Strategic Approaches to Improving and Increasing Biomedical Interven6ons Knowledge Among Communi6es Interested in HIV Preven6on.

Transcription

1 Strategic Approaches to Improving and Increasing Biomedical Interven6ons Knowledge Among Communi6es Interested in HIV Preven6on USCA October 2014

2 INTRODUCTIONS Russell Campbell, Office of HIV/AIDS Network Coordina6on Bertram Johnson, Office of HIV/AIDS Network Coordina6on Luis Viquez, Gay City Health Project Kimberly Parker, Texas Woman s University Michelle Scavnicky, The AIDS Ins6tute

3 Overview HIV Preven6on Research & Basic Scien6fic Literacy Modules Russell Campbell, Bertram Johnson & Luis Viquez Strategic Biomedical HIV Approaches to Reaching an AIDS Free Genera6on Michelle Scavnicky Project PrEPUP!- Results from and individual- level pilot study to access likelihood of using PrEP by increasing knowledge Kimberly Parker

4 HIV Preven6on Research (HPR) & Basic Scien6fic Literacy (BSL) Modules Overview

5 Background This project was supported through Federal funds from the Division of AIDS (DAIDS), NaHonal InsHtute of Allergy and InfecHous Diseases, NaHonal InsHtutes of Health, Department of Health and Human Services Grant # UM01 AI068614: Leadership Group for a Global HIV Vaccine Clinical Trials (Office of HIV/AIDS Network CoordinaHon).

6 Background Purpose HPR: As part of delivering Scien4fic Informa4on Training and Transfer (SITT) to BTG Bridge Partners, a biomedical HIV preven4on research module was developed. The module focuses on basic awareness and understanding of biomedical preven4on modali4es (vaccines, PrEP, and microbicides). Target Audience: Community members and ASO/CBO staff

7 Background HPR Chronology: Planning began in early 2012 HPR content development and review February September 2013 Field test conducted in September 2013 HPR Key par4cipants: Instruc4onal Designer/Developer (Cranmer Communica4on) Subject MaWer Experts (HPTN,HVTN,MTN) HANC/BTGB Staff Gay City Health Project & NE Two- Spirit Society

8 CONTENT OVERVIEW

9 HPR Content Full Course (All Day) 1. What Is HIV/ AIDS? 5. What Are HIV Preven6on Tools and How Are They Used in HIV Preven6on Research? HIV Preven4on Research 2. What Is Clinical Research? 4. What Is HIV Preven6on and the HIV Preven6on Toolkit? 3. What Is Community Engagement

10 HPR Content Short Course (Half Day) 1. HIV Preven6on Tools 2. What Is HIV Preven6on and the HIV Preven6on Toolkit? 3. What Are HIV Preven6on Tools and How Are They Used in HIV Preven6on Research?

11 Ac6vity Structure Whole Group Ac6vi6es and Discussions Individual Ac6vi6es Small Group Ac6vi6es and Discussions Examples: What Did You Learn? Pre/Post Assessments Preven4on Tools How HIV Is TransmiWed What Would You Do?

12 BSL Content Full Course (All Day) 1. What Is Science? 4. The Human Side of Science Basic Scien4fic Literacy 2. What Is Scien6fic Research? 3. What Is the Scien6fic Method

13 Ac6vity Structure Whole Group Ac6vi6es and Discussions Individual Ac6vi6es Small Group Ac6vi6es and Discussions Examples: What Did You Learn? Pre/Post Assessments Experiment Ac4vity What is the Scien4fic Method? The Human Side of Science

14 MATERIALS OVERVIEW

15 For Presenters

16 For Par6cipants

17 FIELD TEST RESULTS

18 Field Test Overview Date/loca4on: September 28, 2013 in SeaWle, WA Par4cipants: BTGB Bridge Partner Presenter (Luis Viquez Gay City Health Project) 4 Observers One HVTN Network Representa4ve Three HANC and BTGB Staff Representa4ves 12 Audience Members Instruc4onal Designer and BTGB staff awended Evalua4on Tools: Presenter Interview Observer survey Audience survey Pre/post knowledge assessment

19 Pre/Post Assessments (Level II Evalua6on) Training goal: 80% comple4on Actual comple4on: 81% Significant increase in knowledge of 31 percentage points (or 63%) across all items

20 Pre/Post Assessments (Level II Evalua:on), cont. Level Scores by modality: Microbicides score increased 50 percentage points (from 25% to 75%). Vaccine and TasP scores increased by 25 percentage points (33% and 50% increases, respec4vely). PrEP score remained about the same (at 76, and 75 percentage points, respec4vely); scores were generally higher on the post- assessment.

21 Trainings Tulsa Two- Spirit Gathering April 2014 Bay Area American Indian Two- Spirit Society (BAAITSS) August 2014 Upcoming Training: NorthEast Two- Spirit Society Gathering, October 16-19, 2014, Buffalo, NY

22 Basic Scien6fic Literacy

23 Background Purpose BSL : To develop basic, introductory training for communi4es, ASOs/CBOs and Community Advisory Board (CAB) members interested in and working with HIV clinical trial sites. The goal was to develop a trainer s guide and training module on the topic of basic scien4fic literacy that will serve as an introduc4on before taking the BHPR training. Target Audience: Community members and ASO/CBO staff

24 Background BSL Chronology: Planning began in early 2012 HPR content development and review February August 2014 Field test conducted in August 2014 BSL Key par4cipants: Instruc4onal Designer/Developer (Cranmer Communica4on) Subject MaWer Experts (Community Partners & DAIDS) HANC/BTGB/Gay City Health Project Staff Evolu4on Center at AID Atlanta

25 Basic Scien6fic Literacy Welcome to this workshop about basic scien4fic literacy that will provide a general founda4on in science. Science provides knowledge about how and why things work the way they do. This knowledge can help you understand the world around you and your place in it.

26 Thank You!

27

28 Strategic Approaches to Improving and Increasing Biomedical Interven6ons Knowledge Among Communi6es Interested in HIV Preven6on Michelle Scavnicky, MS Director of Educa:on and Capacity Building The AIDS Ins:tute and AIDS Alliance for Women, Infants, Children, Youth & Families October 2014

29 COMMUNITY INVOLVEMENT Why is it important to have community involvement and understanding of biomedical HIV preven4on and research?

30 OBJECTIVES 1) Provide a brief overview of The AIDS Ins4tute/AIDS Alliance s work to increase awareness and knowledge around biomedical HIV preven4on research. 2) Discuss efforts that include targeted training to community educators on biomedical HIV preven4on interven4ons that support a comprehensive approach to reaching an AIDS free genera4on.

31 OBJECTIVES 3) Provide a summary of the community educa4on sessions q Review the evalua4ons from the par4cipants q Discuss feedback from the community educators who shared their experiences in conduc4ng the biomedical HIV preven4on interven4on sessions

32 AGENDA 1) Project Background and Overview 2) Overview of Train the Trainer model for Community Educators 3) Summary of Community Educa4on Sessions q q 4) Q & A Par4cipant feedback Community Educator experience/perspec4ve

33 PROJECT BACKGROUND/ OVERVIEW

34 BE THE GENERATION BRIDGE PARTNERSHIP PROJECT The AIDS Ins4tute/AIDS Alliance s work to increase awareness and knowledge around biomedical HIV preven4on research and discuss efforts that include targeted training to community educators on biomedical HIV preven4on interven4ons that support a comprehensive approach to reaching an AIDS free genera4on.

35 PROJECT GOALS q Educate the community of providers, consumers and their family and friends about biomedical HIV preven4on research and advances through our website, s, conferences and other means q Educate, train, mentor and support a group of community leaders who will provide local community educa4on about biomedical HIV preven4on research q Provide feedback and informa4on to researchers about community beliefs, knowledge and mo4vators

36 PROJECT GOALS q Expand knowledge of Consumer Leadership Guide community educators (trainers) in conduc4ng community educa4on sessions using the following modules: 1. Biomedical HIV Preven4on: Microbicides 2. Biomedical HIV Preven4on: PrEP 3. Biomedical HIV Preven4on: Treatment as Preven4on 4. Biomedical HIV Preven4on: Vaccines

37 EXTENSION TAI/AA s Project was extended through December 2013 Broaden biomedical HIV preven4on educa4onal training modules Worked with Community Educators to con4nue to conduct educa4onal sessions

38 BIOMEDICAL INTERVENTIONS The community educators were able to explore and provide informa4on on biomedical HIV preven4on including but not limited to preven4on of mother to child transmission, PrEP, microbicides, Preven4on with Posi4ves, HIV vaccines, male circumcision and other strategies to prevent HIV transmission.

39 BIOMEDICAL INTERVENTIONS Biomedical HIV preven4on strategies use medical and public health approaches to block infec4on, decrease infec4ousness, and reduce suscep4bility.

40 BIOMEDICAL INTERVENTIONS An4retroviral Therapy as an HIV Preven4on Strategy Blood Safety and Availability Contracep4on to Prevent Unplanned Pregnancies among Women with HIV Condoms Diagnosis and Treatment of Sexually TransmiWed Infec4ons HIV Tes4ng and Counseling as Preven4on HIV Vaccines Infant Feeding for Mothers Living with HIV Injec4on Safety

41 BIOMEDICAL INTERVENTIONS Microbicides Oral Pre- exposure Prophylaxis (PrEP) for HIV Preven4on Post- exposure Prophylaxis (PEP) Preven4on of Mother- to- Child Transmission of HIV (PMTCT) Preven4on with Posi4ves Voluntary Medical Male Circumcision

42 TRAINING MODEL FOR COMMUNITY EDUCATORS

43 RECRUITMENT/TRAINING 1) Recruitment of consumer leaders q 20 accepted out of 44 recruited q 17 completed specific program and training requirements prior to conduc4ng sessions 2) Train the trainer webinars were conducted q Power Point & Handouts developed 3) Staff coaches assigned 4) BTG Sessions conducted

44 MATERIALS PROVIDED PowerPoint presenta4ons- Comprehensive Version n Intro + Microbicides n Intro + PrEP n Intro + TaP n Intro + Vaccines Fact Sheets/Handouts n Intro + Microbicides n Intro + PrEP n Intro + TaP n Intro + Vaccines

45 COMMUNITY EDUCATORS ROLE q Become bewer educated- awend webinars q Become familiar with our material q Par4cipate in regular check- ins q Choose focus q Plan community educa4on sessions q Conduct Up to 4 community sessions q Submit evalua4ons of sessions

46 EDUCATOR S OPTIONS Series of 4 talks in same place Session 1- Microbicides Session 2- PrEp Session 3- TaP Session 4- Vaccines Any combina4on of topics One topic 1-4 4mes Complete Overview

47 EDUCATORS ROLE IN PLANNING SESSIONS Anywhere that is comfortable for you (Goal: 5 awendees minimum) n Support Groups n Community Center n Church n SA Center n School n Staff mee4ng n Social Event

48 EDUCATORS ROLE IN PLANNING q Introductory lewer SESSIONS q Plan your focus so you can describe 4me request q PowerPoint capability/appropriateness q Why are you involved in this?

49 EDUCATORS ROLE IN CONDUCTING SESSIONS Set- Up Room n Lap- top? n Refreshments? n Flip chart? n Copies? n Sign in sheet Welcome & Introduc4on & Ground Rules Presenta4on & Discussion Evalua4on of session

50 EVALUATION OF SESSIONS Evalua4on form n Place n AWendees n Topic n Discussion highlights n Interes4ng points, ques4ons Submit and awach sign- in sheet from sessions

51 DOCUMENTATION q Submit electronic form q Reimbursement for expenses $25 /session X 4 sessions Travel (gas, parking, other transport) Refreshments Door prize Copies Supplies (flip chart & markers) q Session Evalua4on Form q /fax Session sign in sheet q Honorium: $50/session

52 EVALUATION SUMMARY

53 COMMUNITY IMPACT # of Community Educators Trained # of Sessions Conducted # of Individuals and Communities Reached

54 WHERE SESSIONS WERE CONDUCTED

55 KEY FINDINGS q Par4cipant evalua4ons q Community Educator experience/perspec4ve

56 ADDITIONAL OPPORTUNITIES q Educa4onal points for considera4on

57 KEY MESSAGES Increase the awareness and knowledge of your organiza4on s staff, board, volunteers and other key stakeholders about biomedical HIV preven4on research and the benefits for your cons4tuency or the communi4es you serve. Conduct an internal knowledge based survey

58 KEY MESSAGES Inform and engage your organiza4on s consumer and provider membership about biomedical HIV preven4on research. Become educated or get trained

59 KEY MESSAGES Report on biomedical HIV preven4on research informa4on or advanced strategies during local or regional community mee4ngs. Make this a regular agenda item. Invite presenters to mee4ngs to share research

60 RESOURCES- GENERAL HIV Preven4on Trials Network (HPTN) HIV Vaccine Trials Network (HVTN) hwp:// Microbicides Trials Network (MTN) hwp://

61 RESOURCES- GENERAL Centers for Disease Control and Preven4on (CDC) hwp:// Na4onal Ins4tute of Allergy and Infec4ous Diseases, Division of AIDS, Research Studies and Programs: hwp:// research/pages/default.aspx Office of HIV/AIDS Network Coordina4on (HANC) hwps://

62 THANK YOU! Michelle Scavnicky, MS Director of Educa6on and Capacity Building The AIDS Ins6tute/AIDS Alliance

63 PROJECT PREP/UP!: RESULTS FROM AN INDIVIDUAL-LEVEL PILOT STUDY TO ASSESS LIKELIHOOD OF USING PREP BY INCREASING KNOWLEDGE AND AWARENESS Kimberly Parker, Sabine Eustache, Bethsheba Johnson, Kirk Myers & Stephanie Holden US Conference on AIDS San Diego, CA October, 2014

64 LEARNING OBJECTIVES Describe the development and implementation of an intervention to increase knowledge and awareness about PrEP among diverse population in the South Identify program objectives and review steps for creating evaluation plan Determine significant difference for pre- and postintervention variables. Examine knowledge as a predictor variable for the likelihood of using PrEP based on constructs based on the Theory of Reasoned Action Discuss possible barriers associated with using PrEP among our target population

65 REPPIN THE SOUTH!

66 PREP RECOMMENDED GUIDELINES Adult IDUs Sexually active MSM Sexually active, high risk heterosexual men and women Sexually active heterosexual men and women in serodiscordant relationships Served as the foundation for Project PrEPUP! target population

67 PROJECT PREP/UP! Location: Abounding Prosperity, Inc., Dallas, TX Target population : Persons infected/affected with HIV/AIDS including African American and Latino/a MSM, heterosexual men and women, and transgender (male-to-female) persons All individual-level intervention participants were HIV negative African American MSM, transgender person, and heterosexual identified commercial sex workers ages 17 and older who attend programs and receive services at AP, Inc. Community-based organization service providers, advocates, social workers, case managers and policy makers, etc.

68 OBJECTIVES 1. Identify a graphic designer and create a logo and marketing plan for Project PrEP/UP! by Month 2 2. Develop an evaluation plan and instruments to assess success and challenges by Month 3 3. Provide 12 awareness forums to 300 individuals infected/affected with HIV and service providers serving this demographic by the end of Year 1 4. Conduct at least 100 one-on-one educational sessions about PrEP and npep by the of Year % of partnering service providers will report sharing information about PrEP/nPEP with the target populations by the end of Year %of target population participants will express interest in learning more about PrEP/nPEP and awareness about accessing PrEP by the end of Year 1

69 INDIVIDUAL-LEVEL INTERVENTIONS Convenience sampling using community-based targeted recruitment Web-based, interactive curriculum developed and implemented based on national standards for community health education programs Recruitment and participation in an hour-long, facilitator-led interactive educational intervention Participant Assessments based on CDC Evaluation Framework Demographics Knowledge (HANC Be the Generation Biomedical HIV Prevention Research Assessment) Clinical Research Involvement Scale

70 DEMOGRAPHIC RESULTS N=105 Males-51; Females-38; FTM-11; MTF-3 MSMs-25; Sex with both men and women-12 Race: AA-92 Mean age-32 Education Level-High school/ged-52 Employment-Fulltime: 50 Commercial Sex Worker-20

71 RESULTS Knowledge; Behavioral Beliefs + Outcome Evaluation = Attitude toward Behavior SA=1 A=2 N=3 D=4 SD=5 Responses Construct N Pre Mean Post Mean Knowledge Knowledge SD (df) t P (95) My community would really benefit from using PrEP and/or npep to prevent the spread of HIV Behavioral Beliefs (92) My actions of attending this program can inspire others to become involved in ways to prevent the spread of HIV/AIDS in my community Behavioral Beliefs (92) People in my community would benefit from PrEP and/or npep as a way to prevent the spread of HIV Behavioral Beliefs (92) I would benefit from taking PrEP and/or npep as a way to prevent the spread of HIV Behavioral Beliefs (92) Taking PrEP and/or npep as a way to prevent the spread of HIV seems risky Outcome Evaluation (92) I would find it embarrassing to use PrEP to prevent the spread of HIV Attitude Towards Behavior (92)

72 RESULTS Normative Beliefs + Motivation to Comply = Subjective Norms SA=1 A=2 N=3 D=4 SD=5 Responses Construct N I think my doctor would approve of me taking PrEP and/or npep to prevent the spread of HIV I think my colleagues would approve of me taking PrEP and/or npep to prevent the spread of HIV My immediate family would be supportive if I took PrEP and/or npep to prevent the spread of HIV Normative Beliefs Pre Mean Post Mean Normative Beliefs Normative Beliefs SD (df) t P (92) (92) (92) Most people who are important to me would approve of me taking PrEP and/or npep to prevent the spread of HIV Normative Beliefs (92) I tend to be concerned about what people think of me, even if I don t know them Motivation to Comply (92) I generally do what my family expects of me Motivation to Comply (92) I would not do something my friends disapproved of Motivation to Comply (92) If my superiors told me to do something I disagreed with, I would obey their wishes Motivation to Comply (92)

73 RESULTS Normative Beliefs + Motivation to Comply = Subjective Norms SA=1 A=2 N=3 D=4 SD=5 Responses Construct N Pre Mean I would take PrEP and/or npep if it was recommended by a doctor. I would take PrEP and/or npep if it was recommended by a close friend I would take PrEP and/or npep to prevent the spread of HIV if it was recommended by a family member Subjective Norm Subjective Norm Post Mean Subjective Norm SD (df) t (92) (92) (92) P

74 RESULTS Attitude Towards the Behavior + Subjective Norm = Behavioral Intentions SA=1 A=2 N=3 D=4 SD=5 Responses Construct N Pre Mean Post Mean SD (df) t P I would take PrEP to prevent the spread of HIV once it became available I would take PrEP to prevent the spread of HIV if I could afford it. I would take PrEP to prevent the spread of HIV if it caused mild, temporary side effects. I would share information about PrEP and/or npep to others in my community. Behavioral Intention Behavioral Intention Behavioral Intention Behavioral Intention (92) (92) (92) (92)

75 SIGNIFICANT EFFECT OF KNOWLEDGE ON Attitudes towards behavior (behavioral beliefs + outcome evaluation) Community/people in my community /I would benefit for the PrEP/nPEP to prevent HIV transmission (BB) Participating in Project PrEP can inspire others to become involved (BB) Taking PrEP/nPEP seems risky (OE)

76 SIGNIFICANT EFFECT OF KNOWLEDGE ON Subjective norms (normative beliefs + motivation to comply) My doctor would approve of me taking PrEP/nPEP (NB) Immediate family would be supportive if took PrEP/ npep (NB) Most people important to me would approve of me taking PrEP/nPEP No significant changes in motivation to comply

77 SIGNIFICANT EFFECT OF KNOWLEDGE ON Subjective norms (direct measure) I would take PrEP/nPEP if Recommended by a doctor Recommended by a close friend Behavioral Intentions I would take PrEP to prevent spread of HIV If I could afford it If it caused mild, temporary side effects I would share information about PrEP/nPEP with others in community

78 LESSONS LEARNED & NEXT STEPS CDC recommendations will increase knowledge and awareness of PrEP but additional assessments for behavioral intentions for using HIV biomedical prevention strategies are needed Health behavior change is often influenced by the value ascribed to the views of those closest to us TRA considers attitudes about a health behavior, subjective norms and behavioral intentions to accept a new innovation Future PrEP education programs should address multi-level factors that influence behavior change including Perceived risk of acquiring HIV Barriers associated with use Diffusion of an innovation Attitudes towards condoms Behavioral intentions associated with a comprehensive community level intervention.

79 Ques6ons

80 Thank You! Russell Campbell: Bertram Johnson: Kimberly Parker: Luis Viquez: