Tools for a comprehensive approach to safer and healthier recreational settings. Outreach work teams. Lisboa, 23 de Setembro de 2015 Paulo Anjos

Transcription

1 Tools for a comprehensive approach to safer and healthier recreational settings Outreach work teams Lisboa, 23 de Setembro de 2015 Paulo Anjos

2 Outreach work A community oriented activity undertaken in order to contact individuals or groups from particular target populations, who are not effectively contacted or reached by existing services or through traditional health education channels Hartnoll et al. (1990) Paulo Anjos

3 Outreach work These teams will meet the Populations in their natural environment Create and maintain direct interpersonal relationships based on trust and professional secrecy Create a support network Listen to people needs, problems, and suggestions Paulo Anjos

4 Outreach work Transmit information through informal and formal conversations Disseminate informative and preventive materials Promote support and psychosocial advice Promote incentives to health care referrals to social health and treatment structures, Enable the acquisition of skills at various levels Paulo Anjos

5 Intervention areas: Streets Abandoned spaces Roads Houses / Apartments Clubs Recreational Spaces (Cafes, bars, disco, etc.) Paulo Anjos

6 Aims / Goals to identify and contact hidden populations to refer members of populations to existing services to initiate activities aimed at prevention and demand reduction and harm reduction to promote safer sex and safer drug use to identify the needs and perceptions Paulo Anjos

7 Activities Psychosocial support Distribution of harm reduction materials (condoms, female condoms, dental dams, bleach kits, lollipops, hear plugs, etc.) Distribution of educational materials (leaflets, literature, referral cards, etc.) Distribution of promotional material (key chains, pens, note pads, pins, etc.) Paulo Anjos

8 Team composition Three main types of workers are active in the field of outreach work: Professionals Peers' Social Workers Psychologists Nurses Volunteers Paulo Anjos

9 Skills required Credibility and respect Capacity to establish interpersonal relationships Ability to listen Ability to adapt the level of language to the caller Frustration tolerance / patience Be prepared to deal with risky situations Teamwork capacity Specific technical knowledge Paulo Anjos

10 Organization of outreach interventions Plan Prepare Registration of Interventions Coordination and Monitoring Paulo Anjos

11 Organization of outreach interventions Community and target populations needs assessment Existing Services and Social responses Characteristics of target populations Gender Age, etc Appropriate schedules to address target populations Behaviors Prevalent risk factors surrounding individuals Definition of problems Paulo Anjos

12 Organization of outreach interventions Days Hours Route to take Type and amount of required material Number of individuals Estimate basic needs Estimate type of problems The composition of the team Paulo Anjos

13 Selection criteria for team members Basic training Professional experience Schedules availability Accept behaviors considered deviant or not normal Ensuring compliance with ethical and deontological codes Ability to work in adverse conditions Teamwork capacity Ability to avoid judging people Paulo Anjos

14 It is fundamental To build ties and trusts community together Maintain consistency Maintain the sensitivity Keep the visibility Keep sincerity Keep genuine respect Do not judge Maintain a discreet and sober attitude Paulo Anjos

15 Associação Existências Paulo Anjos

16 Associação Existências Non Governmental Organization established in 2004 Based in Coimbra Objectives Promotion and health protection Social development Paulo Anjos

17 Projects, Activities and interventions HIV prevention and testing among sex workers Men who have Sex with Men Drug users Promoting sexual and reproductive health Positive prevention among HIV infected Arm reduction associated with drug use Paulo Anjos

18 Paulo Anjos

19 Actual situation Night Recreational Environments are privileged places for the consumption of drugs Low perception of risk Increase of drug consumption Beginning of consumption in earlier ages Low interest in preventive messages Belief in the ability of consumption control and problem resolution Paulo Anjos

20 Activities Interventions at night recreational settings Teams composed of technicians and university students dissemination of information about safer drug use and risk reduction using personal contact leaflets, flyers, posters distribution of condoms Paulo Anjos

21 Activities Implementing conferences and workshops Owners and staff Student association leaders Professionals Development of cultural and social events promoting non alcoholic drinks Research interventions Paulo Anjos

22 ATELIER DE EXPRESSIVIDADE Associação de Estudantes da Escola Superior de Enfermagem de Coimbra ATELIER DE EXPRESSIVIDADE BEFORE YOU GET BURNT University Peer Education BRITO, Irma(1) ; MENDES, Fernando(2) ; HOMEM, Filipa(3) ; (1) Professora Adjunta na ESEnfC e Coordenadora do Atelier de Expressividade (2) Psicólogo e Presidente do IREFREA (Europeean Institute of Studies on Prevention) (3) Enfermeira e Membro do Atelier de Expressividade (Grupo de Educação pelos Pares da AEESEnfC) Paulo Anjos

23 COIMBRA Paulo Anjos

24 The pride of being University Student

25 and the student s parties! Paulo Anjos

26 Acute alcohol intoxication Personal Injury: Unprotected sex Violations Regretted Sex Traffic accidents Violence Paulo Anjos

27 BEFORE YOU GET BURNT Since 2007 Peer Education's group (Atelier de Expressividade) develops interventions in recreation context to prevent the abusive alcohol consumption and to promote fun without risk Peer Education makes use of peer influence in a positive way because it is a pedagogical strategy whereby well trained and motivated people undertake organized educational activities with their peers Information is transmitted more easily if the educators and the audiences shared background and interests in areas, use of the language, family themes, and role demands (cultural adequacy) Mainly nursing students become Peer Educators by a specialized training course (at least 30h with training counseling skills) Maio 2007 Maio 2009 Paulo Anjos

28 ACT RESPONSIBLY / BEFORE YOU GET BURNT STREET PEER DRIVEN COUNSELLING AND FIRST AID Social Marketing (Neiger e Thakeray, 2002) Pilot test in May 2007 (BRITO, 2008) University Students peer to peer counselling by awareness model (Freire, 1991): Dialogic approach with alcohol test and STI s risk Available Condoms (feminine and masculine) First Aid in acute crisis (alcohol/drugs) Paulo Anjos

29 METHODOLOGY During street festivities (7 student s celebrations, 9 nights each one), they conduct peer to peer counselling to increase health literacy, prevent alcohol misuse and promote harm reduction Teach to assess breath alcohol level and pattern Assess sexual behaviour risk and attitude Provide condoms and first aid Paulo Anjos

30 BEFORE YOU GET BURNT peer driven model was effective Results showed that this peer because it promote changes on alcohol consumption and was rated as very positive due to credibility, easier communication, accessibility and availability The qualities highlighted in those peer educators were: Sympathy Patience Not to make value judgments High level of knowledge Understanding Clarity Closeness of age, simplicity and openness Youth Peer Educators are less likely to be seen as authority figures rather than perceived as receiving advice from a friend in the know who has similar concerns and culture Paulo Anjos

31 BEFORE YOU GET BURNT In Coimbra, Peer Education is used to effect individual change by: Developing knowledge, attitudes, beliefs and skills Enabling students to be self responsible to protect their own health It is also a way to youth double empowerment, offering them an opportunity to: to be educators(activities that affect them) to access information and services they need to protect their health The main barriers are: Academic binge drinking culture, especially during student s dinners Not recognition of voluntary student s work Paulo Anjos

32 Thank You! Paulo Anjos