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Brief History

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Minority AIDS Initiatives Brief History Intent & Guidelines Overview of Workplans Strategies MAI Consultation Meeting March 10, 2004 Presented by Robert Tagalicod, MA ... – PowerPoint PPT presentation

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Title: Brief History


1
Minority AIDS Initiatives
  • Brief History
  • Intent Guidelines
  • Overview of Workplans
  • Strategies

MAI Consultation Meeting March 10,
2004 Presented by Robert Tagalicod, MA, PhL
Minority Programs Manager
2
HRSA Guidelines Program Guidance for AETC Funding
  • Brief History of MAI
  • HIV/AIDS in minority communities declared a
    "severe ongoing health crisis (1998)
  • MAI created (2000)
  • Funding for MAI reflected in allocations under
    Reauthorized Ryan White CARE Act (2000)
  • Aim of Current Funding
  • Outcome Improving clinical practices (behaviors)
    of health providers
  • Impact Improved access to quality of care

3
HRSA Guidelines Program Guidance for AETC Funding
Improved quality of life for PLWHA
Improved access to quality of services
Program Logic Deliverables Outcomes
Improved clinical practices
Training Education
4
HRSA Guidelines Program Guidance for AETC Funding
  • Training Priority
  • Level 2 Workshops, seminars hands-on clinical
    experience
  • Level 3 Intensive clinical rotations,
    preceptorships mini-residencies
  • Specific MAI Features
  • Capacity-building based on gap analysis
  • Training-of-trainers other mentoring models
  • Trainee travel for MAI providers
  • Training primary care clinics on US/Mexico border
    (SPNS)

5
HRSA Guidelines Program Guidance for AETC Funding
  • Role of Healthcare Support Services Providers
  • Case managers, social workers, mental health
    workers substance abuse counselors
  • Medical service sites, or
  • HBCUs, HSIs, TCs minority CBOsif part of a
    structured program to expand their ability for
    such training
  • Training of HSSP
  • Must be carefully justified based on needs
    assessment
  • Should result in improved access to /or quality
    of care

6
Overview of Project Outcomes
  • Improved knowledge attitudes
  • Improved clinical practice

7
Specific Project Outcomes Selected Local
Performance Sites Northern California Cluster
  • University of California, Davis
  • Improved multidisciplinary skills among HSSPs
    working with homeless, substance users parolees
    to ensure adherence to antiretroviral therapies
  • San Francisco Area (UCSF)
  • Improved skills among pharmacists other
    targeted providers in correctional settings to
    ensure adherence to antiretroviral therapies

8
Specific Project Outcomes Selected Local
Performance Sites Southern California Cluster
  • University of California, Los Angeles
  • Improved bilingual, community-based services for
    mental health, substance use HIV referrals
    among them
  • University of Southern California
  • Improved skillsboth clinical culturalamong
    minority providers those who serve minorities
  • Drew University
  • Improved clinical knowledge skills including
    training skills among targeted South East Los
    Angeles community-based clinics

9
Specific Project Outcomes Selected Local
Performance Sites Southern California Cluster
  • University of California, San Diego
  • Improved clinical knowledge skills among
    low-volume clinicians in minority neighborhoods
    in greater San Diego
  • University of California, Irvine
  • Improved clinical knowledge skills among Native
    American providers regionally at remote tribal
    facilities

10
Specific Project Outcomes Selected Local
Performance Sites Hawaii, Arizona Nevada
  • University of Hawaii
  • Improved clinical management skills among Pacific
    providers
  • Establishment/expansion of local performance
    site(s) among Pacific Island jurisdictions
  • Upcoming Planned Projects
  • University of Arizona
  • University of Nevada

11
Specific Project Outcomes SPNS Arizona Border
HIV/AIDS Care Project
  • El Rio Health Center
  • Improved capacity to provide outreach
    counseling for at-risk border populations ?
    Increased testing numbers
  • Link PLWHA to primary health care
  • Enhanced capacity of primary care providers in
    rural border communities to provide HIV care

12
Specific Project Outcomes SPNS Southern
California Border HIV/AIDS Project
  • San Ysidro Health Center
  • Increased rates of early detection of underserved
    Latinos living with HIV
  • Increased access to HIV/AIDS primary care
    services
  • Enhanced capacity of Community Health Centers to
    provide culturally competent care core HIV
    services

13
Overview of Local Performance Sites
  • Target Audiences
  • Program Methodologies
  • Evaluation Types

14
Program Overviews UC Davis Modified Direct
Observed Therapy Within Harm Reduction Framework
  • Target Audience
  • Case managers outreach workers
  • Physicians nurses
  • Methodology
  • Modified Direct Observed Therapies (DOT)
    employing Motivational Interviewing
  • Evaluation
  • Formative evaluation with on-going participation
    of experienced outreach workers case managers
  • Project evaluation, e.g., increased number of
    patients showing greater adherence to therapy
    harm reduction protocols

15
Program Overviews San Francisco Area HIV
Pharmacotherapy for Correctional Health Care
Providers
  • Target Audience
  • Pharmacists other targeted providers in
    correctional settings including juvenile
    facilities
  • Methodology
  • All-day clinical training workshops
  • Regional distribution of curriculum
  • Evaluation
  • Immediate post-training evaluations followed by
    short- long-term surveys (including qualitative
    assessments via phone interviews)

16
Program Overviews UC Los Angeles Bilingual
Referral Networking Among Mental Health
HIV/AIDS Providers
  • Target Audience
  • Mental health workers including counselors
  • Case managers
  • Methodology
  • On-site/off-site intensive all-day workshops
    Train-the-Trainer workshops
  • Evaluation
  • Process evaluation by participants via pre/post
    event surveys open-ended interviews
  • Project evaluation, e.g., number of successful
    referrals

17
Program Overviews University of Southern
California Standardized Patients
  • Target Audience
  • Physicians, nurses, nurse practitioners
  • Social workers, case managers counselors
  • Methodology
  • Facilitated small group to practice patient
    interviewing counseling skills with minority
    Standardized Patients
  • Evaluation
  • Standardized Patients feedback to the
    participants
  • Trainee self-assessment surveys

18
Program Overviews Drew University Capacity
Building Among South East Los Angeles Community
Clinics
  • Target Audience
  • Physicians, physician assistants nurses
  • Pharmacists, dentists dental assistants
  • Methodology
  • Trainingoftrainers workshops including
    activities on crosstraining cross-referral
  • Interactive workshops focusing on dual/multiple
    diagnoses treatment issues
  • Evaluation
  • Formative evaluation
  • Project evaluation, e.g., increased number of
    patients showing greater adherence to treatment

19
Program Overviews UC San Diego Outreach to
Training of Low-Volume African American Providers
  • Target Audience
  • Low volume clinicians practicing in minority
    neighborhoods, i.e., African American physicians
    providers in greater San Diego
  • Methodology
  • Full day half-day clinical conferences
  • Mentoring by recognized experts
  • Evaluation
  • Post-conference evaluations
  • Project evaluation, e.g., geo-tracking number of
    consults by experts with minority providers
    tracking HIV patient volume of trained minority
    providers

20
Program Overviews UC Irvine Capacity-Building
Among Native American Providers
  • Target Audience
  • Native American nurses at remote tribal centers
  • Regional Native American health providers
  • Methodology
  • Intensive on-site visits with follow-up
    consultations
  • Three-day clinical training workshops at UCI
  • Evaluation
  • Semi-longitudinal review of clinical outcomes
    pre-/post-ELISA, pre-/post-training surveys

21
Program Overviews University of
Hawaii Capacity-Building Among the Pacific
Island Jurisdictions
  • Target Audience
  • Doctors, nurses health educators in Hawaii
    Pacific Island jurisdictions (PIJ)
  • Methodology
  • Intensive 5-day training
  • Follow-up satellite case conferencing
  • Strategically planned site visits as needed
  • Evaluation
  • Semi-longitudinal post-training evaluations
    follow-up e-mail evaluations
  • Follow-up interviews of sampled PIJ providers

22
Program Overviews SPNS El Rio Health
Center Capacity-Building Among Arizona Border
Primary Care Providers
  • Target Audience
  • Primary Care Providers in Various Settings
  • Cochise County Health DepartmentYuma County
    Health DepartmentMariposa Community Health
    CenterChiricahua County Health CenterBorder
    Health Foundation
  • Methodology
  • Outreach, e.g., promotores
  • Eight core training modules
  • Evaluation
  • Centro de Evaluación, Oklahoma
  • Matrix design multi-site analysis

23
Program Overviews SPNS San Ysidro Health
Center Capacity-Building Among Southern
California Border Health Centers
  • Target Audience
  • Community Health Centers
  • Clinicas de Salud del Pueblo, Imperial
    CountyFamily Health Center, Central San
    DiegoVista Community Clinic, Northern San
    Diego-- Comprehensive Health Centers
  • Methodology
  • Outreach, e.g., promotores
  • Core primary care services at partner sites
  • Evaluation
  • Centro de Evaluación, Oklahoma
  • Matrix design multi-site analysis

24
Where Do We Go From Here?
  • Strategies Toward Successful Outcomes

25
Strategies Assuring Outcomes
  • Continuous Refined Needs Assessments
  • Collaborative Efforts
  • Complementary, non-duplicative coordinated with
    other LPS Central Office with national AETCs
  • Partnered with recognized clinical centers of
    excellence
  • Targeted Programs
  • Aimed at low/mid-volume providers HSSPs
  • Methodologically sound curricula that result in
    measurable improvements in quality of care or
    increased access to care
  • Evaluation
  • Continuous focused on outcomes impact
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