This document provides guidance on effective outreach strategies. It defines outreach as interventions conducted by outreach workers to provide prevention information, education, and referrals to at-risk populations in community settings. Effective outreach requires assessing community needs, building trust, working in pairs for safety, and team outreach activities. Safety guidelines for outreach workers include establishing police contacts, having contingency plans, and avoiding drugs. Barriers to outreach include stigma, lack of trust, and lack of community support.

1. OUTREACH STRATEGIES TRAINING
The basic underlining principle of outreach is: to start
where the client is - outside on the streets and in the
community!

2. Basic Definitions
 OUTREACH is:
 An intervention/activity generally conducted by outreach workers, peer
educators, and or health educators, out on the streets, face-to-face, with
individuals at risk for sexually transmitted diseases, chemical dependency
and or homelessness.
 Outreach activities attempt to provide prevention information, education,
risk reduction counseling, referrals, and treatment options to the greater
population(s) on the streets.
 The concept of outreach demonstrates an agency’s willingness to go to the
community rather than wait for the community to come to the agency.

3.  EFFECTIVE OUTREACH
 Is done by trained peer educators who: self-identify with members of
the target population before entering the community to educate on
prevention and the availability of social services.
 Peer educators provide life saving messages, and the dissemination of
educational/harm reduction materials such as: pamphlets, safer sex
cards, condoms, bleach kits, and sexual responsibility kits - free of
charge - to targeted at high risk groups.

4.  OUTREACH
 Efforts result in developing a liaison between the agency and the
community.
 Outreach also fosters networking and collaboration between existing
services and organizations.
 Most importantly, when conducted consistently, outreach can
stimulate behavioral change and the implementation of risk/harm
reduction modalities among the targeted groups.

5.  THE TARGET POPULATION
 Is the population for whom the intervention was developed.
 Target population is described in terms of demographics, social, and
behavioral characteristics. For example: gender, sexual orientation,
age, race, ethnicity, geographic location, and behavioral status.
 An effective outreach program recognizes the extreme diversity of the
target populations and the difference in economic and political
circumstances of these groups.

6. STRATEGIES FOR EFFECTIVE
OUTREACH

7. COMMUNITY NEEDS ASSESSMENT
 A COMMUNITY NEEDS ASSESSMENT
 is a critical first step to any prevention and education program,
including outreach.
 In order to provide outreach services it is important to understand how
sexually transmitted diseases, substance abuse, homelessness and
legal concerns (e.g., sex workers, narcotics, etc) affect your target
population.
 It is also important to assess the current existing services available to
the target community.

8.  The following information would provide insight into the needs of the
target community:
 demographic data,
 HIV seroprevalence data
 risk assessment data for other STDs and drug use
 homelessness statistics
 prevailing attitudes and policies of the legal authorities
 This assessment process will help incorporate and create new
outreach programs and eliminate the duplication of
services/programs. A needs assessment is an essential tool that can
also be utilized for strategic planning, execution of services, program
evaluation, and the overall program monitoring process.

9.  In outreach, the data and surveillance reports gathered from the health
departments and clinics can be a useful tool to orientate outreach
workers on local populations and statistics, since the data is divided
by exposure groups, sex, race, ethnicity, age, and sometimes area of
residence.

10. COMMUNITY NEEDS ASSESSMENT
 Consists of outreach workers canvassing the local scene.
 During the assessment, outreach workers introduce themselves, the
program, and the agency.
 Community assessments are part of an integral, ongoing process
which contributes to the overall success rate of an outreach program.
 Outreach Workers disseminate educational/harm reduction materials,
referral cards, and explain the mission/purpose of their efforts.

11.  Outreach workers must utilize their listening skills in order to learn the
community’s needs.
 Mapping out trends and learning the key players (“gatekeepers”) of
the neighborhoods will help overall outreach efforts.
 Building trust within the community commences at the community
assessment stage.

12. BUILDING RAPPORT/TRUST WITH THE
COMMUNITY
 Building rapport/trust within the community is a critical prerequisite to
conducting street/community outreach.
 Building rapport is helpful and contributes to the overall safety of the
outreach worker while on the streets.
 This is a time consuming task and an on-going process.
 The following basic strategies should be applied in order to build trust
and deliver services out on the streets:
 remain consistent, sensible, visible, sincere, respectful,
genuine, nonjudgmental.

13.  It is also important that the outreach workers “dress down” in order to
blend in with the community.
 All these factors will help the process of building rapport/trust if
applied appropriately.
 Active participation and presence of an outreach worker at the
following local activities/events can also contribute to the process of
building rapport/trust:
 block parties, street/health fairs, holiday festivities, community
board meetings, public hearings
 Remember, an effective outreach program will advocate for its target
population/community.

14. OUTREACH IN PAIRS
 Outreach in pairs offers stability to the program and can be a key
strategy to conducting effective outreach.
 Ideally a community outreach pair should consist of a male and a
female, and be reflective of the racial, ethnic, and linguistic make up of
the target community.
 Partners can help each other in many ways.
 Some of the advantages of working in pairs are: safety, mutual
support, encouragement, presentation of different view points, ideas,
messages, and outreach techniques.

15. TEAM & TABLE OUTREACH
 The concept behind this strategy is to produce visibility as well as to
facilitate team building.
 During this outreach activity, a coordinator and the outreach workers
set up a table on a corner in the heart of a high-risk targeted
neighborhood.
 A Banner and/or poster displaying the agency’s name, address, and
telephone number is also set up.
 Educational/harm reduction materials (condoms, dental dams, female
condoms, bleach kits, literature, referral cards, etc.) and promotional
materials (key chains, pens, note pads, pins, etc.) are neatly placed on
the table.


16.  A couple of outreach workers remain behind the table to answer
questions, provide information, make referrals, arrange appointments,
and demonstrate the correct way to use a condom and/or bleach kits.
 The other outreach workers walk around the neighborhood saturating
it with information about HIV/STDs, location and telephone numbers
of clinics, treatment/rehab programs, shelters, other social services
and distributing educational/harm reduction materials.
 This strategy helps to raise community awareness and to increase
skills in risk reduction.

17.  All materials should be informational and educational, culturally
sensitive and nonjudgmental.
 The approach is always one of harm reduction and is never
threatening or coercive both of which are antithetical and
counterproductive to the philosophy and strategy of street outreach.
 Police should be notified beforehand of the time and place of the
team/table outreach activity; not only for safety reasons, but also, to
keep them away in order to be effective within the community.

18. BUILD RELATIONSHIP WITH LOCAL
POLICE PRECINCTS
 The program director or coordinator should build and establish a
working relationship with the Community Affairs Officer and the local
precincts in those communities where outreach activities are being
conducted.
 This relationship should be on-going and informative.
 It is recommended that the program director or coordinator visit each
roll call on a regular basis to introduce the agency, the outreach
program, the program’s mission and the employees.
 The presentation should point out the benefits/advantages of
conducting outreach in their community and with the target
populations.

19.  These presentations help outreach workers to avoid harassment by
the police officers when working in a high risk or high drug trafficking
area.
 Outreach workers should not make the presentations to the police
precincts for the simple reason that if a client witnesses the outreach
worker entering and/or exiting the local police precinct it will stir up
suspicion and may ruin the outreach worker’s credibility/rapport
within the community.
 An outreach worker/program must respect the client’s rights and not
breach confidentiality.

20. TACTICS FOR STREET
OUTREACH

21.  Outreach efforts provide risk reduction messages and services outside of the
traditional health/social care settings to at high risk individuals, groups, and
communities.
 The level of interventions of an outreach worker/program can range from one-on-one
client services to services to groups of various sizes, to interventions directed at
changing community wide norms.
 The ability to effectively conduct outreach is one of skills, talents, and commitment.
Outreach workers should be respected and recognized as health care professionals.

22.  Outreach interventions have had direct impact on behavioral and social level theories
in a variety of risk reduction and prevention activities.
 Via outreach we have learned and can continue to learn the reasons why people
behave as they do.
 Outreach workers have assisted in developing/identifying interventions that can
influence health and social risk behaviors due to their ability to identify with the target
population as well as to document results.
 Training, staff development, and capacity building are recommended to outreach
workers/programs on an on-going basis in order to remain effective when providing
prevention and education services.

23. Dos & DO NOTs
 The street outreach tactics (DOs & DO NOTs) presented in the
following pages are general techniques that should or should not
be applied when conducting street/community outreach.

24. DOs
 Do conduct needs assessments and evaluate areas where your target
populations hangs out and there is intense activity.
 Do be flexible in scheduling.
 Do accommodate target populations.
 Do establish contacts with police precincts in all areas where you conduct
outreach.
 Do carry identification at all times.
 Do let someone know where you are at all times.

25.  Do work with a partner and be aware of your surroundings.
 Do be aware of how you are feeling and how your partner is feeling as well.
 Do have contingency plans for emergencies and dangerous situations.
 Do accept offers of help from community residents.
 Do find a hook or a way to engage people in conversations on the streets.
 Do learn to recognize some of the characteristics and behaviors of the target
populations.

26.  Do know “avoid & approach” techniques.
 Do know when it is appropriate to engage with a client and when not.
 Do avoid entering shooting galleries and other areas where people are getting
off.
 Do behave respectfully to addicts, dealers, pimps, sex workers and all other
clients in order to win personal trust and confidence.
 Do know the sex workers stroll areas and their hours of operation.

27.  Do have good listening skills; hear people out.
 Do dispel myths and misconceptions about AIDS, drug abuse and other social
ills.
 Do distribute literature that is culturally appropriate.
 Do suggest that clients pass along their literature, extra condoms, and bleach
kits to their friends, families and loved ones. Do distribute literature that is
culturally appropriate.
 Do describe treatment options and make them available to clients in the
streets.

28.  Do be ready to direct clients to social services.
 Do assure clients that you will maintain confidentiality.
 Do provide follow-up and deliver promises.
 Do tell clients when you will be back and where you can be reached. Give them
a hotline or work phone number.

29. DO NOTs
 Do not wear expensive clothes jewelry or uncomfortable shoes.
 Do not carry valuables or large amounts of money, or take your wallet out.
 Do not use a beeper in a visible way. It makes clients nervous and the police
may think you are a runner. You must keep it hidden and in the vibrate/silent
mode.
 Do not carry weapons.
 Do not carry, hold, handle, or sample any kind of controlled substance or other
merchandise such as works and/or other drug paraphernalia.

30.  Do not pretend to be an active addict, sex worker, etc. in order to ingratiate
yourself or gain information. Be honest about your role.
 Do not pass any information you may have about where drugs are being sold.
 Do not get high, have sex, or engage in criminal activities with clients.
 Do not buy stolen goods.
 Do not give or lend money to clients.

31.  Do not act pretentious, be honest, be yourself.
 Do not come on too strong, pressuring clients to change behavior and/or
accept materials.
 Do not counsel on the streets or act as a social worker, nurse, etc. Use your
referral network to direct clients to services.
 Do not play doctor or clinician and try to diagnose infections, or any ailment or
mental health issue.

32.  Do not expect all clients to achieve immediate results and implement behavior
change. Concentrate on helping them reduce risk and acknowledge whatever
changes and/or progress they have accomplished/demonstrated.
 Do not make promises on the streets that you can not deliver.

33. SAFETY GUIDELINES

34. SAFETY ON THE STREETS
 The safety and well being of the outreach workers, in general, cannot be
guaranteed while out on the streets.
 The reason for this is that outreach is mostly always conducted in high risk
areas such as: high drug trafficking areas, gang war areas, and high crime
areas.
 This might pose a danger to anyone’s well- being and safety.
 Also, the behavior of substance abusers, mentally ill, chemically dependent
and homeless clients, needs to be addressed tactfully.

35.  This is not to insinuate that all areas and target populations are dangerous.
 However, it is intended to raise awareness with reference to the reality that
outreach workers are always at risk due to the unforeseen.
 Outreach workers must literally watch each other backs while on the
street/communities.

36.  Outreach programs can implement and adhere to field safety guidelines such
as the following to ensure some degree of safety/well being:
 Carry picture identification at all times, including the agency’s name, name of
project, outreach worker’s name and title.
 Work in pairs so that while one outreach worker is engaging in dialogue with a
client, the other must literally “watch their backs” and surroundings.
 Remember to have the program director or coordinator establish a relationship
with the local police precincts.
 Make contingency plans for worst case scenarios. These plans should be
shared with partners and agreed on by teams.

37.  Get a TB skin test and retest periodically.
 Be aware of weather conditions and be prepared for natural occurrences.
 Design and adhere to a schedule.
 Avoid drinking alcohol or buying, receiving, sampling, and doing any drugs
while conducting outreach.
 Establish a mechanism to keep supervisor(s) aware and informed of your
locations and activities at all times.
 Always call the office/supervisor at the end of shift.
 These recommendations are designed to be a working tool and are
not engraved in stone; therefore, they may be amended as deemed
necessary and appropriate for your outreach program.

38. BARRIERS TO OUTREACH

39. COMMUNITY BARRIERS
 Stigmas, myths and misconceptions
 Drugs and behaviors
 Politics
 Lack of support
 Lack of trust
 Lack of funds
 Community barriers to effective outreach will always exist.
 However, outreach workers should take every opportunity to explain in clear,
culturally appropriate terms the goals of their outreach efforts.

40.  The view of distrust that exists in communities in which outreach efforts are
performed, makes community relations an indispensable part of outreach work.
 Active listening will help you learn what your clients’ needs are and how to
better serve them.

41. PERSONAL BARRIERS
 Negative attitudes, prejudices, homophobia, sexism, etc.
 Being judgmental toward clients/target populations
 Lack of respect for clients, agency, or outreach efforts
 Health conditions
 Relapse and/or substance abuse problems
 Personal barriers to effective outreach will also always exist.

42.  It is the responsibility of the outreach worker to give his/her target population
100% while on the streets.
 Outreach workers must remain nonjudgmental and present information,
treatment options and harm reduction materials regardless of personal
feelings, beliefs, and experiences.
 Note. It is also the responsibility of the coordinator/supervisors to provide
their staff with a safe space to discuss issues in relation to prevention case
management, stress management and relapse prevention.

43. ADVANTAGES OF OUTREACH
 Raise awareness about prevention, treatment, care and social services for
HIV/AIDS/STDs, chemical dependency, homelessness, etc.
 Create support for the target populations and communities.
 Provide resources and referrals of current services.
 Advocate for target population(s), available services, and increase funding.
 Educate community in general.
 Provide life saving information and messages.

44.  Foster networking and collaboration.
 Gather findings/data for research.
 Build self-esteem among targeted population.
 Change attitudes to hopefully foster behavioral modification and/or
implementation of harm reduction strategies.
 Overall, outreach efforts are important for effective prevention programming.

45.  The information provided in this training guide is intended to strengthen the
capacity of outreach workers.
 This is a reference tool and you are encouraged to apply, and amend
information as deemed appropriate.
 Remember, while the basic outreach strategies may be universal there are also
specific tactics, techniques, and strategies that need to be applied according to
the target population, proposed interventions, and program’s objectives.