Culturally Appropriate Interventions of Outreach, Access, and Retention among Latino/a Populations Initiative
Latino/ETAC Site: Hektoen/CORE
Title of the Project/Intervention: Proyecto Promover
PI: Dra. Pamela Vergara-Rodriguez
Project Director: Dra. Patricia Aguado
Evaluator: Dra. Susan Ryerson Espino
Intervention Characteristics:Intervention Start Date (or expected). / September 2014- Community Education/Testing
November 2014-Individual/clinic intervention
December 2014- Social Marketing Launch
Intervention Description. Brief description of intervention components (ICs). / Community Awareness: stigma reduction through testing, education and social marketing; clinical patient navigation including outreach and linkage to care.
. What is the level of your intervention (e.g., individual, group, community)? / Individual, group, and community
Community HIV awareness campaign is a multilevel intervention (individuals are tested, groups participate in education talks, and community is exposed to social marketing)
Clinical patient navigation is an individual level intervention that includes the patient and their family or friends should they be receptive to including others. (Intervention team has not ruled out group level work within the clinic).
. What portions of the HIV care continuum does each intervention component target? / Community testing campaign work targets HIV identification (and prevention)
Outreach linkage work targets early linkage to care
Clinical patient navigation targets retention, medication adherence and suppression
. How have you adapted your intervention (e.g., culturally, transnational perspective)? / All staff on this project bicultural and bilingual Spanish speakers. In general, through our community education, testing initiative and clinic intervention we are working against the cultural construct of fatalismo and fostering familisimo. Our interventions include discussions about HIV testing/education/care as routine/ preventative care. Funneling the message that “to get tested for HIV and stay engaged in HIV care is a way to take care of yourself and to take care of the people you love.”
Identification/Recruitment:
Community Marketing materials: Our materials were developed after meetings with 6 focus groups with our target population, as well as informed through research. Our materials utilize imagery of everyday working Mexican people. The materials were conceptualized in Spanish and are only available in Spanish. The marketing team we worked with is a bicultural/ bilingual Sp Sp group that has experience in marketing to Latinos.
Identification/Recruitment/Engagement:
Community Education/testing: We have designed a conversation/discussion based intervention with 4-5 broad questions to attend to the varying educational needs of our community groups. The goal is to employ constructs of personalismo, respeto and familiarismo to engage participants in these educational groups.
Engagement/Retention:
Clinic intervention: Our goal through our 5-series Charlas is to assist patients in utilizing their own identified values, both cultural and personal, as their strength to identify and address some of the sociocultural barriers that are influential in keeping an HIV infected person engaged in care. Again the goal is to draw on the cultural constructs of personalismo, respeto and familiarismo and to work against fatalismo.
How will clients be identified? / Reviewing last 12 months and current data on newly diagnosed or Latino patients who have not had 2 or more visits identified in one way or another within the county health system.
Target Population: / Mexicans
Target N= / 120
Planned process for pilot of intervention (if applicable). Description of pilot (which components, when, how many participants, how long) / (Summer/Fall 2014) Formative feedback was received on social marketing materials from community members, patients, county marketing specialists, and cultural advisory board members.
(Summer/Fall 2014) Formative feedback was received on community education and clinical patient navigation components from cultural advisory board members.
Ongoing process evaluation of all components includes observations, debriefing with intervention team, monitoring of patient recruitment, consenting, outreach, navigation and primary care services. Regular check ins around process evaluation data will help explore need for refinements
Cross-site Evaluation Procedures:
Planned process for participant survey.
. When will/did you begin administration of participant survey? / November 2014
. How will clients be recruited for cross-site survey? / 1
. Who will administer the cross-site survey? / ACASI with intervention team oversight
. Who will manage the cross-site survey data? / Project Director & Evaluator
. Who will transmit data to ETAC? / Project Director
Planned process for intervention exposure data.
. Who will collect the process data (intervention staff)? / Evaluation team and Intervention Staff
. Who will manage the process data? / Evaluation team
. Who will transmit process data ETAC? / Evaluation team when it is clear what is desired
Planned process for clinical data abstraction.
. To what clinics will you refer patients? / Internal
. Are any of these clinics external to your organization? / No
. Have you established a relationship with any/all external clinics? / N/A
. Have you identified technical staff who will be responsible for abstraction of clinical data? / Yes
. Have you established an MOU will any/all external clinics? / N/A
Local Evaluation (if applicable)
Planned process for local evaluation of ICs. Describe all components (formative, summative) of local evaluation / (Summer/Fall 2014) Formative feedback was received on social marketing materials from community members, patients, county marketing specialists, and cultural advisory board members.
(Summer/Fall 2014) Formative feedback was received on community education and clinical patient navigation components from cultural advisory board members.
Ongoing process evaluation of all components includes observations, debriefing with intervention team, monitoring of testing and educational contacts, monitoring of patient recruitment, consenting, outreach, navigation and primary care services. Regular check ins around process evaluation data will help explore need for refinements
Qualitative methods (if applicable). Describe qualitative methods to be employed [design (focus groups, key informant interviews), target population, number of groups/participants, data collection method, methods of analysis, products] / We will be collaborating with cross site on process interviews and much of local process evaluation data are qualitative in nature.
Quantitative methods. Describe quantitative methods to be employed. [design, target population, number of participants, data collection methods, methods of analysis, products] / Longitudinal cohort analysis of cross site and local survey data and medical chart data to explore facilitators and barriers to care, changes of same over time, and relation between clinical navigation services, changes over time on psychosocial variables as well as retention and suppression
How do you plan to measure/monitor fidelity to your intervention (monitoring, supervision, etc.)? / Ongoing process evaluation of all components includes observations, debriefing with intervention team, monitoring of testing and educational contacts, monitoring of patient recruitment, consenting, outreach, navigation and primary care services. Regular check ins around process evaluation data will help explore need for refinements
Study Organization:
IRB approval date (or expected) / 1st round English: 9/09/14; 2nd round Spanish 10/21/2014
IRB expiration date / 09/08/2015
Third All-Sites Meeting. December 11-12, 2014 UC Washington DC
(One-pager form 17NOV14)