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GRANT WRITING PREPAREDNESS:WEBINAR SERIES

GRANT WRITING PREPAREDNESS:WEBINAR SERIES

A collaboration:•Shared ActionAIDS Project Los Angeles-

•C4H ProjectAsian & Pacific Islander American Health Forum

•The California STD/HIV Prevention Training Center

TODAY’S WEBINAR:

California STD/HIV Prevention Training CenterCapacity Building Assistance Program

Gustavo Campos

WAS DEVELOPED BY:

4C A PA C I T Y B U I L D I N G

A SS I S TA N C E P R O G R A M

SelectingEffective Behavioral Interventions

andPublic Health Strategies

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Agenda

1. Four Steps for selecting an Effective

Behavioral Intervention (DEBI)

2. Defining and describing Public Health

Strategies (PHS) for HIV prevention

3. Integrating PHSs and DEBIs

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Four Steps for Selecting an Effective Behavioral Intervention (DEBI)

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This doesn’t look like the

iPad I wanted…

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Knowintimately

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Knowintimately

Assess CommunityHIV Prevention Needsand Strengths

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Browse for Gift Options

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Browse for Gift Options

ExamineBehavioral Interventions

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What ismyGift

Budget?

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What ismyGift

Budget?

AssessAgency

Capacity

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Choose…

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Choose…

…the appropriate intervention

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1. Assess community

HIV prevention needs and strengths

2. Examine behavioral interventions & make first match

3. Assess agency

capacity

4. Make final match

of community, DEBI, and

agency

Four steps to select a DEBI

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Two Questions Must Be Answered:

Which is the best behavioral intervention for

my target population?

Does my agency have the resources to

implement and maintain this behavioral

intervention?

22C A PA C I T Y B U I L D I N G

A SS I S TA N C E P R O G R A M

Key DefinitionsMaking sure we are speaking the

same language

What is a Behavioral Intervention?

It is an activity or group of activities based on

behavioral theory, which are intended to

motivate individuals and/or their social groups

to change their behavior in order to reduce

their health risk.

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What is DEBI?

The Diffusion of Effective Behavioral Interventions (DEBI) project was designed to bring science-based behavioral HIV prevention interventions to community-based service providers and state and local health departments.

These packaged interventions are colloquially referred as “DEBIs”

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Levels of InterventionSTRUCTURAL

LEVEL INTERVENTIONS

INDIVIDUAL LEVEL

INTERVENTIONS

POL

Community

PROMISE

Mpowermen

t

MIPPCC

PolicyLaws

SISTA

3MVHealthy Relationships

Respect

D-Up

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Knowintimately

Step 1: Assess CommunityHIV Prevention Needsand Strengths

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1. Assess community

HIV prevention needs and strengths

2. Examine behavioral interventions & make first match

3. Assess agency

capacity

4. Make final match

of community, DEBI, and

agency

Four steps to select a DEBI

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A Reliable Community Assessment includes:

Epidata

PUBLISHEDARTICLES Reports by Local

Organizations

Interviews andfocus groups

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HIV & STD Epi Data

Focus on the Behavioral

Determinants

HIV Risk Factors

HIV Risk Behaviors

How to use Community Assessment Results

Intervention Population

What are HIV Risk Behaviors?

Only those behaviors that can directly pass HIV from one person to another:

1. Unprotected anal and vaginal intercourse

2. Sharing unclean syringes and works

3. Maternal/child contact (pregnancy, delivery, breast feeding)

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HIV & STD Epi Data

Focus on the Behavioral

Determinants

HIV Risk Factors

HIV Risk Behaviors

How to use Community Assessment Results

Intervention Population

What are HIV Risk Factors?

Behaviors or circumstances that increase the

chances that HIV transmission will occur

Some Risk Factors are behavioral

determinants

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HIV & STD Epi Data

Focus on the Behavioral

Determinants

HIV Risk Factors

HIV Risk Behaviors

How to use Community Assessment Results

Intervention Population

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What are Behavioral Determinants?

Things that have been proven to influence risk behaviors

Often have to change BEFORE actual risk behavior can change

Behavioral interventions are designed to change these determinants

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Behavioral Determinants

Intention

Knowledge

Attitudes and beliefs

Perception of risk (and

others)

Self-efficacy

Skills

Values

Perceived norms

Social norms

Social support

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HIV Risk Factors

DepressionEconomic

dependency

Low levels of education

Low skills in condom

negotiation

Low self-efficacy for condom use with main partner

Gets STDs from main partner

Poverty

Doesn’t know

STD makesher more

vulnerable to HIV

Lives in high STD & HIV census

tract

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HIV Risk Factors

DepressionEconomic

dependency

Low levels of education

Low skills in condom

negotiation

Low self-efficacy for condom use with main partner

Gets STDs from main partner

Poverty

Doesn’t know

STD makesher more

vulnerable to HIV

Lives in high STD & HIV census

tract

Behavioral Determinants: knowledge, self-efficacy, skills in condom negotiation

Doesn’t know

STD makesher more

vulnerable to HIV

Low self-efficacy for condom use with main partner

Low skills in condom

negotiation

38C A PA C I T Y B U I L D I N G

A SS I S TA N C E P R O G R A M

Ready to recognize “behavioral

determinants” in the

daily language people use?

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“I know you don’t need to get tested for STDs if

you don’t have symptoms”

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“I know you don’t need to get tested for STDs if

you don’t have symptoms”

knowledge

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“You can’t walk up and be in the group, you have to bareback to

prove you’re one of us”

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“You can’t walk up and be in the group, you have to bareback to

prove you’re one of us”

social norms

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“I mean…we use condoms, but I don’t think you’re expected to do that with a ‘regular’ partner”

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“I mean…we use condoms, but I don’t think you’re expected to do that with a ‘regular’ partner”

perceived norms

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“Getting HIV isn’t that

bad; you just have to

take a bunch of pills”

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knowledge • attitudes & beliefs • perceived risk/severity • intentions

self-efficacy • skills • values • perceived norms • social norms • social support

“Getting HIV isn’t that

bad; you just have to

take a bunch of pills”

perceived risk/severity

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With history of STDs

Urban Community

Narrowing your Population Intervention

African American

MSMage 24-34

Has not been tested for HIV in over 2 years

You might choose any of these

groups as your DEBI intervention

population

STD history & has not been tested for HIV in over 2 years

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Browse for Gift Options

Step 2: ExamineBehavioral Interventions

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1. Assess community

HIV prevention needs and strengths

2. Examine behavioral interventions & make first match

3. Assess agency

capacity

4. Make final match

of community, DEBI, and

agency

Four steps to select a DEBI

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How to Learn about DEBIs

Go to www.effectiveinterventions.org

Use the Behavior Change Logic Models

Review the Behavioral Determinants

Read the DEBI Fact Sheets

Also review: CDC procedural guidance & research

article on the intervention

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How do DEBIS work?In this Intervention Population

TheseHIV Risk Behaviors and Factors

Which lead to these

Outcomes

Which will be influenced by these Intervention Activities

Include these Behavioral Determinants

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Intervention Outcomes

Immediate Intermediate Long Term

Changes in behavioral determinants

Decrease in HIV risk behaviors

Decrease in new cases of HIV

The measured changes expected from the DEBI

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Behavioral Determinants

of HIV RiskBehaviors

InterventionActivities

IntendedOutcomes

(Immediate, Intermediate

& Long-term)

Behavior Change Logic Model

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Problem Statement“Black gay men and other Black MSM are at risk for HIV infection because of HIV risk behaviors, low levels of health-promoting behaviors, and the high background prevalence of HIV and STDs among Black MSM. A combination of social, cultural, and personal factors influences these behaviors”

Example: “Many Men Many Voices”Logic Model

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- Lack of knowledge

- Low perception of risk

- Lack of skills

- Low self-efficacy

- Lack of social support

Group sessions involving

discussions and role plays about:

- Roles & risks of tops & bottoms

- STD & HIV interactions

- Harm reduction

- Partner communication

-Condom negotiation

-Increase knowledge of the

interaction between STDs & HIV (immediate)

-Perception of risk increases

(immediate)

- Reduced frequency of

unprotected anal sex (intermediate)

- HIV infections decrease (long

term)

Behavioral Determinants Activities Outcomes

Example: “Many Men Many Voices”Logic Model

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First Match

Your • Intervention

Population• HIV Risk

Behaviors • Behavioral

Determinants

DEBIs• Intervention

Population• HIV Risk

Behaviors• Behavioral

Determinants

Find a few DEBIs with the best Match

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What ismyGift

Budget?

Step 3: AssessAgency

Capacity

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1. Assess community

HIV prevention needs and strengths

2. Examine behavioral interventions & make first match

3. Assess agency

capacity

4. Make final match

of community, DEBI, and

agency

Four steps to select a DEBI

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How do I know that I have adequate capacity?

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Agency Assessment Overview

Do we have the capacity to:

Plan and put in place new programs and services?

Recruit and retain and work with the intended intervention population?

Implement and maintain the DEBIs initially chosen from 1st Match?

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Tools for Capacity Assessment

Agency Readiness Self-Assessment Tool

Program Implementation Plans

CDC’s Procedural Guidance for each DEBI

Fact Sheets, Starter Kit, Administrator’s Preview Guide, Technical Assistance Guide

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How to Access the Tools

Go to www.effectiveinterventions.org

Click on specific DEBI on left

Click on Resources and Tools on right

Also check training requirements

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Step 4: Choose…

…the appropriate interventionFinal Match of Community, DEBI,

and Agency

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1. Assess community

HIV prevention needs and strengths

2. Examine behavioral interventions & make first match

3. Assess agency

capacity

4. Make final match

of community, DEBI, and

agency

Four steps to select a DEBI

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Two Questions Must Be Answered:

Which is the best behavioral intervention for

my target population?

Does my agency have the resources to

implement and maintain this behavioral

intervention?

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Public Health Strategies (PHS) For HIV Prevention

Defining and Describing

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What are Public Health Strategies?

Public Health Strategies are time tested protocols used by public health practitioners in the prevention, screening, diagnostic, or treatment processes. They are based on established principles of public health; including primary, secondary, and tertiary prevention, and may include a range of activities.

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Current Public Health Strategies for HIV Prevention

HIV Counseling, Testing and Referral (CTR)

Comprehensive Risk Counseling & Services (CRCS) for Uninfected/ PLWH

Rapid HIV Testing in Nonclinical Settings

Incorporating HIV into the Medical care of PLWH

Partner Services

ResourcesPlanning

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Does my agency have the adequate capacity for a specific PHS ?

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ReviewCDC's Procedural Guidance for CBOs

Implementation Planning and Program Objectives Tools

Monitoring and Evaluation (M&E) Key Activities

http://www.effectiveinterventions.org/en/PublicHealthStrategies.aspx

Integrating PHSs and DEBIs

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Some things go well

together…

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Public Health Strategy

DEBI DEBI

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Counseling, Testing & Referral

Personalized Cognitive Counseling (PCC) Respect

Comprehensive Risk Reduction Counseling and

Services (CRCS)

CLEAR

Webinar May 10 @ 11:00 am. www.stdhivtraining.org

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Incorporating Prevention into the Medical Care of

PLWH

Partnership for Health

85C A PA C I T Y B U I L D I N G

A SS I S TA N C E P R O G R A M

What is the potential new role of

CBOS in helping to deliver public

health strategies?

Selecting Effective Behavioral Interventions Course

April 20-21, 20 118:30- 5:00 pm

Oakland, CaliforniaCall (510) 625-6000 or visit www.stdhivtraining.org

for information

87C A PA C I T Y B U I L D I N G

A SS I S TA N C E P R O G R A M

Thank You!For questions contact: Gustavo Campos, MS

gustavo.campos@ucsf.edu

Developing an Evaluation Plan April 12, 2011 at 11am (PST)

Grant Writing April 15, 2011 at 11am (PST)

Oscar Marquez: omarquez@apla.org

GRANT WRITING PREPAREDNESS:WEBINAR SERIES

AIDS Project Los Angeles- Shared Actionwww.sharedaction.org

C4H Project at the Asian & Pacific Islander American Health Forum

www.capacity4health.org

The California STD/HIV Prevention Training www.stdhivtraining.org

GRANT WRITING PREPAREDNESS:WEBINAR SERIES

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