This Webinar was the last of a three-part series synthesizing some of the successful practices in engaging hard-to-reach populations from SPNS population-specific initiatives.
Speakers included:
Dr. Angulique Outlaw from Wayne State University and the SPNS Young Men who have Sex with Men Initiative, discussing motivational interviewing
Dr. Nikki Cockern from Wayne State University and the SPNS Young Men who have Sex with Men Initiative, discussing enhanced case management
Dr. Margaret Hargreaves from Mathematica and Principal Investigator for the Latino HIV Care Best Practices Study, discussing engagement and retention of Latinos in HIV care
The document outlines the GATHER approach for family planning counseling. The 6 steps are: Greet the client respectfully, Ask about their family planning needs, Tell them about contraceptive options, Help them choose a method, Explain how to use the chosen method, and schedule a return visit for follow up. Effective counseling requires building trust, maintaining privacy, using simple language, and verifying the client understands through repetition. Non-verbal communication, technical knowledge, and addressing individual client factors also impact counseling outcomes.
The document discusses Information, Education and Communication (IEC). It defines IEC as combining strategies that enable individuals and communities to play active roles in achieving and sustaining their own health. The goals of IEC are to create awareness, increase knowledge, change attitudes and encourage people to adopt innovations. IEC initiatives should have clear objectives, target specific audiences within a set timeframe, and address specific health problems. The document outlines the various components, approaches, resources and role of IEC in nursing.
This presentation to a public health strategy workshop discussed how we could embed behaviour change at population level into our public health strategy
This document discusses communication and health education. It defines communication as a two-way process of exchanging ideas to bring about desired changes in recipients. The communication process involves a sender, receiver, message, channel, and feedback. Effective health education aims to encourage healthy lifestyles and proper health service use through providing information, education, and skills development. It discusses various models and principles of health education, including approaches like lectures, demonstrations, group discussions, and use of mass media. The goal is to bridge the gap between knowledge and behavior change.
This document describes an integrative behavioral health care program for LGBTQ youth at Howard Brown Health's Broadway Youth Center in Chicago. The program aims to provide trauma-informed mental health care, train staff in trauma-responsive care, conduct community outreach, and measure impact. It began by offering therapy sessions and trained staff in trauma-responsive care. It evolved to offer drop-in crisis intervention and brief therapy sessions. Key challenges addressed were developing crisis procedures, reducing mental health stigma, and training staff in de-escalation. Accomplishments included implementing assessments respecting gender identity and involving multi-disciplinary staff in care planning. Lessons highlighted the importance of self-care, integrated care team meetings, and continuing trauma education for
The document discusses behavior change and behavior change communication (BCC) strategies for targeted interventions. It states that behavior determines health risk and interventions aim to change risky behaviors to safe behaviors. BCC uses dialogue and messages to bring about behavior change at individual, community, and societal levels. Effective BCC recognizes that behavior change is a process that occurs in stages from knowledge to practice. BCC should be paired with other strategies like enabling environments and is most effective with community participation. Peer education is highlighted as a key BCC method for targeted interventions.
The document outlines the GATHER approach for family planning counseling. The 6 steps are: Greet the client respectfully, Ask about their family planning needs, Tell them about contraceptive options, Help them choose a method, Explain how to use the chosen method, and schedule a return visit for follow up. Effective counseling requires building trust, maintaining privacy, using simple language, and verifying the client understands through repetition. Non-verbal communication, technical knowledge, and addressing individual client factors also impact counseling outcomes.
The document discusses Information, Education and Communication (IEC). It defines IEC as combining strategies that enable individuals and communities to play active roles in achieving and sustaining their own health. The goals of IEC are to create awareness, increase knowledge, change attitudes and encourage people to adopt innovations. IEC initiatives should have clear objectives, target specific audiences within a set timeframe, and address specific health problems. The document outlines the various components, approaches, resources and role of IEC in nursing.
This presentation to a public health strategy workshop discussed how we could embed behaviour change at population level into our public health strategy
This document discusses communication and health education. It defines communication as a two-way process of exchanging ideas to bring about desired changes in recipients. The communication process involves a sender, receiver, message, channel, and feedback. Effective health education aims to encourage healthy lifestyles and proper health service use through providing information, education, and skills development. It discusses various models and principles of health education, including approaches like lectures, demonstrations, group discussions, and use of mass media. The goal is to bridge the gap between knowledge and behavior change.
This document describes an integrative behavioral health care program for LGBTQ youth at Howard Brown Health's Broadway Youth Center in Chicago. The program aims to provide trauma-informed mental health care, train staff in trauma-responsive care, conduct community outreach, and measure impact. It began by offering therapy sessions and trained staff in trauma-responsive care. It evolved to offer drop-in crisis intervention and brief therapy sessions. Key challenges addressed were developing crisis procedures, reducing mental health stigma, and training staff in de-escalation. Accomplishments included implementing assessments respecting gender identity and involving multi-disciplinary staff in care planning. Lessons highlighted the importance of self-care, integrated care team meetings, and continuing trauma education for
The document discusses behavior change and behavior change communication (BCC) strategies for targeted interventions. It states that behavior determines health risk and interventions aim to change risky behaviors to safe behaviors. BCC uses dialogue and messages to bring about behavior change at individual, community, and societal levels. Effective BCC recognizes that behavior change is a process that occurs in stages from knowledge to practice. BCC should be paired with other strategies like enabling environments and is most effective with community participation. Peer education is highlighted as a key BCC method for targeted interventions.
Counseling is helping process by which, we first understand the problem, and then help the people to understand their problem, and then we need to work together with them to find solution that is appropriate to their situation.
Health education, information and communicationwrigveda
This document discusses health education, information, and communication. It provides definitions of health and health education, and describes the objectives and goals of health education programs. These include informing people, motivating behavior change, and guiding people into healthy actions. The document also discusses the communication process, different types of communication, and barriers to effective communication. It explains the roles of information, education, and communication in health programs and disease prevention. Overall, the document outlines the key concepts and approaches used in health education and communication efforts.
The document discusses several models of health communication and persuasion. It describes the linear and transactional approaches to communication. It also summarizes several key models including the Shannon-Weaver model, Hargie's interpersonal communication model, Rosenstock's health belief model, Rogers' therapeutic communication model, and the theory of planned behavior. The document then discusses factors that influence persuasion such as the elaboration likelihood model, communicator credibility, emotional appeals, and personal versus media influence.
This presentation is from a recent CALPACT webinar. To view the event archive page to access the recording and resources, please visit:
https://cc.readytalk.com/cc/s/meetingArchive?eventId=ws23yprxpjgd&campaignId=xceb0hiurg66
Public Health professionals communicate with a variety of audiences in their daily work. While reasonably well-accepted that special consideration be given to low-literate health care consumers in clinical settings, less emphasis has been given to applying health literacy in diverse sectors of public health. Poor health literacy is not limited to those with language or reading skill barriers - only 12% of Americans understand the health information they receive.
As public health professionals we have a responsibility to understand the health literacy barriers. This presentation will provide tips and resources where public health professionals can make a difference in increasing the success of their communication efforts.
While one flu season can pass mildly and with minimal activity, another may hit the country early and hard. CDC health communicators work with subject matter experts and stakeholders to develop messages for a variety of audiences, employing different types of media for effective reach. Due to unforeseen variables, the 2012-2013 flu season posed specific challenges. This presentation will highlight some of those challenges, showcase strategies and messaging used, and preview what’s to come for the 2013-2014 season.
This webinar was the second session in the CALPACT sponsored Health Communication Matters series, which will help participants in all walks of public health to apply health literacy principles to their everyday communications.
Follow Us on Twitter: @CALPACT
Facebook: http://www.facebook.com/CALPACTUCB
Website: www.calpact.org
Questions?
Email sphcalpact@berkeley.edu
The document discusses the key components and principles of effective health communication. It outlines the communication process, including sender, message, channels, and feedback. It describes different types of communication like one-way, two-way, verbal, and non-verbal. The functions and methods of health communication are to provide information, education, motivation, and counseling to promote health. The principles of health education emphasize generating interest, ensuring participation and comprehension, providing motivation and reinforcement, and using community leaders.
The document discusses several theories of health communication, including the Bull's Eye/Linear Theory, Ping-Pong/Circular Flow Theory, and Spiral of Silence Theory. The Bull's Eye Theory proposes that effective communication involves using the right words to convey the intended message to change the receiver's behavior. The Ping-Pong Theory views communication as an interactive process where messages are exchanged back and forth between the sender and receiver. The Spiral of Silence Theory suggests that people are less likely to express opinions they believe are in the minority due to fears of isolation.
INFORMATION, EDUCATION AND COMMUNICATION FOR HEALTHmathewtjoy
The document discusses health education and communication. It defines health education as aiming to achieve individual and community health by translating health knowledge into desirable behaviors. Health education involves providing information, motivating behavior change, and guiding people to adopt healthy practices. It should be tailored based on the target population's sociocultural characteristics. Effective health communication requires clear, accurate, consistent messages delivered by trusted sources across various individual, group and mass methods and media.
The document discusses communication, education, and information strategies for health workers. It makes three key points:
1. Effective communication requires understanding factors like prejudices, attitudes, and life experiences that influence relationships. It also requires clear messaging with a sender, receiver, and message.
2. There are various communication techniques for health workers, including public meetings, group discussions, demonstrations, and various media. Good listening skills and addressing barriers are also important.
3. Providing health information alone is not enough; it must be converted to simple ideas tailored to the community's education level and culture through education and ensuring it meets their "felt needs" to effectively create behavior change.
This document provides information about an academic poster session on health communication and social marketing. It includes learning outcomes focusing on explaining concepts in health communication, social marketing, and creating a problem description for a social marketing plan. Tasks involve individually producing an academic poster and working in teams to identify elements of the social marketing process like producing a poster template and timeline. The document also summarizes models for social marketing including the 4Ps and 7Ps models, and outlines the social marketing process from describing an issue to implementing and evaluating an intervention.
This document discusses the basic principles of health education and communication (IEC). It defines key terms like health education, information, and communication and explains the communication process. Some key points covered are:
- The goal of IEC is to raise health awareness and help people adopt healthy behaviors through informed decision making. It uses various approaches like mass media and interpersonal communication.
- Effective IEC is based on needs assessments, educational principles, and evaluation. It aims to promote specific, desirable behaviors and considers social influences on health.
- Principles of health education include establishing credibility, engaging interest, encouraging participation, providing motivation and reinforcement, teaching from simple to complex, leading by example, and incorporating feedback.
Tailored communication aims to create targeted health messages for individuals based on their unique characteristics. It seeks to increase personal relevance and involvement to better influence behavior change. Research shows tailored interventions can be effective by providing customized messaging that increases relevance, though the impact of message framing on behavior is complex. While gains frames may work better for preventive behaviors like dental hygiene, the effect of framing depends on the behavior and individual motivations being addressed. Ongoing research is needed to refine practical guidelines for developing optimally persuasive health messages.
This document discusses health communication strategies and frameworks. It provides an overview of key components of health communication including senders, receivers, messages, channels, and feedback. It describes the WHO's strategic communication framework, which is based on six principles: making information accessible, understanding audiences, promoting awareness and understanding of risks, promoting knowledge of solutions, instilling confidence to act, and influencing social norms. The goal is to provide information to audiences to prompt actions that protect health.
This document provides an overview of an interprofessional education event focused on collaborative practice with underserved populations. It includes:
- Objectives around developing a shared understanding of teamwork, collaboration, and interprofessional education; providing an overview of national trends in these areas; and discussing populations served and applying principles of interprofessional collaboration.
- Definitions of key terms like interprofessional education, collaborative practice, and interprofessionality.
- Information about the medically complex conditions, rural populations, child poverty, and veterans populations in Maine that are being served.
- An overview of core competencies for interprofessional collaborative practice like values/ethics, roles/responsibilities, communication, teamwork/team
This document summarizes a longer document about factors that influence human behavior and how understanding these factors can help develop effective communications strategies. It discusses three levels that influence behavior - personal, social, and environmental factors. Personal factors include knowledge, attitudes, habits, and beliefs. Social factors refer to interpersonal influences, and environmental factors include local and wider contextual influences. The document also provides overviews of behavioral economics principles and theories of behavior change. It emphasizes that to effectively influence behavior, communications strategies need to address factors at multiple levels rather than just focusing on one.
This document discusses advance nursing practice and information, education, and communication (IEC) strategies. It defines IEC as an approach to change or reinforce behavior regarding a specific health problem. The objectives of IEC are to increase access to services, improve quality, and link supervision with training. IEC aims to change health behaviors through awareness, education, and motivation. Key components of IEC include visit schedules, training, supervision, and monitoring/evaluation. Effective communication and incorporating various media are also emphasized.
This document discusses information education and communication (IEC) and its importance in bringing about positive changes in knowledge, attitudes, and behaviors related to health. IEC involves providing scientific health information to people and educating them to change behaviors and lifestyles to improve their health and community health. The document outlines the IEC process, including planning, implementation, monitoring, and evaluation. It also discusses developing messages and materials, choosing appropriate communication channels, and overcoming barriers.
Steps of developing Behavior Change Communication (BCC) for family planningZakiul Alam
The document outlines the 5 steps for developing effective behavior change communication (BCC) for family planning programs: 1) Analysis of the situation and audience, 2) Strategic design of objectives and implementation plan, 3) Development and testing of BCC materials, 4) Implementation and monitoring, and 5) Evaluation and re-planning if needed. It describes each step in detail, from gathering information in the analysis to ensuring BCC materials are clear, easy to remember, and culturally appropriate, to tracking whether the materials achieve the desired changes in knowledge, attitudes and behaviors. The goal is to use a cyclic approach to continuously improve BCC until successful behavior changes around family planning are achieved.
In 2015, at the NAFSA Region I conference, Apinant Hoontrakul (from International Student Insurance), Ayumi Giampietro (from Pacific International Academy) and Christy Babcock (from Boise State University) presented on the topic of "Increasing Mental Health Awareness Among International Students"
The document discusses interpersonal communication (IPC) and behavior change communication (BCC) approaches. IPC is focused on individual messaging while BCC is outcome-oriented, research-based, and uses participatory methods. BCC addresses knowledge, attitudes, and practices through audience analysis and segmentation. It uses an appropriate mix of interpersonal, group, and mass media channels. The document also outlines key barriers to behavior change in Rajasthan, India and priority areas for a BCC strategy such as antenatal care, institutional deliveries, and nutrition. Current BCC activities in Rajasthan include MCHN day, home visits, group meetings, and folk performances.
The document discusses the importance of relationships when engaging and retaining HIV clients in medical care. It notes that barriers like poverty, health illiteracy, unemployment, violence, and other social determinants of health negatively impact engagement and retention in care, with racial and ethnic minority populations particularly affected. The document presents several case studies that illustrate how linkage coordinators established relationships to link clients into care, addressing issues like lack of transportation, confidentiality concerns, housing instability, and mental health challenges. It emphasizes that early treatment and long-term adherence lead to better health outcomes.
1) Engagement in HIV care ranges from fully engaged patients who regularly attend medical visits to non-engagers who are unaware of their HIV status or never enter into care.
2) Missing medical visits for HIV care can negatively impact health outcomes like increased viral load and drug resistance, and has been associated with higher mortality.
3) Strategies that have been shown to improve retention in HIV care include outreach programs, case management, addressing practical barriers, and strengthening the patient-provider relationship.
Counseling is helping process by which, we first understand the problem, and then help the people to understand their problem, and then we need to work together with them to find solution that is appropriate to their situation.
Health education, information and communicationwrigveda
This document discusses health education, information, and communication. It provides definitions of health and health education, and describes the objectives and goals of health education programs. These include informing people, motivating behavior change, and guiding people into healthy actions. The document also discusses the communication process, different types of communication, and barriers to effective communication. It explains the roles of information, education, and communication in health programs and disease prevention. Overall, the document outlines the key concepts and approaches used in health education and communication efforts.
The document discusses several models of health communication and persuasion. It describes the linear and transactional approaches to communication. It also summarizes several key models including the Shannon-Weaver model, Hargie's interpersonal communication model, Rosenstock's health belief model, Rogers' therapeutic communication model, and the theory of planned behavior. The document then discusses factors that influence persuasion such as the elaboration likelihood model, communicator credibility, emotional appeals, and personal versus media influence.
This presentation is from a recent CALPACT webinar. To view the event archive page to access the recording and resources, please visit:
https://cc.readytalk.com/cc/s/meetingArchive?eventId=ws23yprxpjgd&campaignId=xceb0hiurg66
Public Health professionals communicate with a variety of audiences in their daily work. While reasonably well-accepted that special consideration be given to low-literate health care consumers in clinical settings, less emphasis has been given to applying health literacy in diverse sectors of public health. Poor health literacy is not limited to those with language or reading skill barriers - only 12% of Americans understand the health information they receive.
As public health professionals we have a responsibility to understand the health literacy barriers. This presentation will provide tips and resources where public health professionals can make a difference in increasing the success of their communication efforts.
While one flu season can pass mildly and with minimal activity, another may hit the country early and hard. CDC health communicators work with subject matter experts and stakeholders to develop messages for a variety of audiences, employing different types of media for effective reach. Due to unforeseen variables, the 2012-2013 flu season posed specific challenges. This presentation will highlight some of those challenges, showcase strategies and messaging used, and preview what’s to come for the 2013-2014 season.
This webinar was the second session in the CALPACT sponsored Health Communication Matters series, which will help participants in all walks of public health to apply health literacy principles to their everyday communications.
Follow Us on Twitter: @CALPACT
Facebook: http://www.facebook.com/CALPACTUCB
Website: www.calpact.org
Questions?
Email sphcalpact@berkeley.edu
The document discusses the key components and principles of effective health communication. It outlines the communication process, including sender, message, channels, and feedback. It describes different types of communication like one-way, two-way, verbal, and non-verbal. The functions and methods of health communication are to provide information, education, motivation, and counseling to promote health. The principles of health education emphasize generating interest, ensuring participation and comprehension, providing motivation and reinforcement, and using community leaders.
The document discusses several theories of health communication, including the Bull's Eye/Linear Theory, Ping-Pong/Circular Flow Theory, and Spiral of Silence Theory. The Bull's Eye Theory proposes that effective communication involves using the right words to convey the intended message to change the receiver's behavior. The Ping-Pong Theory views communication as an interactive process where messages are exchanged back and forth between the sender and receiver. The Spiral of Silence Theory suggests that people are less likely to express opinions they believe are in the minority due to fears of isolation.
INFORMATION, EDUCATION AND COMMUNICATION FOR HEALTHmathewtjoy
The document discusses health education and communication. It defines health education as aiming to achieve individual and community health by translating health knowledge into desirable behaviors. Health education involves providing information, motivating behavior change, and guiding people to adopt healthy practices. It should be tailored based on the target population's sociocultural characteristics. Effective health communication requires clear, accurate, consistent messages delivered by trusted sources across various individual, group and mass methods and media.
The document discusses communication, education, and information strategies for health workers. It makes three key points:
1. Effective communication requires understanding factors like prejudices, attitudes, and life experiences that influence relationships. It also requires clear messaging with a sender, receiver, and message.
2. There are various communication techniques for health workers, including public meetings, group discussions, demonstrations, and various media. Good listening skills and addressing barriers are also important.
3. Providing health information alone is not enough; it must be converted to simple ideas tailored to the community's education level and culture through education and ensuring it meets their "felt needs" to effectively create behavior change.
This document provides information about an academic poster session on health communication and social marketing. It includes learning outcomes focusing on explaining concepts in health communication, social marketing, and creating a problem description for a social marketing plan. Tasks involve individually producing an academic poster and working in teams to identify elements of the social marketing process like producing a poster template and timeline. The document also summarizes models for social marketing including the 4Ps and 7Ps models, and outlines the social marketing process from describing an issue to implementing and evaluating an intervention.
This document discusses the basic principles of health education and communication (IEC). It defines key terms like health education, information, and communication and explains the communication process. Some key points covered are:
- The goal of IEC is to raise health awareness and help people adopt healthy behaviors through informed decision making. It uses various approaches like mass media and interpersonal communication.
- Effective IEC is based on needs assessments, educational principles, and evaluation. It aims to promote specific, desirable behaviors and considers social influences on health.
- Principles of health education include establishing credibility, engaging interest, encouraging participation, providing motivation and reinforcement, teaching from simple to complex, leading by example, and incorporating feedback.
Tailored communication aims to create targeted health messages for individuals based on their unique characteristics. It seeks to increase personal relevance and involvement to better influence behavior change. Research shows tailored interventions can be effective by providing customized messaging that increases relevance, though the impact of message framing on behavior is complex. While gains frames may work better for preventive behaviors like dental hygiene, the effect of framing depends on the behavior and individual motivations being addressed. Ongoing research is needed to refine practical guidelines for developing optimally persuasive health messages.
This document discusses health communication strategies and frameworks. It provides an overview of key components of health communication including senders, receivers, messages, channels, and feedback. It describes the WHO's strategic communication framework, which is based on six principles: making information accessible, understanding audiences, promoting awareness and understanding of risks, promoting knowledge of solutions, instilling confidence to act, and influencing social norms. The goal is to provide information to audiences to prompt actions that protect health.
This document provides an overview of an interprofessional education event focused on collaborative practice with underserved populations. It includes:
- Objectives around developing a shared understanding of teamwork, collaboration, and interprofessional education; providing an overview of national trends in these areas; and discussing populations served and applying principles of interprofessional collaboration.
- Definitions of key terms like interprofessional education, collaborative practice, and interprofessionality.
- Information about the medically complex conditions, rural populations, child poverty, and veterans populations in Maine that are being served.
- An overview of core competencies for interprofessional collaborative practice like values/ethics, roles/responsibilities, communication, teamwork/team
This document summarizes a longer document about factors that influence human behavior and how understanding these factors can help develop effective communications strategies. It discusses three levels that influence behavior - personal, social, and environmental factors. Personal factors include knowledge, attitudes, habits, and beliefs. Social factors refer to interpersonal influences, and environmental factors include local and wider contextual influences. The document also provides overviews of behavioral economics principles and theories of behavior change. It emphasizes that to effectively influence behavior, communications strategies need to address factors at multiple levels rather than just focusing on one.
This document discusses advance nursing practice and information, education, and communication (IEC) strategies. It defines IEC as an approach to change or reinforce behavior regarding a specific health problem. The objectives of IEC are to increase access to services, improve quality, and link supervision with training. IEC aims to change health behaviors through awareness, education, and motivation. Key components of IEC include visit schedules, training, supervision, and monitoring/evaluation. Effective communication and incorporating various media are also emphasized.
This document discusses information education and communication (IEC) and its importance in bringing about positive changes in knowledge, attitudes, and behaviors related to health. IEC involves providing scientific health information to people and educating them to change behaviors and lifestyles to improve their health and community health. The document outlines the IEC process, including planning, implementation, monitoring, and evaluation. It also discusses developing messages and materials, choosing appropriate communication channels, and overcoming barriers.
Steps of developing Behavior Change Communication (BCC) for family planningZakiul Alam
The document outlines the 5 steps for developing effective behavior change communication (BCC) for family planning programs: 1) Analysis of the situation and audience, 2) Strategic design of objectives and implementation plan, 3) Development and testing of BCC materials, 4) Implementation and monitoring, and 5) Evaluation and re-planning if needed. It describes each step in detail, from gathering information in the analysis to ensuring BCC materials are clear, easy to remember, and culturally appropriate, to tracking whether the materials achieve the desired changes in knowledge, attitudes and behaviors. The goal is to use a cyclic approach to continuously improve BCC until successful behavior changes around family planning are achieved.
In 2015, at the NAFSA Region I conference, Apinant Hoontrakul (from International Student Insurance), Ayumi Giampietro (from Pacific International Academy) and Christy Babcock (from Boise State University) presented on the topic of "Increasing Mental Health Awareness Among International Students"
The document discusses interpersonal communication (IPC) and behavior change communication (BCC) approaches. IPC is focused on individual messaging while BCC is outcome-oriented, research-based, and uses participatory methods. BCC addresses knowledge, attitudes, and practices through audience analysis and segmentation. It uses an appropriate mix of interpersonal, group, and mass media channels. The document also outlines key barriers to behavior change in Rajasthan, India and priority areas for a BCC strategy such as antenatal care, institutional deliveries, and nutrition. Current BCC activities in Rajasthan include MCHN day, home visits, group meetings, and folk performances.
The document discusses the importance of relationships when engaging and retaining HIV clients in medical care. It notes that barriers like poverty, health illiteracy, unemployment, violence, and other social determinants of health negatively impact engagement and retention in care, with racial and ethnic minority populations particularly affected. The document presents several case studies that illustrate how linkage coordinators established relationships to link clients into care, addressing issues like lack of transportation, confidentiality concerns, housing instability, and mental health challenges. It emphasizes that early treatment and long-term adherence lead to better health outcomes.
1) Engagement in HIV care ranges from fully engaged patients who regularly attend medical visits to non-engagers who are unaware of their HIV status or never enter into care.
2) Missing medical visits for HIV care can negatively impact health outcomes like increased viral load and drug resistance, and has been associated with higher mortality.
3) Strategies that have been shown to improve retention in HIV care include outreach programs, case management, addressing practical barriers, and strengthening the patient-provider relationship.
aids conference 2016, hiv and aids, hiv interventions, hope program, kenya, nope kenya, people living with hiv, uptake of hiv testing and adherence to hiv treatment
This document discusses strategies for improving retention in HIV care. It provides data showing that missed clinic visits are associated with worse health outcomes and increased mortality. Various reasons are discussed for why patients may miss visits, including work/family conflicts, transportation issues, and forgetting appointments. Successful programs have utilized outreach workers, appointment reminders, reducing barriers to care, and health literacy education to re-engage sporadic patients and improve retention. Clinic strategies discussed include ensuring appointment coverage, using patient tracking databases, pre-appointment reminders, and scheduling labs before visits.
This document summarizes issues related to pediatric adherence for HIV treatment in children and adolescents. It provides data on pediatric enrollment and adherence from ICAP programs in multiple countries. Key challenges to pediatric adherence are forgetting doses, staying away from home, and sleeping through doses. Developmental factors like age and disclosure status can also impact adherence. The document discusses strategies to support pediatric adherence, including education, reminders, involvement of caregivers, clinics that are child-friendly, and multidisciplinary teams. Country examples from South Africa, Kenya, and Ethiopia demonstrate approaches like appointment diaries, integration of services, and collaboration between medical and psychosocial teams to address children's developmental needs.
АРТ в 2016-2017 гг: неизменная потребность в индивидуализации лечения для улу...hivlifeinfo
PB has several considerations for her antiretroviral regimen:
- She wants a single tablet regimen
- Her CD4+ count and viral load make her a good candidate for most regimens
- She has HCV genotype 1a infection
- She takes lovastatin for hyperlipidemia
The best regimen for PB would be:
- DTG/ABC/3TC as it is recommended for most patients, has few drug interactions, and does not interact with lovastatin.
Close monitoring of her liver function would be needed if she initiates HCV treatment in the future while on an antiretroviral regimen.
Join us for an interactive, reflective, and hands-on learning session for school and mental health leaders. Together, we will build out your leadership toolkit to develop the mental health systems and practices on your school campus. In this workshop, we will cover the best practices for school mental health, funding streams (such as Medi-Cal and the Mental Health Services Act) that sustain those practices, and policy approaches that support them. Participants will leave with strategies and knowledge that will support enhanced leadership to drive school mental health equitably in their school community.
This document summarizes a gender-informed program called "What Were We Thinking" that aims to prevent postnatal mental health problems in women. It discusses the partnership between Monash University and Jean Hailes for Women's Health that generates and translates knowledge on this topic. It also provides information on prevalence of postnatal mental disorders, risk factors, existing prevention approaches, and describes the psychoeducational program components and evaluation through a randomized controlled trial. Translations for health professionals and consumers are discussed, along with strategies for sustainability.
The document discusses the role of information, education, and communication (IEC) in public health. Some key points:
- IEC aims to change health behaviors through communication methods over a defined period of time. It is a continuous process that plays an important role in advocacy.
- IEC involves providing information, education to increase knowledge and awareness, and communication to disseminate messages through various channels. Its goals are to facilitate public health education, prepare communities for behavioral changes, and obtain social and political support.
- Effective IEC requires understanding target audiences, developing appropriate messages and materials, disseminating through relevant media channels, and monitoring and evaluating the program's impact on behaviors. Bottlenecks include unclear
This presentation developed by Michelle Constable and Jim McManus, explores how health psychology can help the work of Environmental Health Officers and was part of an introductory workshop for the Environmental Health Profession organised by the Beds and Herts Branch of the Chartered Institute of Environmental Health
This workshop brought together, for the first time, the pioneers and the partner organisations of the Integrated Care and Support programme. It focused on building a learning community that will help develop, share and spread knowledge and solutions at scale and pace across the country.
More information: http://www.nhsiq.nhs.uk/news-events/events/integrated-care-and-support-pioneers-inaugural-workshop.aspx
More about the integrated care and support pioneers programme: http://www.nhsiq.nhs.uk/7862.aspx
This document outlines a training curriculum developed to increase cultural competency around understanding drug-related stigma. The 3-hour training is targeted at non-clinical providers and aims to make concepts of stigma more tangible, translate knowledge into practice, and create a safe space for introspection. The curriculum takes an interactive approach using lecture, discussion, activities, and multimedia. It explores what stigma is, its forms and functions, key elements of drug-related stigma, and implications for providers. Participants analyze strategies to address stigma on individual, staff, and community levels. The goal is to encourage discussion beyond professional experiences and embrace the "messiness" of introspection around personal values and subtle implications of stigma.
Abigail Yeomans is seeking a position utilizing her counseling skills and trauma-informed care background. She has over 1000 hours of clinical experience providing individual and group counseling. She completed her master's degree in clinical mental health counseling and is licensed as a professional counselor-in-training. Her experience includes positions at Rogers Memorial Hospital and The Healing Center providing trauma-informed care for clients with PTSD, substance use disorders, and other conditions.
Realising the Value Stakeholder Event - Main slide deckNesta
This document provides an agenda and background information for a stakeholder event called "Realising the Value". The event aims to empower people and communities to take a more active role in managing their health and care. It will include workshops on understanding value, desired behavioral changes, prioritizing approaches, and how the system can better support individuals and communities. The program seeks to demonstrate the impact of person-centered approaches, develop tools to support implementation, and provide recommendations to enable the healthcare system to work more collaboratively with patients and communities.
Chikungunya definition and it managementMuniraMkamba
This document discusses integrated health services and rural health services in Kenya. It defines integrated health services as the organization and management of health services so that people receive continuous care when and where they need it. Rural health services in Kenya comprise health centers and dispensaries that offer basic promotive, preventive, and curative services. Outreach activities, mobile clinics, and school health services further aim to improve access and continuity of care for rural populations.
The Centre for Children and Young People’s Participation, University of Central Lancashire. Presentation for seminar Series 2014, Children and Social Justice, May 2014
'Embedding children and young people’s participation in health services and research'
Embedding CYP’s participation in health services & researchLouca-Mai Brady
Louca-Mai Brady's background includes research on embedding children and young people's participation in health services and research. There is a lack of evidence on how to ensure participation is meaningful, effective and sustained. Barriers include understanding participation, power dynamics, and challenges recruiting and sustaining involvement of diverse groups of young people. Through action research case studies in an NHS trust and clinical trial, Brady is exploring how to define, operationalize and embed participation at different levels and settings to overcome barriers and be meaningful, effective and sustainable. Flexible, local, youth-centered engagement has proven more successful than traditional advisory groups.
This document summarizes the outcomes of a self-management workshop. Key points include: engaging patients is important for self-management; providing diverse self-management resources embedded in clinical pathways makes it easier for all parties; professionals need skills to motivate self-management and refer to resources; patients and carers benefit from feeling empowered and knowing where to access help; and a pathway approach along with expanding skill sets can help address self-management of health issues holistically rather than just mental health aspects. The group discussed quick wins like a website with resources and embedding some into clinical pathways, as well as longer term goals like culture change across the healthcare system and not just calling it "self management".
Creating value through patient support programsSKIM
Creating value through patient support programs. The document discusses how adopting a patient-centric approach through patient support programs can enhance patient engagement, improve adherence and outcomes, and increase brand loyalty. It provides an overview of traditional versus holistic support programs and outlines key elements such as benefits investigation, education, nursing support, and peer resources. The document also discusses frameworks for understanding patient journeys, stakeholder needs, and conducting market research to identify opportunities to intervene with support.
The Essential Package_Nicole Richardson_4.25.13CORE Group
This document provides an overview of an Essential Package for addressing the needs of young vulnerable children affected by HIV/AIDS. It discusses:
1) What early childhood care and development (ECD) entails and why the earliest years are most critical for development.
2) The components of the Essential Package framework, which provides age-appropriate support for children aged 0-8 and their caregivers.
3) Research conducted in Malawi and Zambia to evaluate implementation of the package and identify best practices, challenges, and recommendations to strengthen and scale up the program.
South EIP Peer & Carer Peer Worker Open Forum - PIER, Portland, Maine (USA) Sarah Amani
We were very happy to hear that Health Education England has an ambition to double the number of Peer Support Workers in mental health as we believe that peer support is such an important part of early intervention in psychosis. EIP teams in the South of England have grown their peer support workforce from 5 to 26 in the last couple of years. To support further development, we have set up a monthly forum for peer support workers and this forum is open to other professionals every 3 months. For the next forum, we will be joined by Randy Morrison (Director of Peer Services), Sarah Lynch (PIER Programme Manager) Danny Kochanowski (Peer Services Supervisor) and Saras Yerlig (Youth Peer Support Worker from the Portland Identification and Early Referral (PIER) Service in Maine, Portland (USA) to hear about how they have embedded peer support work across all their services and how they support peer workers to develop within their role.
Marilyn Wise (Health Public Policy Centre for Health Equity Training and Evaluation) delivered the keynote address at the AFAO/NAPWA Gay Men's HIV Health Promotion Conference in May 2012.
She reflected on what she described as the 'system' of complex, multiple responses, that has evolved in Australia to contain HIV, and what we can learn from our successes in order to address the goals of the UN Political declaration on HIV and meet Australia's targets for HIV prevention and treatment.
Self Management Presentation - Patient Centered Medical Home 2011pedenton
This document discusses patient self-management support, which involves helping patients manage their chronic conditions through education, goal-setting, and developing self-management skills. It describes strategies for supporting self-management, including assessing patient needs and barriers, collaborative goal-setting, enhancing problem-solving skills, and arranging follow-up care. The document also outlines how practices can meet NCQA standards for self-management support and provides resources for implementing self-management programs.
CAMHS Specialist trainees management april 2013Tim Morris
This document provides information about a management competency workshop for child and adolescent psychiatrists. It includes an introduction to the workshop topics such as finance, commissioning, and clinical skills. It also discusses managing yourself, department organization, leadership, communication, and external factors related to working in child and adolescent mental health services. Key points emphasized are the need for multidisciplinary teams, clear roles and responsibilities, effective communication across agencies, and services shaped around the needs of children and families rather than providers.
This document summarizes a presentation about two patient safety improvement projects conducted by Hertfordshire Partnership NHS Foundation Trust. The first project introduced "Care Calls" conducted by the Crisis Assessment and Treatment Team (CATT) for patients not continuing care. The second project used "Moving on Plans" in the Acute Day Treatment Unit (ADTU) to improve knowledge and understanding of the discharge process. Both projects received positive feedback and seemed to improve safety. The document discusses the progress and impact of the projects and includes case studies. It also reviews learning points and recommendations for other trusts.
The document discusses the Right Here initiative, a 5-year pilot program funded by MHF and PHF to improve mental health services for youth ages 16-25 in Brighton and Hove, UK. It is being run by Sussex Central YMCA and Mind in Brighton and Hove through resilience activities, campaigns, peer research, and fast-track counseling. It also details work being done with GPs, including youth research on experiences with GP services, assessment visits to GPs to provide best practices, and developing digital tools like "Doc Ready" and "My Places" to help prepare youth for doctor visits and find local mental health resources.
Similar to Engaging Hard-to-Reach Populations in HIV Care: Empowering the Patient (20)
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations in HIV care and services within their own practices. This Webinar is the third in a three-part series exploring innovative approaches to delivering oral health care and services to people living with HIV/AIDS, featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) Innovations in Oral Health Care Initiative (Oral Health Initiative).
This Webinar explores the clinical aspects of oral health care for people living with HIV/AIDS (PLWHA). The presenters include Dr. David Reznik of Grady Health System in Atlanta, GA and HIVdent and Ms. Helene Bednarsh, MPH of Boston Public Health Commission in Boston, MA and HIVdent. Dr. Reznik and Ms. Bednarsh detail common oral health diseases among HIV-infected people, as well as the prevention, detection, and treatment of these diseases.
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations in HIV care and services within their own practices. This Webinar is the second in a three-part series exploring innovative approaches to delivering oral health care and services to people living with HIV/AIDS, featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) Innovations in Oral Health Care Initiative (Oral Health Initiative).
This Webinar outlines dental case management programs at the AIDS Care Group (ACG) in Chester, PA and the Native American Health Center (NAHC) in San Francisco, CA. The presenters include Dr. Howell Strauss and Mr. Nelson Diaz from ACG; and Dr. Carolyn Brown and Ms. Lucy Wright, RDH, representing the NAHC. The presentation details the pros, cons, and considerations of dental case management from administrative and clinical perspectives. The presenters also provide tips for being a good dental case manager and how this can result in improved health outcomes.
This Webinar provides an overview of common oral health barriers for people living with HIV/AIDS (PLWHA) and the importance of overcoming these barriers. It will also share some of the ways HRSA has helped link PLWHA to oral health care, including the SPNS Oral Health Initiative. Featured presenters include:
- Dr. Mahyar Mofidi; Branch Chief of the Division of Community HIV/AIDS Programs and Chief Dental Officer of the HRSA HIV/AIDS Bureau
- Jane Fox, MPH; Project Director of SPNS Oral Health Initiative Evaluation Center for HIV and Oral Health (ECHO), Boston University School of Public Health.
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations within their own practices and clinics. This Webinar is the first in a three part series featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) Enhancing Linkages to HIV Care & Services in Jail Settings Initiative (Jail Linkages Initiative), as they share lessons learned and advice for others hoping to create or expand similar programs.
Explore how to secure buy-in and foster partnerships within correctional settings, as well as how to navigate the “culture of corrections.” Hannah Zellman of Philadelphia FIGHT, a SPNS Jail Linkages grantee, will present alongside Dr. Linda Rose Frank and Debra D’Alessandro of the PA/MidAtlantic AIDS Education and Training Center about the work their organizations have done individually and collaboratively in the corrections setting.
In this webinar, clinicians from two Ryan White clinics with successful buprenorphine programs describe what buprenorphine is, how it works, what opioids do to the brain, how buprenorphine differs from methadone, important drug-drug interactions, the concept of precipitated withdrawal and how to recognize it, how to determine patient eligibility, and clinical aspects of working with opiod-addicted people living with HIV.
Presenters Pamela Vergara-Rodriguez, MD, (CORE Center in Chicago), and Jacqueline Tulsky, MD (University of California at San Francisco and San Francisco General Hospital), also describe the challenges and successes of the SPNS buprenorphine projects at their institutions.
Visit the Integrating HIV Innovative Practices webpage to learn more about integrating buprenorphine into HIV primary care settings and to access additional training materials.
The intersection of opioid use and HIV is well documented. More than one-third of all AIDS cases in the U.S. are directly or indirectly linked to injection drug use. Additionally, dependence and abuse of pain relievers is on the rise; people living with HIV/AIDS who suffer from chronic pain may be at particular risk. Opioids are highly addictive and mortality among illicit opioid users is estimated at 13 times that of the general population. The SPNS Buprenorphine Initiative investigated the effectiveness of integrating buprenorphine opioid abuse treatment into HIV primary care settings.
This Webcast is the first in a series under the new SPNS Integrating HIV Innovative Practices project (www.careacttarget.org/ihip) to assist providers in replicating SPNS work in their sites. This Webcast will introduce providers to the SPNS Buprenorphine Initiative, its findings, its synergy with the National HIV/AIDS Strategy, and provide an overview of opioid use and HIV.
The subsequent Webcast in the series will examine the clinical aspects of buprenorphine therapy, best practices, and implementation guidance. See also Integrating Buprenorphine Therapy Into HIV Primary Care Settings, a monograph on best practices, available at: https://careacttarget.org/content/integrating-buprenorphine-therapy-hiv-primary-care-settings.
A tremendous need exists to engage hard-to-reach populations in HIV/AIDS care. That’s because numerous factors prevent people living with HIV/AIDS (PLWHA)—especially disadvantaged and disproportionately affected populations—from engaging in care or remaining in care.
This Webcast introduces providers to several successful strategies for reaching the most vulnerable populations:
Howell Strauss, DMD, AIDS Care Group, discusses traditional street outreach, as well as his involvement with both the SPNS Oral Health Initiative and the SPNS Jail Initiative.
Lisa Hightow-Weidman, MD, MPH, Department of Infectious Diseases University of North Carolina at Chapel Hill, shares best practices in social marketing outreach in the context of her work as a SPNS Young Men who Have Sex with Men of Color Initiative grantee.
This Webinar is the second of a three-part series synthesizing successful practices to engage hard-to-reach populations into HIV primary care. Lessons are drawn from SPNS population-specific initiatives, and speakers will offer insights relevant to a wide range of audiences, from clinicians to social workers. Presenters discussed the use of data to improve inreach.
Jane Herwehe, DeAnn Gruber, Betsy Shepard, and Debbie Wendell; Louisiana Public Health Information Exchange (LaPHIE)
Peter Gordon, MD; New York-Presbyterian Hospital/Columbia University
Jesse Thomas; RDE Systems
The goal of Integrating HIV Innovative Practices (IHIP) is to enable health care providers to implement proven innovations within their own practices and clinics. This Webinar is the second in a three part series featuring grantees of the Health Resources and Services Administration’s Special Projects of National Significance (SPNS) initiative on Jail Linkages, as they share lessons learned and advice for others hoping to create or expand similar programs.
Learn how to build a new jail linkage program and what to consider for expanding an existing one. Jail Linkages SPNS grantees—including Dr. Timothy Flanigan of Miriam Hospital, Alison Jordan of New York City Department of Health and Mental Hygiene, and Dr. Ann Avery of Care Alliance Health Center describe the steps their programs took to implement their respective jail linkage programs, and provide advice for others hoping to replicate this work.
The document discusses a project called EnhanceLink that provided HIV testing and linkage to care services for individuals being released from 20 jails over 6 years, finding that 26% of those enrolled had suppressed viral loads 6 months after release, with involvement of case managers in care being a key factor of success. It also presents results of an evaluation and cost analysis finding the interventions were cost-effective from a societal perspective.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
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A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
2. Agenda
Introduction
to SPNS Integrating HIV Innovative
Practices (IHIP) project
Sarah
Cook-Raymond, Impact Marketing +
Communications
Presentations
from SPNS grantees
Angulique Outlaw, Horizons Project
Nikki Cockern, Horizons Project
Margaret Hargreaves, Mathematica
Brief
Q
post-Webinar questionnaire
&A
3.
4. IHIP Resources:
Innovative Approaches to Engaging Hard-to-Reach Populations
Living with HIV/AIDS into Care
IHIP Tools on Engaging Hard-to-Reach Populations
Training Manual
Curriculum
Webinar Series
Outreach – April 18; see archive recording
Inreach – May 1; archive recording to be up soon!
Empowering the Patient - May 15
5. An Introduction to
Motivational Interviewing (MI)
Angulique Y. Outlaw, Ph.D.
Assistant Professor
Director of Prevention Services
Wayne State University School of Medicine
Horizons Project
7. Why Is Change So Hard?
• Lack of motivation from within a person
–
–
–
–
People are not motivated by nagging or fear
Most people don’t change for another person
When pushed, people push back
Ambivalence (pros and cons)
• Lack of confidence (self-efficacy)
• Lack of social support, role models
• Life gets in the way!
8. What Do We Do To Try To
Make Other Change?
• Given them Insight – if you can just make
people see, then they will change
• Give them Knowledge – if people just know
enough, then they will change
• Give them Skills – if you can just teach
people how to change, then they will do it
• Give them Hell – if you can just make people
feel bad or afraid enough, they will change
9. What Is
Motivational Interviewing (MI)?
• Evidenced based intervention to promote
health behavior change
• *MI is
– Client-centered,
– Goal-oriented approach
– Focused on increasing intrinsic motivation for
change by:
• Resolving ambivalence about different
potential courses of action
• Increasing self-efficacy about change
*Miller & Rollnick (2002, 2007)
10. What Is MI?
• A method of communication
– Not a specific session by session
intervention
– Not a bag of tricks
• Good communication at a micro-level
• Making every word count
• Develop rapport, understand the client’s
view
• Elicit and reinforce any and every
communication about behavior change
11. Advantages Of MI
• Client-centered intervention
• Can be performed by a variety of
staff members
• Occurs in a natural setting
• Ambivalence is addressed
12. What Does The Conversation Look
Like?
Empathic and warm
Listening and understanding
Expressing optimism and hope
Reinforcing specific strengths
Emphasizing personal choice and
responsibility
• Offering menu of options
• Discussing value-behavior incongruence
•
•
•
•
•
18. Change Talk
• Disadvantages of doing what you are
doing
• Advantages of change
• Optimism about change
• Intention to change
19. Horizons Project
• Dedicated to providing HIV prevention
services to at-risk youth and direct
care services to youth living with HIV
ages 13-24
• Is the only comprehensive HIV/AIDS
program in Michigan focusing on youth
20. Continuum Of Care
Other Medical Sites
Serving HIV+
Youth
HIV+
Horizons Community
Outreach
Horizons Field &
Internet Outreach
Horizons Peer
Advocacy
C&T Sites
HIV+
Horizons C&T
Horizons Case Finding:
Agency/Field Outreach
Community Agencies
and Resources
Horizons
Clinical Care
Team
Primary Medical Care
Medical Specialty Care
Nursing Services
Health Education
Adherence Support
Social Work Services
Case Management
Ongoing Advocacy
Mentoring
Consumer Involvement
Therapeutic Activities
Transportation
Psychological Services
Psychiatric Consultation
Education and Training
MI for Retention
Prevention Services
(MI and Group)
21. How We Use MI
• Single session (30 minutes)
– As part of field outreach to encourage HIV
C&T
• Single session (30 minutes)
– At initial appointment or first return to care
appointment focused on engagement and
retention in care
– Focused on adherence to antiretroviral
therapy (initiation and maintenance)
– Focused on risk reduction
22. MI Computer Applications
• *Motivational Enhancement System for
Sexual Risk & Adherence
– MISTI (Sexual Risk)(Feasibility study)
• Single session face-to-face or computer delivered
intervention
– MISTI-II (Sexual Risk)
• Two session computer delivered intervention (Baseline
and 3 months)
– MESA (Adherence)
• Two session computer-delivered intervention (Baseline
and 1 month)
*adapted by Ondersma et. al
23. To Sum Up
• Remember MI Elements
– Spirit
• Collaboration, Evocation, & Autonomy
– Principles
• Express Empathy, Develop Discrepancy, Roll
with Resistance, & Support Self-Efficacy
– OARS
• Open-Ended Questions, Affirmations,
Reflective Listening, & Summaries
24. To Sum Up
• Remember MI Elements
– Change Talk
• Disadvantages of Staying the Same,
Advantages of Change, Positive Things
About Change, & Intention to Change
25. MI Resources
• Motivational Interviewing (2012,
2007, 2002) Miller and Rollnick
• Motivational Interviewing with
Adolescents and Young Adults (2010)
Naar-King & Suarez
• www.motivationalinterviewing.org
27. Engaging & Retaining Youth in
Care
Engaging Hard To Reach Populations – HRSA Webinar
Nikki Cockern, PhD
Assistant Professor
Clinical Care Manager
Wayne State University School of Medicine
Horizons Project
May 2013
28. Issues of Adolescence
• Trust
• Often not ready to change, not motivated
• Lack of impulse control
• Rebel against prescriptive approaches – educational, skills
building, traditional counseling
• Physical Changes (thanks to puberty)
• Peak of peer involvement and peer norms
• Heightened experimentation
29. What’s Unique about
Adolescents?
Environment-vitally important
Separation/individuation
• Identity formation as separate from authority figures
• Translating personal goals into behavior within a
constrained environment
• Mood fluctuates
• Trying to figure out who they are and try different roles
Communication skills are still developing
30. Horizons Project
• Dedicated to providing HIV prevention services to
at-risk youth and direct care services to
adolescents and young adults living with HIV
(ages 13-24)
• Has continued to grow as the only
comprehensive HIV/AIDS program in Michigan
focusing on youth
• Wayne State University School of Medicine
(WSU) and the Detroit Medical Center (DMC)
serve as fiduciaries.
30
31. Engagement Strategies
“One-stop shopping” & multidisciplinary approach to HIV care, that is youth sensitive &
culturally competent. Meeting youth “where they are” and focusing on building relationship
Intensive Case Management Services
Identification of needs (initial & ongoing)
Development of comprehensive service plan, including strategies for implementation
Coordination of care & services
Mental Health/Psychosocial Services
Client Advocacy
Transportation
Treatment Adherence Program
Lost to Follow-Up (L2FU) Program
Use of Multi-media tools
32. Horizons Project Enhancements
• Advocates assist youth in enrolling and remaining in care
• Rapid linkage into care
• Intake and medical appointments are provided within the first
week of contact
• Youth often receive resources prior to their med visit
• Direct linkage & support to ancillary care services and resources
• Motivational Interviewing is offered
• Multi-modal contact to youth in preferred medium (i.e. phone,
text, email, Facebook inboxes)
• Jam Sessions (support groups)
• Transportation to ‘life critical’ services (DHS)
• Provide a link to advocacy services if youth do not want to
enroll in medical care
• Actively Promote Consumer Involvement
33. Horizons Project Modifications
• Quickly establish and maintain rapport
•
•
•
Highlight and vitally protect confidentiality, while treating each with dignity and respect
Contact with youth is consistent, yet at varied times and amongst several staff
Staff is available outside of typical “working hours/days” and can be reached via cell and email daily
• Patient advocacy is vital to keeping youth connected and meeting their needs
•
•
Staff often accompany youth to other necessary medical and ancillary care appointments (i.e. DHS,
colposcopy, Dental, GYN, etc.)
Phone contacts for transportation to clinical and ancillary appointments, JAM sessions, other care
related activities
• Decrease barriers to access services
•
•
•
•
Increase frequency of medical clinics held, so more appointment slots are available (including separate day
youth can come in for treatment)
Reserved new patient and sick patient slots during each clinic session
Combined mom/baby or family clinic sessions to decrease the frequency of visits parents have to keep
Use of laptops in medical clinic in order to complete on-line applications for insurance and/or supplemental
coverage programs
• Provide incentives for improved adherence
•
i.e. keeping appointments, reducing drug use ,decreasing incidence of STIs, etc. (works with mental health
team)
• Provide lost to follow-up outreach
•
i.e. phone calls, letters, and home visits (MI)
34. L2FU Program Protocol
MI @ point of
contact & @
clinic appt.
1. Maintain List
Identify youth who
missed clinic
appt. & not
able
to reschedule
5.
Contact made w/
Client & clinic
visit scheduled
Or
Repeat
MI via
phone
MI @ HV if
contact
made
2.
1st month after
missed clinic
visit. Advocate
attempts
Contact via phone/text
4.
3 month
Home Visit
rd
3.
2 month
Mail post
Card sent
nd
35. Social Media Tools
General Information and linkage to Horizons Project and
Community Services
• Horizons Project Website:
http://peds.med.wayne.edu/horizons
Horizons specific information and events/activities
• FaceBook
• Twitter
Adherence to Appointments & ARV regimen
Text Messages (regular, timed texts for youth starting meds & those
w/sig adherence problems) (appointment reminders & check ins)
Email invites on the spot for upcoming med visits w/alarm
Private inbox message through Facebook
37. Summary
One stop shopping, multi-disciplinary team approach to care
• Clinical Services, including intensive case management
• Psychosocial Services
Engagement & Retention Strategies include:
• Rapid Linkage to Care
• Multiple clinic sessions options
• Practical and Concrete Support for accessing resources
• Peer Advocacy, access to support outside conventional time
• Transportation
• Treatment Adherence Program
• L2FU Program
• Use of social media tools
38. Staff Acknowledgement
Director of Medical Service and Research : Elizabeth Secord, MD
Director of Prevention Services: Angulique Outlaw, PhD
Consultant for Psychological Services and Research: Sylvie Naar-King, PhD
ATN Behavioral Research Coordinator: Monique Green Jones, MPH
ATN Clinical Research Coordinator: Charnell Cromer, MSN
Clinical Care Manager: Nikki Cockern, PhD
Clinical Nurse Practitioner: Debbie Richmond, NP
Clinical Social Worker: Tiffani Hollowell, CMSW
Care Coordinator/Case Manager: Keshaum Houston, BS
Adolescent Consultant : Jessica Daniel, MPH
MSM Prevention Coordinator: Jeremy Toney
MSM Outreach Workers: Bre’ Campbell, David Perrett
ATN C2P Coordinator: Emily Halden Brown, MPP
ATN Research Assistant: Cindy Chidi, BS
ATN Linkage to Care Specialist: Valentina Djelaj, LLMSW
ATN 110/117 Outreach Coordinator: Bryan Victor, MSW
Fisher HRH Prevention Coordinator : Te’Neice Dobbins, BS
40. Latino HIV Best Practices:
Improving Access, Engagement and
Retention in Care
May 15, 2013
Engaging Hard-to-Reach Populations – HRSA Webinar
Margaret Hargreaves, Ph.D., M.P.P.
41. Study Methods
Review of the literature
– Impact of HIV/AIDS epidemic on Latinos
– Evidence of effective practices for engaging and
retaining HIV-positive Latinos in HIV care
Site visits to 10 exemplary sites
– 6 States selected for study
– 10 sites selected across 6 states
– 1 to 1.5 day site visits by bilingual teams
Analysis of sites’ 2009 RDR and 2010 RSR data
– Racial/ethnic analysis of client characteristics,
service use, and clinical outcomes
41
42. Selected Sites
–
–
–
–
–
–
–
–
–
–
CARE Resource, Miami, FL
CommWell Health, Dunn, NC
Elmhurst Hospital Center – ID Clinic, Brooklyn, NY
Centro de Salud Familiar La Fe, El Paso, TX
Miami Beach Community Health Center – Immune
Support Program, Miami, FL
Mission Neighborhood Health Center – Clinica
Esperanza, San Francisco, CA
Montefiore AIDS Center, Bronx, NY
San Ysidro Health Center – CASA, San Ysidro, CA
Valley AIDS Council, Harlingen, TX
West Side Community Health Center – Clinic 7, St.
Paul, MN
42
44. Site Characteristics
7 Federally Qualified Health Centers (FQHCs),
2 hospital outpatient departments, 1 AIDS
service organization
RWHAP Funding: Parts A, B, C, D, F, MAI, SPNS
Populations served: Mexico, Caribbean, Central
America, South America, Migrant farm workers
HIV clients served: 160 clients - 2665 clients
Percentage Latino clients: 20 – 80 percent
44
45. Sites’ Quality of Latino HIV Care
9 providers prescribed HAART to Latino
clients at same or higher rate than non-Latinos
4 providers conducted CD4 counts for over
90% of Latino clients in the last year; another 3
providers conducted CD4 counts for over 80%
of Latinos in the last year
3 providers conducted viral load tests for over
90% of Latino clients in the last year; another 4
providers conducted viral load tests for over
80% of Latinos in the last year
45
46. Barriers and Strategies
Barriers to Latino access, engagement, and
retention in HIV care identified at five levels
–
–
–
–
–
Individual
Clinician
Organization
System
Community
Total of 43 strategies were used by HIV
providers to address identified barriers to Latino
access, engagement, and retention in HIV care
46
47. Strategies to Address Individual-level Barriers
– Help completing applications and obtaining eligibility
documentation for Medicaid, Medicare, ADAP, SSA,
Ryan White, SNAP (n=10)
– Referrals for social services, including food and
housing assistance, domestic violence services,
legal aid, immigration services (n=10)
– Transportation assistance, including vans and
metro/bus cards (n=9)
– Targeted Latino support groups for MSM, women,
transgender, Spanish speakers, hepatitis C,
treatment adherence, substance abuse, domestic
violence, HIV education (n=8)
47
48. Individual-level Strategies, Cont.
– Peer health educators, peer counselors, buddies,
who provide health education, system navigation,
social support, and client advocacy (n=7)
– Reinforcement of treatment adherence messages
geared to client literacy levels, using reminder
calendars, pictures, symbols, color codes, pill boxes,
key chains, directly observed therapy, literacy
lessons (n=7)
– Home or clinic delivery of HIV medications by
pharmacy or clinic staff (n=3)
– Client social groups, knitting, arts, crafts (n=3)
48
49. Strategies to Address Clinician-level Barriers
– Knowledge of traditional home remedies, foods,
cultural values, religious beliefs, differences among
Latino subpopulations (n=10)
– Showing warmth, respect, friendship to clients and
their families; having a passion for the work (n=10)
– Fluent Spanish speakers, interpreter lines,
translation support from bilingual staff, certified
interpreters (n=10)
– Staff “willing to go the extra mile” for clients (n=7)
– Home visits, hospital visits, long-term follow-up
(n=7)
– Mostly Latino/Hispanic staff (n=5)
– Avoidance of culturally loaded terms such as gay,
mental health, and psychiatry (n=5)
– Training in cultural competency (n=3)
49
50. Strategies to Address Organization-level Barriers
– Comprehensive one-stop shop of HIV ambulatory
outpatient care and supportive services (n=10)
– Flexible scheduling, double-booking, walk-ins, open
slots for emergencies (n=10)
– Clinic materials in Spanish (signs, notices, videos,
website, brochures, medication labels, posters)
(n=10)
– Frequent appointment reminder calls, missed
appointment follow-up calls, free cell phones to
receive reminders (n=9)
– Close tracking of visits, labs, medications, and
contact information for treatment adherence and
retention purposes (n=9)
– Client confidentiality policies and practices (n=8)
50
51. Organization-level Strategies, Cont.
– Universal screenings for mental health and/or
substance abuse to reduce treatment stigma (n=7)
– Discreet name and location of clinic (n=6)
– Long appointment times for visits with clinicians,
case managers, and counselors (n=6)
– Multidisciplinary teams, team meetings, patient
briefings, case conferences (n=6)
– Expanded clinic hours, evening hours (n=5)
– Comfortable, home-like environment (n=3)
– Offices arranged to facilitate staff/client interaction
and communication (n=3)
– HIV clinician team includes specialists (i.e.,
dermatology, OB-GYN) (n=3)
51
52. Strategies to Address System-level Barriers
– Network of client referrals from Latino-serving
organizations; no wrong door entry into system
(n=10)
– Partnerships, consortia, and collaborations of
Latino-serving organizations (n=8)
– HIV care tracking and coordination across
inpatient/outpatient settings, agencies, states,
U.S./Mexican border (n=7)
– Latino representation on HIV prevention and
treatment planning councils (n=6)
– Health policy or funding advocacy for Latino HIV
services (n=5)
– Expedited, client hand-offs among testing, linkage,
bridge, and retention services staff (n=4)
52
53. Strategies to Address Community-level Barriers
– Targeted outreach to Latino subpopulations—MSM,
women, incarcerated, transgender, migrants,
undisclosed MSM (n=9)
– Discrete identity of outreach and linkage staff to
protect client privacy (n=7)
– Pride events and Latino celebrations to reduce
stigma (n=6)
– Regional HIV conferences and retreats to improve
HIV care (n=4)
– HIV talks to community groups, in churches, on
radio, TV (n=3)
– Latino theatre troops to increase awareness of HIV
(n=2)
53
54. Preliminary Conclusions
Some strategies are linguistically or culturally
specific to Latino populations
Some strategies address barriers common to
underserved populations
Some strategies cost little or nothing to start
By addressing barriers, providers can reduce
or eliminate disparities in Latino access, use,
and retention in HIV care
54
56. Q&A
To be informed when these upcoming IHIP resources are ready,
keep an eye out for HRSA announcements or sign up for the IMC
newsletter email scook@impactmc.net.
Connect with Us
Sarah Cook-Raymond, Managing Director |Impact Marketing + Communications |
Twitter: @impactmc1| Facebook: ImpactMarCom |www.impactmc.net | 202-588-0300
Editor's Notes
I recommend passing out the SPNS Part F fact sheet, the IHIP One-Pager, and a sign-up sheet for the IMC newsletter, along with your business cards of course, and any IHIP samples you want to provide.
Promote Consumer Involvement
Community site for delivery of psychosocial services
Transportation, health education, treatment adherence, mentoring, support groups (jam sessions) and therapeutic activities
Access Dental Clinic
Medical Referrals (consults)
Programmatically, we meet youth where they are and focus highly on building relationships that’s centered on them and done in a respectful and non-judgmental manner
Process includes: Phone calls, Postcards, Home visits, social media, texting & Facebook and MI integrated into calls, home visits, & clinical appointments
Improvement Process-Missed Appointment ProcessYouth who have missed a scheduled medical clinic appointment, without contacting team and scheduling another within 30 days. List Prioritization1. Clients who missed their clinic appointment within the first month (21-30) days and have not rescheduled2. Clients who have not attended a clinic appointment in 2-6 months3. Clients who have not attended a clinic appointment in 6-12 months
Thank you for your time
-My contact information and the Impact Marketing + Communications Website are at the bottom, so please feel free to reach out any time if you have questions about our firm, the IHIP work or any other HRSA deliverables we’ve created, or if there are any marketing or communications projects we can help you with.
- At this time, I’d be happy to take any questions you have about the presentation.