I want to thank you all for attending this workshop today. During the time we have together I would like for you to contribute to what I have put together. This is your workshop and everyone here has much to offer and share. So lets get started.
First and foremost engage the community when planning on the delivery of an intervention. Is it appropriate to the community you are targeting? Are you going to be able to recruit the populations necessary to deliver according to your objectives?
Remember that recruitment and retention can take different forms, depending on the most appropriate approach for a specific target population and on the needs, abilities and resources of the organization engaging in the activity that meets those needs.
Use information from multiple sources to describe common characteristics of the target population. Develop and deliver appropriate health messages for the setting. Remember to recruit for specific services or interventions such as: testing and counseling, CRCS, HR, etc…. Track completion of referrals to monitor the effectiveness of the referral strategy. Revise strategies or venues, as appropriate.
What is an effective recruitment strategy? A strategy should bring an adequate number of high risk persons into an intervention. An adequate number is typically defined by the characteristics of the target group, the type of intervention and the risk profile of the community or the service area.
It is the way a person at risk for HIV or the transmission of HIV is brought into a prevention intervention program. This includes: locating people at risk, engaging them, and motivating them to participate in the intervention.
Recruitment can take different forms, depending on the intervention, the most appropriate approach for a specific target population, the needs, abilities and resources of the organization engaging in the activity. OUTREACH: Staff or volunteers seek and encounter members of targeted population in their own environment and deliver recruitment messages: examples are Venue-based and Internet-based. INTERNAL: Staff or volunteers who provide one intervention or service within an agency screen clients for other servicers, & when appropriate, refer to another intervention or service. AGENCY or EXTERNAL: Other agencies deliver recruitment messages for specific intervention services to members of the targeted population and provide referrals. SOCIAL: Network Referrals are members of high risk networks deliver recruitment messages for specific intervention services to other members of those networks. Marketing Referrals are the use of marketing techniques to deliver specific recruitment messages to specific audiences through use of media such as an HIV testing mini campaign.
Just implementing an “effective intervention” is not enough to achieve effective HIV prevention. An intervention can only be effective if it reaches the intended target population. Effective HIV prevention involves reaching the right population with the right intervention and reaching the right population requires effective recruitment strategies.
Who: High risk – what are the markers of the risk? Identify characteristics of the risk population such as demographic, social & cultural features, such as race/ethnicity, gender, age, sexual orientation, sexual identity, drug use pattern, homelessness, sex bartering, relationship to another person, etc. Where: What are venues where potential clients live, socialize, “hang out”, congregate, do business, receive services, meet partners, or engage in high risk behavior? Which venues are people most accessible (most receptive to what you are offering). Look at factors such as confidentially, safety, stigma, trust, drug use patterns, etc.. When: Once potential venues are identified, determine the times when members of the targeted population can be found and are most receptive to promotion of services. Schedule staff based on client accessibility. What: Take into consideration factors that present barriers to service. Why aren’t people testing or using CRCS services? Messages should be chosen that effectively address barriers to accessing and using services. Messages should be culturally and linguistically appropriate. How: Is it in a culturally appropriate manner. If using visual messages, be sure they are appropriate. If using written messages take into consideration the appropriateness of the message and the literacy level of the clients. Who: Are they peer messengers? Appropriate? Culturally competent? Trained to follow protocols?
It involves maintaining client participation for the duration of the intervention cycle. Whether it is a multi-session group level or individual level intervention: The completion of all sessions is required for the delivery of the intervention. The completion of all sessions required to complete the prevention plan.
Why is retention important? In order to realize the full effect of an intervention, the clients must receive the full cycle. The “effectiveness” of an effective intervention was demonstrated among those who completed it and not those who dropped out. No intervention is effective if people do not stay in it. A client who does not complete the intervention or service cycle is taking the place of a client who may have completed.
Communicate with the clients. Be responsive to their needs and their need for agency services. Set objectives for retention rates and then monitor them. Revise retention strategies as needed. Anticipate barriers to retention and plan around them.
Look at the location: is it safe, convenient, easy to get to? Look at the environment: Is it comfortable and confidential? Look at the quality of the interaction: Is it inclusive, non-judgmental. Non-coercive, and speaks to the person and their issues? Look at the clients expectations: Are the participants clear on what the intervention is, it’s process and the commitment involved? Look at the opportunities for the client to access other services.
Look at your schedule: Is it on the “right” day and at the “right” time? Is there anything else in a person’s life that may interfere with their participation and their coming back that can be planned around? Such as childcare needs. Are there social opportunities that may interferr with the intervention?
Remember to ask yourself: Are you reaching the target population? The high risk population? Are you in the right place? Are you there when the client is there and is accessible? Is the right message being delivered? Is the message being delivered in the right way? Is the messenger the right person?
Recruitment & Retention Presentation
Bring Them and Keep Them: “Successful Recruitment and Retention Planning” <ul><li>Cora E. Giddens BA, BS </li></ul><ul><li>UT Southwestern Medical Center </li></ul>
<ul><li>HIV/STD prevention providers experience difficulty recruiting and retaining their program’s target population due to the lack of community input during program planning and a number of other external and/or structural factors (poverty, lack of access to physical/mental health services, stigma around sexual orientation, childcare and housing needs, transportation barriers, etc.). </li></ul>
The target population’s personal and/or internal factors (addiction, distrust of the system, low self-esteem, rejection by family/friends, etc.) are also challenges.
Prevention programs must develop a recruitment and retention plan during program planning based on input from the target population. It is necessary for the plan to include techniques, approaches, and/or methods that will remove barriers and ensure successful recruitment and retention during the implantation of the plan.
Recruitment & Retention <ul><li>Effective recruitment and retention strategies are critical to ensuring successful programs </li></ul><ul><li>Strong participation rates are often challenging for prevention providers </li></ul><ul><ul><li>This is particularly true when agencies are providing new services or outreaching to new communities or populations </li></ul></ul>
Recruitment is a proactive ongoing effort that includes distribution of marketing pieces, building personal contacts, and increasing referrals. Attendance and/or participation in the following local events can produce a positive client base from which to recruit: <ul><li>Community-based organization meetings </li></ul><ul><li>AIDS service organization meetings </li></ul><ul><li>Ryan White Council meetings </li></ul><ul><li>Agency network meetings </li></ul><ul><li>Parents and families of lesbians and gays meetings </li></ul>
Be knowledgeable and call on all area HIV/AIDS service provider locations such as: <ul><li>HIV/AIDS clinics and health care services (men’s and women’s) </li></ul><ul><li>HIV/AIDS dental services </li></ul><ul><li>HIV/AIDS food pantry </li></ul><ul><li>HIV/AIDS child care services </li></ul><ul><li>HIV/AIDS case management agencies </li></ul><ul><li>HIV/AIDS support groups </li></ul><ul><li>HIV/AIDS residential homes </li></ul>
Be open to expanding your search to venues that you do not know there are HIV+ persons, but go with the intent to make known the opportunity to access the intervention is available. Such sites maybe: <ul><li>Alcohol and/or drug council agencies </li></ul><ul><li>Alcohol and/or drug support groups </li></ul><ul><li>Gay, lesbian, bi-sexual, transgender service providers </li></ul><ul><li>Gay, lesbian, bi-sexual, transgender events and/or programs </li></ul><ul><li>Counseling centers </li></ul><ul><li>Health departments - free clinics </li></ul><ul><li>Colleges and/or technical schools </li></ul><ul><li>Homeless shelters </li></ul><ul><li>Soup kitchens </li></ul><ul><li>Day centers </li></ul>
Agency Considerations Related to Recruitment: <ul><li>Agency knowledge of the intervention </li></ul><ul><li>Appropriate method of screening potential clients </li></ul><ul><li>Reputation and credibility </li></ul><ul><li>Experience working with behavioral interventions </li></ul>
Planning a Recruitment Strategy: <ul><li>Agencies developing a recruitment strategy should answer the following questions related to their target populations : </li></ul><ul><li>Who is being targeted through the recruitment? </li></ul><ul><li>Where is the appropriate place to recruit clients? </li></ul><ul><ul><ul><li>When should recruitment be done? </li></ul></ul></ul><ul><ul><ul><li>What messages should be delivered during recruitment? </li></ul></ul></ul><ul><ul><ul><li>How should the messages be delivered? </li></ul></ul></ul><ul><ul><ul><li>Who is the most appropriate person to do recruitment? </li></ul></ul></ul>
What is Retention? <ul><li>A conscious and specific process that keeps your participant returning to programs. The process finally engages those same persons to refer people from the social network to your agency. </li></ul>
Retention relies on: <ul><li>Facilitation skills, creative incentives, adaptation, follow-up, and intervention maintenance. </li></ul><ul><li>Fostering active support for participants by including family members to give encouragement to attend, increasing access to sessions through flexible meeting times, and removing other barriers to participation are some additional techniques used to improve retention. </li></ul>
Tactics for Successful Retention <ul><li>Frequent contacts </li></ul><ul><li>Maintaining personal relationships </li></ul><ul><li>Identifying client’s likelihood of returning </li></ul><ul><li>Ease clients into the program </li></ul><ul><li>Client-Centered </li></ul><ul><li>Referrals from current participants </li></ul><ul><li>Competent and confident staff </li></ul><ul><li>Intervention that is adapted to meet the needs and strengths of the intervention population </li></ul>
What’s required to do it well <ul><li>Be comfortable with the subject and situation </li></ul><ul><li>Be confident </li></ul><ul><li>Be credible </li></ul><ul><li>Be enthusiastic about the subject </li></ul><ul><li>Be knowledgeable </li></ul><ul><li>Be organized </li></ul><ul><li>Be prepared </li></ul><ul><li>Be witty and humorous (know your participants) </li></ul>
Retention Ideas: <ul><li>Phone calls and/or e-mails for reminders: before, between, and after the groups/meetings </li></ul><ul><li>Contact case managers for assistance </li></ul><ul><li>Make available information on public transportation and/or coupons or passes to ride for free </li></ul><ul><li>Identify convenient and confidential location for groups/meetings to meet </li></ul><ul><li>Have flexible meeting times </li></ul><ul><li>On-site day care may be needed </li></ul><ul><li>Make available resource packets with referral information and basic life skills </li></ul>
More Retention Ideas: <ul><li>Keep the sessions fun and interactive </li></ul><ul><li>Serve refreshments </li></ul><ul><li>Celebrate any birthdays within the group </li></ul><ul><li>Have a gift for a lottery give a-way at the end of each session </li></ul><ul><li>Have incentives upon completion of each session so each participant will receive some token for their time (ie. gift cards, fast food coupons, etc.) </li></ul><ul><li>Have a graduation meal at the last session </li></ul><ul><li>Award certificates upon completion </li></ul>
Thank You Cora E. Giddens UT Southwestern Medical Center 400 S. Zang Blvd. #520 Dallas, TX. 75208 214.645.7316 [email_address]