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CAI News October - December 2008 Vol. 1, No. 4 |
CAI Celebrates 30 Years of Service
Cicatelli Associates Inc. (CAI) is proud to announce that 2009 marks our 30th Anniversary of providing training and capacity development for health and human services providers that is directed at enhancing the breadth and quality of health care and social services being delivered to underserved and vulnerable populations. As CAI marks this momentous occasion, we remain dedicated to addressing some of the most challenging health issues of our times by working to overcome health disparities, eliminate stigma and discrimination, and provide solutions to addressing increasing needs in the face of decreasing resources.
AFBCF Awards New Grants and Conducts Teleconferences and Webinars
Since 2000, the Avon Foundation has funded CAI to administer, coordinate and manage the Avon Foundation Breast Care Fund (AFBCF) and distribute more than US$6 million in grants to more than 140 national community-based, non-profit organizations each year. Through a competitive annual application and independent grant review process, programs are chosen based on their ability to reach women who face barriers to receiving health care.
The competitive review of applications for 2009 funding was just completed and a total of $6,150,000 will be awarded to 143 organizations across the United States, with at least one AFBCF funded project in every state. These projects are expected to bring more than 100,000 women into breast cancer screening and treatment during 2009.
In other news, in 2008 the AFBCF presented 14 educational teleconferences and webinars to grantees. The purpose of these programs is to provide an opportunity to learn about new issues and pertinent cutting-edge information about breast health and other related topics from leading experts. In the past the AFBCF only used conference calls, but this year the presentations were greatly enhanced through webinar. With webinar technology the speakers can present PowerPoint slide presentations in real time with the audience following on their computers while listening to the speaker on the phone.
Topics for the 2008 programs were suggested by the 145 grantees, and they ranged from a discussion on complementary and alternative medicine to a more technical presentation on mammographic breast arterial calcification and risk of cardiovascular disease. Other programs presented were:
A new Avon Foundation initiative called the Army of Women was highlighted in our October webinar. The Avon Foundation has partnered with the Dr. Susan Love Foundation to sign up more than a million volunteers who are willing to participate in cancer prevention research. The research projects will focus on cancer prevention strategies rather than cancer treatment. Dr. Dixie Mills, medical director of the Susan Love Foundation and Dr. Marc Hurlbert of the Avon Foundation were the presenters for the program.
For more information on the AFBCF, please visit www.avonbreastcare.org. To learn more about the Army of Women, please go to www.armyofwomen.org.
Three-Year Project Summary: Integrating Peer Advocates as Essential Members of Multi-Disciplinary Healthcare Teams
As a three-year demonstration project, Integrating Peer Advocates as Essential Members of Multi-Disciplinary Healthcare Teams, helped Ryan White Care Act (RWCA) clinical sites improve client adherence to medication and retention in care by building their capacity to have peers work effectively on their healthcare teams. This project included the development of a training curriculum and toolkits, and the delivery of training and follow-up technical assistance for Peer Advocates and Supervisors. CAI also produced a Promising Practices document that allows clinical sites to replicate the program nationwide. During the project, CAI trained 190 Peers, Supervisors, and Clinic Managers from 57 RWCA clinical sites nationwide.
The four-day training program on integrating peers has three main components. Days one and two work with peers to increase their knowledge, skills and abilities within their healthcare roles and responsibilities. On day three, managers and supervisors join the peers to discuss together how peers can best be integrated into healthcare teams so they are most effective. On the final day, only peer supervisors and clinic managers attend to learn ways of recruiting peers, defining their roles and developing their skills.
All clinical sites that attended the training participate in follow-up technical assistance activities such as post-training conference calls and webinars, and some clinics also received on-site intensive technical assistance. The conference calls and webinars have allowed training participants from across the country to network and receive additional information on relevant topics such as “Boundaries” and “Motivational Interviewing”.
To offer additional support to clinic sites in the integration of the Peer Advocates post-training, CAI also created two separate toolkits for Supervisors and Peers. The toolkits can be downloaded on the TARGET center website (www.careacttarget.org).
The final component of the project is the development of a Promising Practices Report, which was written by James Bell Associates. This report utilizes data from qualitative case studies and includes strategies for the adoption of Promising Practices as well as resource requirements and step-by-step instructions on replication in other agency settings. The report will be available on the CAI website in Spring 2009.
Healthy Teens Initiative Expanding to Brooklyn
The New York City Department of Health and Mental Hygiene (NYC DOHMH) Healthy Teens Initiative (HTI) is wrapping up activities in the Bronx and moving on to Brooklyn in January 2009. The HTI was launched in 2006 as part of an effort to increase access and reduce teen pregnancy in boroughs with some of the highest teen pregnancy rates in New York City; CAI’s role is to provide free training and ongoing support to all HTI partners. After HTI partners complete required and optional trainings they are eligible to receive a range of individualized instruction, technical assistance and ongoing support offered by CAI that helps them to make dramatic improvements to their health care systems to increase both access to and quality of sexual and reproductive health care provided to tweens, teens and their parents or caregivers.
As part of the HTI in 2008 in the Bronx, five clinics in pediatric and family practice settings participated in intensive on-site training and technical assistance. Accomplishments included providing on-site training to more than 120 multidisciplinary clinic staff on minors’ rights and delivering teen friendly services. A number of participating sites also increased access to birth control by initiating same-day start of hormonal birth control, dispensing birth control – including emergency contraception – on site (instead of writing a prescription), and increasing appointment lengths for adolescents to assure enough time to address psychosocial concerns. One site elected to open a Teen Only clinic on Wednesday afternoons and all sites are working toward implementing policies to provide reproductive health services to unaccompanied minors.
The Initiative will start in Brooklyn in January 2009 with a slightly revised model. All activities will be focused among providers in the Brooklyn District Public Health Office that are located in communities that have significant health disparities. Providers who sign on to be Healthy Teens Initiative Partners will participate in district-wide HTI Trainings focused on providing all health care providers with baseline knowledge about the need for reproductive health services among adolescents. Topics to be covered include: Minors’ rights to access confidential reproductive health care without parental/caregiver consent; Removing financial barriers to youth accessing reproductive health care without a parent/caregiver; and Increasing access to hormonal birth control.
Partners will also be offered an opportunity to participate in an HTI “Model Clinic” Collaborative – a tool developed by the Institute for Health Care Improvement that is utilized around the world to make dramatic improvements in the quality and consistency of health care delivery systems. Collaborative members will work together to plan and implement improvements to health care delivery systems that result in increased access to reproductive health care for adolescents over a 12-month period.
CAI Named Statewide Training Center for the New York Women, Infants, and Children (WIC) Program
CAI is the new Statewide Training Center for the WIC Program. In this role CAI will develop and implement a statewide training initiative for staff of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program and other programs administered by the New York State Department of Health, Division of Nutrition, Bureau of Supplemental Food Programs.
CAI will develop and deliver training and follow-up technical assistance to the approximately 1,700 staff from 99 WIC local agencies operating 530 sites across New York State, and an additional 180 WIC State staff statewide. Besides providing specialized training to WIC local agency staff in WIC policies, procedures and regulations, CAI will provide training on building the key competencies necessary to successfully perform the Value Enhanced Nutritional Assessment (VENA) to improve nutrition education.
As the WIC Training Center, CAI will offer several training modalities – computer based training, classroom training, teleconferences and satellite video conferences – as well as provide 500 hours of technical assistance annually. For the first time, there will be multiple training center locations: one in New York City and one in Albany. Trainings will also be provided at several other locations throughout the state, helping to reduce associated travel time and costs, as well as making them more accessible to WIC sites around the state.
PWA/LTI World AIDS Day Activities
The People Living with HIV/AIDS Leadership Training Institute (PWA/LTI) would like to recognize and congratulate members of the AIDS Institutes' Quality of Care Young Adults Advisory Committee for their role in providing education to more than 1,700 elementary, middle, and high school students who visited a portion of the AIDS Memorial Quilt on display during World AIDS Day activities held in Albany from December 1-4. LTI staff hope the trainings the Committee members participated in, including "Becoming Your Own Health Care Advocate," "Disclosure" and "Presentation Skills,” prepared them for their role as educators about the realities of living with HIV/AIDS and will assist them to drive home HIV prevention messages among their peers. Exemplifying the LTI's philosophy and values, these individuals are the next generation of leaders; the LTI would like to thank them for their courage, leadership and dedication to making a difference in the fight against HIV and AIDS.
Staten Island STOP Receives Recognition and Media Coverage
CAI is funded by the New York State Department of Health Tobacco Control Program (NYSDOH TCP) to integrate treating tobacco dependence into health care services on Staten Island. CAI is working with health care providers on treating tobacco dependence in clinical, mental health and substance abuse service settings while identifying current practices and policies, assessing training needs, and providing technical assistance and training.
In November, CAI’s Staten Island STOP (Support to Overcome Puffing) project received recognition and media coverage for its smoking cessation efforts. Staten Island Borough President, James P. Molinaro, honored SI STOP at a Proclamation Ceremony held at Staten Island Borough Hall. CAI also received a Certificate of Recognition from the American Cancer Society Eastern Division for its commitment to the Staten Island Quits campaign. At the Richmond University Medical Center’s successful Great American Smokeout event, where attendees were screened and counseled to make a quit attempt, SI STOP provided nicotine replacement therapy and New York State Quitline literature. Several local media outlets, including TV station NY1, and the Staten Island Business Trends and Staten Island Advance newspapers, covered the events and SI STOP’s activities.
New York State Department of Health Mental Health Trainings Conducted
In 2008, as part of a new initiative to provide direct mental health services for persons living with HIV, the New York State Department of Health (NYSDOH) awarded $4.4 million in grants to 20 health and research organizations throughout the state. As one of the grantees, CAI is providing training and technical assistance to mental health providers who work with the treatment and management of individuals with mental illness and HIV infection.
Thus far, CAI has conducted four 2-day trainings on the topics: “Applying Motivational Interviewing Techniques into Mental Health Services for PWHAs” and “HIV/AIDS, Mental Illness, Substance Abuse: Working with the Triply Diagnosed Client”. Both trainings will also take place in January in Batavia, NY for mental health professionals from Batavia, Rochester, Buffalo and Syracuse areas. In addition, the Community Psychoeducation Forums for Providers and the Community Psychoeducation Forums for Consumers are beginning in January 2009. CAI plans to hold five forums for Providers and six forums for Consumers throughout NYC and upstate New York.
Guyana
As a partner under the five-year Guyana HIV/AIDS Reduction and Prevention Project (GHARP), CAI was responsible for designing and implementing the Community Home-Based and Palliative Care (CHPC) program, which included training providers in pain management and mental health assessment and care. As part of the CHPC program, CAI also developed and conducted the Case Navigator Demonstration Project and provided capacity building in implementing Social Networks Strategy and Secondary Prevention. CAI also conducted several Income Generation and Workforce Development Activities in Guyana.
In the last quarter of 2008, CAI was busy with activities related to finalizing its projects for the GHARP. CAI conducted several final evaluations of its projects; provided four additional young adults scholarships for on-the-job skills-based training at the Iwokrama International Centre for Rain Forest Conservation and Development; and contributed to Guyana's National Mental Health Initiative, led by the Ministry of Health, by conducting a training in Early Childhood Trauma for ages 0 to 5.
In November, CAI conducted several final evaluations of its projects in Guyana. The first of these evaluations assessed the home-based care project to determine the health needs and experiences with service delivery among clients served by USAID/GHARP-funded NGO home-based care volunteers and nurse supervisors in Region IV of Guyana. CAI also conducted final evaluations of its case navigation projects to determine if it had increased the number of persons newly diagnosed with HIV who access care and treatment, as well as to measure the effect of the project on Case Navigators and the multidisciplinary care team with regards to knowledge, attitudes and beliefs around case navigation and its role in the delivery of care to PLWHA.
CAI also conducted evaluations of its skills-based training and income generation projects to gain an understanding of how the training affected the participants' job readiness skills and their self-efficacy to obtain a job, as well as if the training resulted in job opportunities or increased income for the participants. The findings of these evaluations, which will be available in January 2009, will help implementing agencies in Guyana, including the Ministry of Health and the National AIDS Programme Secretariat, in designing appropriate strategies to better address the training and supportive programs needs to improve the lives of PLWHA.
Four additional young adults received scholarships for on-the-job skills-based training at the Iwokrama through CAI/GHARP. As part of their scholarship, the participants are attending a three-month training course at the Iwokrama field station in central Guyana where they are learning knowledge and skills including Amerindian history and culture, wilderness first aid, wildlife and plant life identification, tour-guiding, interpersonal skills, wilderness survival skills, and community tourism. The participants will also complete two on-site internships at eco-lodges in Guyana as part of their training experience.
Also in November, CAI contributed to Guyana's National Mental Health Initiative, led by the Ministry of Health, by conducting a training in Early Childhood Trauma for ages 0 to 5. This program was designed to contribute to Guyana's goals of increasing awareness of mental health issues and providing guidance to direct line staff on how to intervene with families in an appropriate manner, as HIV and other traumatic events affect many young children and their immediate families in Guyana. This three component training program was designed to heighten the awareness of providers to better identify young children who have experienced trauma, to work more cohesively with families, to design easy home-based interventions, conduct case conferences and make appropriate referrals.
Dominican Republic
The Henry M. Jackson Foundation for the Advancement of Military Medicine contracted CAI to perform a study of high-risk sexual behavior among Dominican military personnel stationed at frontier postings along the border of the Dominican Republic and Haiti. This study is intended to provide the Dominican armed forces with baseline data on domains of high-risk sexual behavior within their population of military personnel stationed along the border with Haiti, as well as baseline data on personnel knowledge of STI/HIV/AIDS. The secondary purpose of this study is more academic in nature – to examine the relationship between high-risk sexual behavior and various types of psychopathology that have been documented as notably prevalent in populations of military personnel. This will be the first study to assess the prevalence and risk factors for high-risk sexual behavior among military personnel in the Dominican Republic.
Data collection began in November 2008 in the Dominican Republic's western province of Dajabon. A second phase of the study occurred in December of 2008 in the province of Jimani. The third and final phase of data collection is scheduled for early January 2009 in the province of Elias Pina.
El Salvador
In November, Dr. Tony Jiménez, Deputy Director of Training at CAI, was the keynote speaker at two forums in El Salvador: Foro de Seguridad Humana (Forum on Human/Public Safety) and Foro Nacional de VIH-SIDA/ITS El Salvador 2008: Juventud y Prevencion (El Salvador National Forum on HIV-AIDS/STI: Youth and Prevention). The forums were moderated by El Salvador’s Minister of Health and attended by the country’s President.
Dr. Jiménez gave keynote speeches and presentations on several topics, including: Estrategias para Abordaje del Trauma (Strategies to Address Trauma); Jóvenes, Trauma y Conductas de Riesgo (Adolescents, Trauma and Risk Behavior); Consejeria en VIH (HIV Counseling); and Estrategia Para el Cambio de Comportamiento en Adolescentes (Strategies for Behavior Change in Adolescents). During the forum, El Salvador’s Ministry of Health also presented CAI with an award for providing invaluable support to the National Effort to Fight HIV/AIDS.
In 2009, CAI will be working on a continuation of the civil society strengthening project of 2007-08 titled, Institutional Strengthening for NGOs that Support Vulnerable Populations in El Salvador. As in past years, the goal of the project will be to increase the capacity of NGOs to organize, plan, administer, supervise the implementation of, and monitor and evaluate programs. The goal of the project is to provide training and technical assistance to 14 NGOs on establishing administrative processes, including defining organizational structure, policies and procedures; leadership and administration of human resources; and communications.
Also in early 2009, CAI will be facilitating a retreat with the personnel of the Ministry of Health National STI HIV/AIDS Program.
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© 2008,
Cicatelli Associates Incorporated, 505 Eighth Avenue,
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phone:
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