Minority SAHIV Initiative

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Minority SA/HIV Initiative

• MAI Training
• SPF Step 1 Assessment
• Dortha Cummins, CSAPs Southwest CAPT

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Learning Objectives

• Review Strategic Prevention Framework
• Overview assessment
• Define components of assessment
• Explore assessment in context of MAI grant
• Discuss the role of cultural competency in
  capacity building
• Explore sustainability as it relates to capacity

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Outcomes-Based Prevention
Substance abuse related problems
Intervening Variables
Programs, Policies Practices
Planning, Monitoring, Evaluating, and Replanning
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(No Transcript)
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Strategic Prevention Framework

• Step 1 Assessment
• Profile population needs, resources, and
  readiness to address needs and gaps
• Step 2 Capacity
• Mobilize and build capacity to address needs
• Step 3 Planning
• Develop a comprehensive strategic plan
• Step 4 Implementation
• Implement evidence-based programs, policies,
  practices
• Step 5 Evaluation
• Monitor, evaluate, sustain, and improve

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Goals of the Minority SA/HIV Initiative

• Build foundation for delivering and sustaining
  quality, accessible state-of-the-science SA and
  HIV prevention services
• Engage community groups to prevent and reduce the
  onset of SA and transmission of HIV/AIDS
• Focus on high risk sub-populations

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Assessment - Definition

• Process of collecting data to define problems,
  resources, and readiness within a geographic area
  to address needs and gaps

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Why Do Assessment?

• Answers the question, What is going on in my
  community?
• More specifically, it identifies
• The nature and extent of the problem
• The conditions that contribute to the problem
• The resources that currently exist
• The gaps in resources
• The readiness of the community to address the
  problem

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Defining the Problem

• Involves examining the data related to the
  communitys substance abuse and related problems
• Quantitative data are expressed in numerical
  terms and answers the question How Many?
• Qualitative data are non-numeric data rich in
  detail and description and helps answer the
  question What Does it Mean?

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Defining the Problem (cont.)

• Develop an Epidemiological (Epi) profile
• Admission to treatment facilities by drug of
  choice
• Substance consumption and consequence data
• Rate of HIV by gender, exposure category (MSM),
  reported cases, age breakdown
• Conduct focus groups with these sub-groups
• Identifies populations most at risk
• Defines target population in more detail

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Collecting Data

• Collect qualitative data from the identified
  focus population
• Conduct focus groups
• Conduct key informant surveys
• Provides more specific information about the
  problem and ways to address it

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MRT Community Needs Assessment Synopsis
Information

• Target Geographical Area
• Target Gender
• Target Race
• Target Ethnicity
• Target Sexual Orientation
• Target Age Group
• Target Sub-Population(s)
• Needs, Resources, Gaps
• Findings of Epi Data
• Target Risk and Protective Factors

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Assessing Existing Resources

• Resource Assessment is a systematic approach to
  identify existing resources for a specified
  defined service or need
• Also assists in the identification of resource
  gaps

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What Resources Do We Assess?

• Assess those resources currently addressing
  substance abuse, HIV/AIDS and any other
  consequences identified in the data examination.
  Specifically
• Organizations
• Programs
• Individuals

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Identifying Gaps

• Conduct a gaps analysis
• Create a table with two columns
• List the need in the first column
• List the identified resource in the second column
• Gaps exist where no resources are identified
• Create a plan to address the identified gaps

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Sample Gaps Analysis
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Creating a Plan to Address Gaps

• Identify potential evidence-based strategies and
  interventions to address the identified gaps
• Search for evidence-based strategies and
  interventions to fill gaps
• SAMHSA, NIDA, and CDC all have resources
• Addressing substance and HIV/AIDS

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What is Community Readiness?

• Community readiness is
• the communitys
• (or states or organizations)
• awareness of,
• interest in, and
• ability and willingness to support prevention
  initiatives
• Source Achieving Outcomes, August 2002 SAMHSA

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Community Readiness Stages

• Community Tolerance
• Denial
• Vague Awareness
• Preplanning
• Preparation
• Initiation
• Institutionalization
• Confirmation/Expansion
• Professionalization

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Community Readiness Activity

• Consider your own community/organization
• At what stage of readiness is your community?
• Find one strategy that might improving readiness
  in your community

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Readiness Assessment Tools

• Community Readiness Survey, Tri-Ethnic Center for
  Prevention Research
• Community Prevention Readiness Index, Community
  partner Institute
• CSAPs Prevention Platform
• Community Key Leader Survey, Goodman and
  Wandersman
• Community Readiness Survey, MIPH
• Organizational Readiness for Change, Lehman,
  Greener Simpson

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Ensuring Cultural Competence in Assessment

• Cultural Competence
• A set of behaviors, attitudes and policies
• that come together in a system, agency, or
• program or among individuals, enabling
• them to function effectively in diverse
• cultural interactions and similarities within,
• among, and between groups.
• Sources U.S. Department of Health and Human
  Services

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Data Collection and Cultural Competency

• Assessment Data Questions
• What is your priority population(s)?
• Who is collecting the data and information?
• Who is interpreting the data?
• Is the data collected reflective of your priority
  population?
• If there is a lack of reliable information on
  your priority population? If yes, where can you
  go to get data?

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Data and Epidemiology

• Help Agencies, Individuals, and Communities
• Identify and understand the compositions (race
  and ethnicity) of their communities
• Identify the need for data at the community level
  
• Assess adequacy of the data for key tasks
• Identify alternate data sources and methodologies
  for obtaining them

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Cultural Competency Integration

• What is our working relationship with the
  community?
• How do we gain community buy-in, support,
  approval of the data collection and analysis
  process?
• How do we make sure that we are collecting
  cultural competence-related data?
• How do we make sure that the data are culturally
  appropriate and responsive?
• Is our priority population represented in the
  data collected?
• How do we ensure that we are collecting
  culturally relevant data on risk and protective
  factors

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• Addressing Sustainability in Assessment

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Sustainability Defined

• Sustainability is the process of ensuring an
  adaptive prevention system and a sustainable
  innovation that can be integrated into ongoing
  operations to benefit diverse stakeholders
• Ultimately, sustainability is about maintaining
  positive outcomes in communities

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Keys to Sustainability by the Southeast CAPT

• Research document and Training Curriculum
• Looked across organizations at what allows them
  to sustain there outcomes
• Applied the research findings to our prevention
  organizations at the state and sub-state level

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Keys to Sustainability by the Southeast CAPT

• Aligning SPF process researched elements of
  Sustainability
• Identifying elements of Sustainability within
  the 5 SPF steps
• Articulation of these elements with in Action
  plans and other documentation

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The Three Key Objectives for Sustainability are

• Organizational Capacity Assure that the
  community agencies, organizations and
  institutions have adequate internal
  organizational capacity to achieve positive
  outcomes
• Effectiveness Assure effectiveness and alignment
  of the prevention system to produce positive
  outcomes
• Community Support Cultivate community support
  for the prevention system and its positive
  outcomes

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The ten related actions are

• 1. Structures and Formal Linkages
• 2. Policies and Procedures
• 3. Resources
• 4. Expertise
• 5. Quality and Accountability
• 6. Effectiveness
• 7. Reach and Alignment
• 8. Relationships
• 9. Champions
• 10. Ownership

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Elements of sustainability in SPF step 1
Assessment

• What elements of sustainability are present in
  step 1
• How do we know if those elements are present
  (what indicators might be present)
• gtgtgt some guiding questions

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Action areas for SPF step 1 Assessment

• 1. Structures and Formal Linkages (step 1)
• 2. Policies and Procedures
• 3. Resources
• 4. Expertise (step 1)
• 5. Quality and Accountability
• 6. Effectiveness
• 7. Reach and Alignment
• 8. Relationships
• 9. Champions (step 1)
• 10. Ownership (step 1)

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Guiding Questions

• What internal and external linkages, could be
  formalized to ensure the capture and use /
  prioritization of needs assessment data
• Which current skills and expertise will your
  organization rely to obtain and utilize needs
  assessment data?
• Dose your organization have champions in place
  to assist in obtaining hard to access data?

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Action Plan Development Session
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Tough Questions
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MRT Sample Guiding Principles Example

• Cultural Competence affected people in our
  community must be allowed to play a role in
  identifying a rate of prevention and treatment
  strategies, tools, and technologies.
• Data collection data collection must be
  continually recorded, stored, and be accessible
  across silos.

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MRT Sample Accomplishment Barrier Entry

• Accomplishment
• Completion of 20 focus groups with topics
  including cultural view of HIV/AIDS and
  participants perceived risk associated with
  substance use and IV drugs.
• Barrier
• A lack of intervention service awareness exists.

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MRT Sample Conclusions Recommendations Entry

• Conclusion
• Incorporating key guiding principles and
  implementing evidence-based strategies for
  reentry adults is imperative to address the
  needs.
• Recommendation
• Coalition must use the needs assessment data to
  more effectively tailor evidence-based strategies
  to the needs of the community.

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Questions Discussion