Minority SA/HIV Initiative

SPF Step 2 - Capacity BuildingPam Tindall, CSAP’s Western CAPT

Haner Hernandez

Marcus Bouligny

Learning Objectives Learning Objectives

Review Strategic Prevention Framework Overview capacity Define types and levels of capacity Explore capacity in context of MAI grant Discuss the role of cultural competency in

capacity building Explore sustainability as it relates to

capacity

SPF – Step 1: AssessmentReview

Outcome-based prevention focus

SPF process

Step 1: Profile population needs, resources, and readiness to address needs and gaps

Documenting findings in the online Management Reporting Tool (MRT)

Strategic Prevention Framework

Step 1: AssessmentProfile population needs, resources, and readiness to address needs and gaps

Step 2: CapacityMobilize and build capacity to address needs

Step 3: PlanningDevelop a comprehensive strategic plan

Step 4: ImplementationImplement evidence-based programs, policies, practices

Step 5: EvaluationMonitor, evaluate, sustain, and improve

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

Best Processes1 for Implementing the Strategic Prevention Framework

1. Analyzing Information About the Problem, Goals, and Factors Affecting Them

Collecting & Analyzing Data About the Problem and Contributing Factors

3. Defining Organizational Structure and Operating Mechanisms

Defining Organizational Structureand Identify Resources

5. Developing and Using Strategic and Action Plans

Developing and Using Strategic Action Plans

7. Developing Leadership Developing Leadership8. Implementing Effective Interventions

Implementing EffectiveInterventions

9. Assuring Assuring Technical Assistance

10. Documenting Progress and

Using Feedback

Documenting Progress andUsing Feedback

12. Sustaining the Work Sustaining the Work

A. AssessmentA. Assessment

B. CapacityB. Capacity

D. ImplementationD. ImplementationC. PlanningC. Planning

E. EvaluationE. Evaluation

4. Developing a framework or model of change

Developing a Model of Change

1Best processes identified through a literature review conducted by Dr. Renee Boothroyd, University of Kansas – used with permission.

Skills Required to Implement SPF(Core Competencies)

1. Analyzing Information About the Problem, Goals, and Factors Affecting Them

Assess Community Needs and Resources

3. Defining Organizational Structure and Operating Mechanisms

Create and Maintain Coalitions & Partnerships

5. Developing and Using Strategic and Action Plans

Develop Action Plans

6. Arranging Resources for Community Mobilization

Improve Organizational Management & Development

7. Developing LeadershipEnhance Cultural Competence

8. Implementing Effective Interventions

Influence Policy Development

9. Assuring Build Leadership

10. Documenting Progress and Using Feedback

Sustain Projects and Initiatives

11. Making Outcomes Matter Evaluate Initiatives

12. Sustaining the WorkSecure Ongoing Funding

A. AssessmentA. Assessment

B. CapacityB. Capacity

D. ImplementationD. Implementation

C. PlanningC. Planning

E. EvaluationE. Evaluation

4. Developing a framework or model of change

Develop Comprehensive Strategic Plans

.

8. Implementing Effective Interventions

Develop Interventions

Building Capacity- Is it Possible?

A shoe factory sends two marketing scouts to the field to study the prospects for expanding business.

One sends back a telegram saying, SITUATION HOPELESS STOP NO ONE WEARS SHOES

The other writes back triumphantly,GLORIOUS OPPORTUNITY STOP THEY HAVE NO

SHOES!

(The Art of Possibility, Rosamund Stone Zander & Benjamin Zander)

Capacity - Definition

The ability to mobilize stakeholders resources

…in order to implement programs, policies, and other changes designed to reduce the likelihood of substance abuse and transmission of HIV/AIDS

Mobilizing Stakeholders

State SA, HIV/AIDS prevention authorities (CDC, SSA) Service recipients (substance users, injection drug users,

GLBTQ populations, recovering community) SA and HIV treatment providers, counseling services Community-based organizations (coalitions, minority,

Planned Parenthood, GLBTQ organizations, etc.) Public health Media Business community (bar owners, GLBTQ-serving) Law enforcement and justice agencies Religious and fraternal organizations Healthcare providers State, local, tribal, Veteran’s governmental agencies Others with a stake in reducing SA & HIV/AIDS

Mobilizing Resources

Resources: the types and levels of assets that exist in a community prevention system that can help meet SA & HIV/AIDS prevention planning and implementation demands

What Capacities Do We Assess?

Human capacities Personnel Knowledge Skills

Fiscal Technical

Data management Skills

Organizational Coalitions Skills

Assessing Capacity at the Community Level

Determine what resources you have (human, technical, fiscal, and organizational) to…

collect and analyze data assess and increase community readiness select strategies to address needs implement policies, programs, & practices evaluate effectiveness sustain efforts

Examples of Capacities

State level Workforce knowledge,

skills and competencies Infrastructure, such as

coalitions Data systems (CDC, SSA) Knowledge of cultural

protocols in sub- populations

Sub-populations’ capacity for prevention (people, skills, funds…)

Community level Community orgs

addressing SA and HIV/AIDS issues

Leadership within the coalition and the community

Prevention knowledge at the community level

Resources allocated and available to address SA & HIV/AID

How Do We Assess Capacity?

Use capacity assessment tools to:

Identify our strengths

Identify gaps in knowledge and skills, and resources

Focus capacity building where it will be most effective in meeting our goals

Capacity Assessment Form (Community Level)

Communities assess their capacity to carry out effective prevention

Assess 5 areas of capacity Rate themselves currently Rate how important they believe each

indicator is to the success of their prevention effort

Large gap scores indicate focus areas for building capacity

Outcome-Based Prevention

Process: Strategic Prevention Framework

Substance Abuse

& HIV/AIDS Patterns &

Consequences

ContributingFactors

Evidence-Based

Programs, Policies & Practices

Step : Focus Capacity Building Here

SPF Logic Model for Reducing High Risk Drinking 18-25 y/o

Young Adult Binge Drinking

Social Norms Accepting

and/or Encouraging

Binge Drinking

Media Advocacy to

Increase Community

Concern About Binge Drinking

Step 2: Focus Capacity Building Here

Consumption Pattern

ContributingFactors

Strategies

Building Capacity

Identify gaps from community capacity assessment

Create an action plan to address gaps

MRT – Sample Entry: Advisory Group

Our Project Advisory Board includes: State CDC and SSA representatives Service recipients Sub-population representatives SA & HIV/AIDS specialists State public health representatives State, Tribal, Veteran’s government

representatives

MRT – Sample Entry: Governing Board

Our Project Governing Board includes: Project Manager Substance abuse experts HIV/AIDS experts Focus population experts Evidence-based interventions, planning &

implementation experts Epidemiologist Evaluator

MRT – Sample Entry: Collaborators

Our Project Collaborators include: Service recipients Sub-population representatives SA & HIV/AIDS specialists GLBTQ specialists Local public health representatives Business representatives Law enforcement and justice reps Health care/service providers Local, tribal, government representatives

MRT – Sample Entry: Guiding Principles

Cultural Competence Sustainability Continuous Quality Improvement Participatory Involvement

Our project is fully imbedded in the community. Our collaborators provide input into each SPF step, and sub-population focus groups review all project reports, recommendations and materials.

MRT – Sample Entry: Accomplishment & Barrier

Accomplishment

An active coalition of community stakeholders with the knowledge, skills and resources to accomplish a comprehensive needs assessment has been established.

This accomplishment enhanced our project’s capacity to collect and analyze data, involve our focus population in our needs assessment processes, and identify resources and service gaps.

MRT – Sample Entry: Accomplishment & Barrier

Barrier

No centralized state or local data management system exists.

This barrier impacted our project’s capacity to easily access data across silos, centrally archive data, and compare data documented using differing protocols.

MRT – Sample Entry: T/TA Report

Data management TA was delivered by the Project Epidemiologist to address data recording, storage and access across silos. Topics included: Online data reporting system Cross-silo collaboration for data

sharing Data access protocols

MRT – Sample Entry: Conclusions & Recommendations

Conclusion

A strong coalition has the knowledge, skills and resources to perform a comprehensive needs assessment.

The effectiveness of this coalition enhances our project’s capacity to understand the impact of SA and HIV/AIDS within our target population and our community, & to utilize focus groups to understand what is required in order to address these needs.

MRT – Sample Entry: Conclusions & Recommendations

Recommendation

A coordinated data management system is needed to enhance the utility and application of needs assessment data.

A coordinated data management system would enhance our project’s capacity to ensure a comprehensive, accurate needs assessment, easy access to data recorded using common protocols, and effective data comparisons.

Ensuring Cultural Competence in Capacity Building

Cultural Competence:Cultural Competence:

““A set of behaviors, attitudes and policiesA set of behaviors, attitudes and policiesthat come together in a system, agency, orthat come together in a system, agency, orprogram or among individuals, enablingprogram or among individuals, enablingthem to function effectively in diversethem to function effectively in diversecultural interactions and similarities within,cultural interactions and similarities within,among, and between groups.”among, and between groups.”

Source: U.S. Department of Health and Human ServicesSource: U.S. Department of Health and Human Services

Integrating Cultural Competence into Capacity Building

Key Questions:Key Questions:

• How do we examine community How do we examine community resources and readiness?resources and readiness?

► ► Key StakeholdersKey Stakeholders

► ► Gate Keepers and Gate OpenersGate Keepers and Gate Openers

► ► Collaborating PartnersCollaborating Partners

► ► Existing Services and ResourcesExisting Services and Resources

► ► Non-traditional Networks and Support Non-traditional Networks and Support SystemsSystems

Integrating Cultural Competence into Capacity Building

Key Questions Key Questions (continued)(continued)::

• What policies are in place or need to be What policies are in place or need to be developed to improve cultural developed to improve cultural competence?competence?

► ► RecruitmentRecruitment

► ► RetentionRetention

► ► TrainingTraining

► ► CommunicationsCommunications

► ► Community InputCommunity Input

Ensuring Cultural Competence in Capacity Building

• How do we identify and mobilize mutually How do we identify and mobilize mutually acceptable goals and objectives?acceptable goals and objectives?

► ► Collaborative ProcessCollaborative Process

► ► Dynamic and FluidDynamic and Fluid

► ► Sometimes feels “messy”Sometimes feels “messy”

► ► Negotiating DifferencesNegotiating Differences

► ► RepresentationRepresentation

Ensuring Cultural Competence in Capacity Building

• How do we check cultural representation?How do we check cultural representation?►► LanguageLanguage►► GenderGender►► AgeAge► ► AbilityAbility► ► EducationEducation

• How do we ensure tools and technology are How do we ensure tools and technology are culturally competent?culturally competent?

• How do we ensure a safe and supportive How do we ensure a safe and supportive environment for all participants?environment for all participants?

Elements of Sustainability in SPF Step 2: Capacity Building

What elements of sustainability are present in Step 2?

How do we know if those elements are present (what are possible indicators, and how can we began to measure them)?

>>>Guiding questions

Action Areas For SPF Step 2: Capacity Building

1. Structures and Formal Linkages2. Policies and Procedures3. Resources (step 2)4. Expertise 5. Quality and Accountability6. Effectiveness7. Reach and Alignment8. Relationships (step 2)9. Champions 10.Ownership

Guiding Questions for Step 2: Capacity Building

Are key community stakeholders supportive of the goals and efforts of the SPF process?

Are any of these relationships creating a barrier to achieving, demonstrating, or sustaining the strategy’s positive outcomes of our SPF process?

Which current resources are needed to carry out a plan to address the issues identified in Step 1?

Of these resources, which is insufficient or is vulnerable?

How have you communicated your evaluation needs and expectations to your evaluator?