Final Products ReportFinal Products Report

Jeffrey A. Sheldon, M. A., Ed. M.Jeffrey A. Sheldon, M. A., Ed. M.Applied Social Science Research & Evaluation Applied Social Science Research & Evaluation

Intern Intern Psycho-social Support & Counselling Psycho-social Support & Counselling

ProgrammeProgrammeSinikithemba HIV/Aids Care CentreSinikithemba HIV/Aids Care Centre

&&Advanced Doctoral StudentAdvanced Doctoral Student

School of Behavioral & Organizational School of Behavioral & Organizational SciencesSciences

Claremont Graduate UniversityClaremont Graduate UniversityThe Claremont CollegesThe Claremont Colleges

Claremont, California, USAClaremont, California, USA

Motivations:Motivations:

• The current organizational climate at The current organizational climate at Sinikithemba & McCord Hospital is one of Sinikithemba & McCord Hospital is one of readiness and commitment to change and growth. readiness and commitment to change and growth.

• Moving forward the quality improvement Moving forward the quality improvement processes already begun around the systems that processes already begun around the systems that support HIV+ patients towards achieving the support HIV+ patients towards achieving the highest possible level of ARV adherence.highest possible level of ARV adherence.

• Continued systemization of processes and Continued systemization of processes and functions.functions.

Intentions:Intentions:

• Producing tools that initiate discussions, compel Producing tools that initiate discussions, compel action, and inform decisions around the process action, and inform decisions around the process of continuous quality improvement. of continuous quality improvement.

• Work that can be implemented without my Work that can be implemented without my further involvement.further involvement.

• Serving as a point of departure for other applied Serving as a point of departure for other applied social scientists and evaluators. social scientists and evaluators.

Process:Process:

• Ten weeks & approximately 400 hours working Ten weeks & approximately 400 hours working closely with both the psycho-social support team closely with both the psycho-social support team and counseling staff. and counseling staff.

• Observations, reviewing documents, and Observations, reviewing documents, and discussions with staff about processes and discussions with staff about processes and functions. functions.

The “Compendium:”The “Compendium:”

• Provides a rationale for each project.Provides a rationale for each project.

• Delineates implementation and management Delineates implementation and management tasks, and what has been done to date. tasks, and what has been done to date.

• Offers implementation and management tasks Offers implementation and management tasks yet to be undertaken as suggestions for future yet to be undertaken as suggestions for future project direction.project direction.

Projects Started & Projects Started & Developed:Developed:

• On-going Counselling Pilot StudyOn-going Counselling Pilot Study

• Sinikithemba ART Patient Training Knowledge, Attitudes, & Beliefs Sinikithemba ART Patient Training Knowledge, Attitudes, & Beliefs Assessment Pilot StudyAssessment Pilot Study

• Situational Analysis of McCord Hospital’s HIV/Aids Counselling ProgrammeSituational Analysis of McCord Hospital’s HIV/Aids Counselling Programme

• Psycho-social Screening Tool Additions to Psycho-social Screening Tool Additions to TrakTrak Health Health

• Sinikithemba Counselling Programme Situational Analysis & Training Needs Sinikithemba Counselling Programme Situational Analysis & Training Needs AssessmentAssessment

• Sinikithemba Forms & Training Materials EvaluationSinikithemba Forms & Training Materials Evaluation

• External Research & Evaluation Proposal to McCord Hospital/Sinikithemba External Research & Evaluation Proposal to McCord Hospital/Sinikithemba HIV/Aids Clinic HIV/Aids Clinic

On-Going Counselling Pilot On-Going Counselling Pilot Study:Study:

• Purpose:Purpose: Testing the concept of on-going Testing the concept of on-going counseling from the perspective of a more counseling from the perspective of a more proactive approach to engaging with patients. proactive approach to engaging with patients.

• Utility:Utility: Ready for full implementation - the Ready for full implementation - the protocol, counsellor guidelines, and a data protocol, counsellor guidelines, and a data collection tool have been developed. collection tool have been developed.

ART Patient Training ART Patient Training Assessment Methods Pilot Assessment Methods Pilot Study:Study:

• Purpose:Purpose: To test which of the proposed To test which of the proposed knowledge assessment methods, or some knowledge assessment methods, or some combination thereof works best with our patient combination thereof works best with our patient population. population.

• Utility:Utility: There is a pool of questions – oral, written, There is a pool of questions – oral, written, and pictorial from which to draw items for testing and pictorial from which to draw items for testing which mode of assessment or some combination which mode of assessment or some combination thereof is most effective. One type of study thereof is most effective. One type of study (quasi-experimental, post-only) has been (quasi-experimental, post-only) has been designed and there is a protocol that can be designed and there is a protocol that can be followed for its implementation. followed for its implementation.

Situational Analysis Of Situational Analysis Of McCord Hospital’s HIV/Aids McCord Hospital’s HIV/Aids Counselling Programme:Counselling Programme:• Purpose:Purpose: 1) Increasing the awareness of how patients 1) Increasing the awareness of how patients

move throughout the system, in particular where move throughout the system, in particular where counselling is used as an intervention, and 2) what counselling is used as an intervention, and 2) what the ideal patient process might entail from that the ideal patient process might entail from that perspective.perspective.

• Utility:Utility: Serving as a point of departure for 1) Serving as a point of departure for 1) evaluating the gaps between the current patient evaluating the gaps between the current patient system and the ideal patient system, and 2) system and the ideal patient system, and 2) beginning a dialogue around the development of a beginning a dialogue around the development of a planning and implementation process for filling in planning and implementation process for filling in those gaps. those gaps. Sometimes, awareness is enough to Sometimes, awareness is enough to compel action. compel action.

Psycho-Social Screening Psycho-Social Screening Tool Additions To Tool Additions To TrakTrak Health:Health:• Purpose:Purpose: Improving the quality and quantity of Improving the quality and quantity of

information about patients such that non-information about patients such that non-adherence risk-factors can be “red flagged” adherence risk-factors can be “red flagged” earlier in the system and interventions put in earlier in the system and interventions put in place. place.

• Utility:Utility: Serving as a catalyst for discussions about Serving as a catalyst for discussions about quality improvements in the flow and quality improvements in the flow and management of patient information and providing management of patient information and providing a mock-up of what pages might look like on the a mock-up of what pages might look like on the TrakTrak Health system. Health system.

Counselling Programme Counselling Programme Situational Analysis & Situational Analysis & Training Needs Training Needs Assessment:Assessment:• Purpose:Purpose: Continuing the work started by Monty & Continuing the work started by Monty &

Stephanie Thomas around development of a Stephanie Thomas around development of a counselor training program through integration of counselor training program through integration of additional evidenced-based counselor additional evidenced-based counselor competencies and standards. competencies and standards.

• Utility:Utility: Serving as a catalyst that will bring Serving as a catalyst that will bring together for dialogue existing, yet disparate together for dialogue existing, yet disparate elements of a formal, comprehensive counselor elements of a formal, comprehensive counselor training program, e.g., the Training Centre, the training program, e.g., the Training Centre, the Resource Centre, the Psychology Department, Resource Centre, the Psychology Department, et et alal. .

Sinikithemba Forms & Sinikithemba Forms & Training Materials Training Materials Evaluation:Evaluation:• Purpose:Purpose: Creating awareness of 1) all the forms that Creating awareness of 1) all the forms that

are used either directly or indirectly by counseling are used either directly or indirectly by counseling staff and how patient information moves throughout staff and how patient information moves throughout the system, and 2) all the printed materials that are the system, and 2) all the printed materials that are used by counselors or provided to patients during used by counselors or provided to patients during training. training.

• Utility:Utility: Serving as a catalyst for discussions about Serving as a catalyst for discussions about the utility of each form to determine 1) revisions that the utility of each form to determine 1) revisions that need to be made, if any; 2) which forms currently in need to be made, if any; 2) which forms currently in use would better serve in an electronic format; 3) use would better serve in an electronic format; 3) the types of forms that need to be added; and 4) the the types of forms that need to be added; and 4) the accessibility vis-à-vis quality and quantity of the accessibility vis-à-vis quality and quantity of the information patients receive. information patients receive.

External Research & External Research & Evaluation Proposal:Evaluation Proposal:

• Purpose:Purpose: Providing a list of questions to be asked Providing a list of questions to be asked of potential external researchers and evaluators of potential external researchers and evaluators as an indication of their general competency in as an indication of their general competency in conducting research or evaluation and the motive conducting research or evaluation and the motive behind such work. behind such work.

• Utility:Utility: Can be used to pre-screen external Can be used to pre-screen external researchers and evaluators by the Ethics researchers and evaluators by the Ethics Committee and anyone else impacted by the Committee and anyone else impacted by the proposed work.proposed work.

The Final Analysis:The Final Analysis:• This work should be utilized wholly at the discretion of those This work should be utilized wholly at the discretion of those

who are charged with implementing these projects and who are charged with implementing these projects and studies. studies.

• This work should be reviewed by more than one person and This work should be reviewed by more than one person and that as time permits, discussions take place as a collective that as time permits, discussions take place as a collective so any resulting decisions about the use of these materials so any resulting decisions about the use of these materials are mutually agreed upon.are mutually agreed upon.

• Any one project or study is likely to impact multiple areas Any one project or study is likely to impact multiple areas across both Sinikithemba and McCord so involvement of the across both Sinikithemba and McCord so involvement of the many will be more beneficial than involvement of the few. many will be more beneficial than involvement of the few.

Thank You

&

God Bless