.Thus, CBOs must have the capacity to engagesuccessfully in HIV prevention efforts, particularlythose efforts involving the implementation of HIVprevention interventions that have proven to beeffective. 17
    18. 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. 19. Process of CBA ServiceProvision (in HIV Prevention)1. Frame the Problem  Define and fully understand the issue(s)  Tool: Initial Needs Assessment2. Capacity Inventory  Stage the Consumer’s Readiness for CBA  Identify resources/assets of staff, team, management, organization, etc.  Tool: Organizational Assessment3. Comprehensive Analysis of CBO’s Challenges & Threats  Identify intermediate and long-term challenges, barriers and threats to resources, assets, and expected outcomes 19
    20. 20. Process of CBA ServiceProvision (in HIV Prevention)1. Formalize Partnership between CBO & CBA  Tool: MOA2. Action Planning  Develop an approach to address the problem/issue  Refine approach based on CBO feedback3. CBA Service Delivery 20
    21. 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. 22. Process of CBA ServiceProvision (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. 23. Process of CBA ServiceProvision (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 Recommendations2. Additional CBA Services 23
    24. 24. Cornerstones for EffectiveCBA 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. 25. FindingsPassion + Commitment does NOT equal capacity
    26. 26. Broad CBA Needs Identified byHRC Organizational Infrastructure Culturally and Linguistically Appropriate Services and Settings Demonstrated Competence In Foundational Skills and Knowledge Specific to AIDS Service Organizations? 26 26
    27. 27. Barriers to Effective andSustainable 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. 28. HRC’s Lessons Learned ProvidingCBA 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. 29. HRC’s Lessons Learned ProvidingCBA 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. 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. 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. 32. Future Direction of CapacityBuilding 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. 33. “If you have some power, then your job is to empower someone else” Toni Morrison
    34. 34. Contact Info.Camille Abrahams Emeagwali, M.S. Harm Reduction Coalition abrahams@harmreduction.org 212.213.6376