Survival of the Fittest: Techniques and Tools of Special Health Resources for Texas (SHRT) and the Rural Assistance Center (RAC)

Transcription

1 Survival of the Fittest: Techniques and Tools of Special Health Resources for Texas (SHRT) and the Rural Assistance Center (RAC) Presenters: Emmerentie Oliphant Stephen F. Austin State University, School of Social Work Co-author: Kathleen Spencer Rural Assistance Center (RAC) Co-author: Nancy Young-Styles Special Health Resources for Texas, Inc. 25 th Annual Midwest Stream Farmworker Health Forum November 9 12, 2015

2 PRESENTATION OBJECTIVES Participants will understand how a strengths based intervention model that includes survival stories can be developed to empower HIV+ women of color. Participants will understand how social workers, counselors and family therapists can help women learn to overcome barriers and break the cycle of abuse. Participants will be able to use the Rural Assistance Center s Care Coordination Toolkit in order to maximize the value of health and social services delivered to individuals over time. 2

3 HIV/AIDS in East Texas Texas 4th highest in diagnosis of HIV/AIDS! Women of Color (54%) African-American (32.1%) Hispanic (22%) Limited Resources Increasing Number of Elderly Stigma and Isolation impacted by Cultural Issues Survival of the Fittest Project 3

4 Survival of the Fittest Project Special Project of National Significance (SPNS) - Health Resources and Services Administration (HRSA) Started in 2009 Recruit and retain Women into care 18 months EMPOWERMENT Included 129 women, over 500 family members/friends Strengths perspective Partnership network to support and empower 4

5 Barriers Stigma Isolation Shame Poverty including minimum wage Unemployment Religious conflict Rejection by immediate family Intimate partner violence Mental health issues Substance abuse Lack of health insurance Undocumented status 5

6 Strengths Based Intervention Model Perceiving the client s world in the way the client sees it (for example survival stories provide the exact information) Assuming the positive in the client Focus on solutions not problems Clients have strengths that can help them overcome difficulties with HIV/AIDS Clients need the support of people around them to change or move forward Clients can change if they focus on solutions rather than problems Focus on micro-, mezzo- and macro-level 6

7 Empowering Techniques Survival stories Mask-making It gives women a voice! 7

8 Survival Stories The client is the expert Respect survival and strengths Survival stories provide the information about culture Reflection Native tongue Understand more than language Innovative interventions Evaluation purpose 8

9 The Use of Survival Stories Different age groups, women of color, women who were pregnant as teenagers, women who experience domestic violence Women write/tape/draw their survival stories Spanish stories analyzed in Spanish (Preferably not translated) Comparison between urban and rural stories International stories 9

10 Survival Stories Reveal Positive connections with significant others A sense of belonging A positive attitude towards the future Spiritual life Cultural context Feelings strengthen or weaken survival of everyday difficulties Negative social relationships influence progress Survival is the result of positive and negative experiences 10

11 Mask-making Been around for centuries and significant in cultures Used in ceremonies Significant in theater Used as a therapeutic intervention to empower/disempower, build self-esteem Used at the School of Social Work (SFASU) to teach about multicultural social work 11

12 Empowerment and Trust Registered Art therapists & play therapists use the technique as a form of therapy Clinical social workers also use the technique Educators use to teach art and build self-esteem especially when working with children of color Used especially to build trust due to the close proximity of another person working on the face 12

13 Therapeutic Aspects Self-reflective Catharsis Sense of belonging Connection Feelings and thoughts the same rather than different Safe and trusting environment Tangible results Trained the Survival of the Fittest team in mask-making 13

14 Suggestions Awareness of ability to survive Connection with family and support system Self-reflection Planning action to change Client/patient is expert Client/patient stays in control of the change process. 14

15 The Rural Assistance Center (RAC) Information portal and digital library Helps rural communities access full range of resources Gathers & streamlines information Funding by Topic Funding Searches Special Collections (Topic Guides) State Guides Rural Health Models & Innovations Hub 15

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17 Rural Care Coordination Toolkit 1. Introduction to Care Coordination 2. Program Models 3. Implementation 4. Sustainability 5. Evaluation 6. Dissemination of Best Practices 7. Program Clearinghouse

18 Oliphant SFA School of Social Work Thank you!! I feel like it starts with the individual (me) to make the most positive changes in their life. This presentation was made possible by a grant from the U. S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's Special Projects of National Significance Program. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the government. IRB # AY

19 References Cantrell, K. A., Sutton, S., & Gaur, A.H., (2014). Pause, listen, share. JAMA, (312), Dalmida, S., Holstad, M., Diiorio, C., & Laderman, G. et al (2012). The meaning and use of spirituality among African American women living with HIV/AIDS. Western Journal of Nursing Research, (34), Holzemer, W. L. and Henry-Bakken (1991) Nursing care plan for people with HIV/AIDS: confusion or consensus. Journal of Advanced Nursing, (16), Kylma, J. (2005). Dynamics of hope in adults living with HIV/AIDS: A substantive theory. Journal of Advanced Nursing, (52), Prado, G., Feaster, D., Schwartz, S. et al. (2004). Religious involvement, coping, social support, and psychological distress in HIV-seropositive African American mothers. AIDS and Behavior, (8), Riessman, C.K., (2013). Analysis of personal narratives. Qualitative Research in Social Work 2nd ed., pp ). New York, NY: Columbia University Press. White, M. (2004).Working with people who are suffering the consequences of multiple traumas: A narrative perspective. The International Journal of Narrative Therapy and Community Work. 1;