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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?
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