Border Health Foundation

Capacity Building Assistance (CBA) is both the art and science of imparting knowledge, skills and technology that affect individual abilities and organizational systems (including community) towards improving and sustaining effective and efficient HIV prevention. The outcome of CBA is to contribute to an increase in the quality, quantity or cost effectiveness of intervention activities and the sustainability of infrastructural systems that support these activities.
The goal of capacity building is to improve the performance of the HIV prevention workforce by ensuring scientifically sound and culturally proficient assistance through information sharing, training, provision of technical assistance and technology transfer. The HIV prevention workforce consists of key staff from health departments, community-based organizations, public and private hospitals, clinics, social service centers and other sectors that contribute to reducing risks for either contracting or transmitting HIV and other sexually transmitted diseases. The Centers for Disease Control and Prevention, Division of HIV Prevention (CDC/DHAP) is committed to increasing the capacity of the HIV prevention workforce in reducing the number of HIV infections in racial/ethnic minority individuals and ensuring that these individuals have access to HIV prevention, testing, care and treatment services.

The goals of CDC's CBA program are:
1) To improve the capacity of community-based organizations (CBOs) to strengthen and sustain organizational infrastructures that supports the delivery of effective HIV prevention services and interventions for high-risk racial/ethnic minority individuals;
2) To improve the capacity of CBOs and Health Departments to implement, improve, and evaluate HIV prevention interventions for high-risk racial/ethnic minority individuals of unknown serostatus, including pregnant women, and people of color who are living with HIV/AIDS and their partners;
3) To improve the capacity of CBOs and other community stakeholders on how to implement strategies that will increase access to and utilization of HIV prevention and risk-reduction and avoidance services (including those under the Advancing HIV Prevention Initiative) for racial/ethnic minority individuals; and
4) To improve the capacity of Community Planning Groups (CPGs) and Health Departments to include HIV-infected and affected racial/ethnic minority participants in the community planning process, and to increase parity, inclusion, and representation (PIR).

The Border Health Foundation is proactively involved in many key aspects of HIV/AIDS prevention capacity building assistance, including the development of interactive innovative training curricula “tool kits” targeting organizations serving diverse Hispanic/Latino populations. The BHF emphasizes a multi -disciplinary approach that effectively translates theory into evidence-based prevention activities.

All BHF technical assistance training programs are conducted by certified trainers with support from a BHF research department staffed by noted social scientists.

The purpose of Focus Area 2 CBA is to improve the capacity of community based organizations (CBOs) and health departments (HDs) to adapt, tailor, implement, and evaluate effective HIV prevention interventions for individuals whose behavior places them at risk for acquiring or transmitting HIV.

Primary Provider Activities
1. Provide ongoing CBA for CBOs in the adaptation, implementation, quality assurance and evaluation of effective HIV prevention interventions.
2. Provide CBA to HDs on culturally appropriate HIV prevention interventions and strategies for racial/ethnic minority populations
3. Provide CBA on the diffusion of effective behavioral interventions, including training, cultural tailoring of curriculum, and promotion of “boxed” interventions from CDC.

Examples of CBA
• Adaptation, implementation, and cultural tailoring of science-based interventions
• Quality assurance and evaluation of effective HIV prevention interventions
• Needs assessment, priority-setting and preparation for the delivery of interventions
• Development of effective health communication messages and community-based research methods
• Development of effective staff training and linkages to racial/ethnic minority researchers

Cultural Competency
Much discussed but often poorly understood, cultural and language appropriate standards (CLAS) for organizational communications are an integral foundation for programming in relation to providing community-centered services. As such, they form an integral part of intervention implementation. In this training, participants will learn: (a) how culture can affect the multiple routes of HIV transmission; (b) what facets of culture can influence dialogic communication within the delivery of, and response to, AIDS care and services; (c) how culture can both impede as well as strengthen strategic communications; and (d) what role is played by dynamic interactions within HIV education and risk reduction interventions.

Community Assessment
Organizations should have a set of tools and procedures by which they can collect baseline information on their local community, the population(s) that they are serving, and their most pressing social needs. In this training, participants will learn to: (a) identify types of data that provide a comprehensive picture of issues and problems that require resolution; (b) describe how community assessment data can be used for general planning and, more specifically, for the preparation of prevention interventions; (c) identify research methodologies that produce the most appropriate data for particular tasks and situations; (d) plan a community assessment, according to an organization’s available time and staff, and within the parameter of community responsiveness.

Logic Model Development
Logic Models are the blueprint by which an organization is able to design, construct, monitor, and assess the programs that fulfill its mission. In this training, participants will learn to (a) unlock the mystery of Logic Models and the basic purposes they serve; (b) structure a Logic Model that contains material that may range from general program content to HIV intervention content; (c) use a Logic Model as a visual path, or map, in strategic organizational planning; and (d) incorporate a Logic Model within the process of planning and adapting-implementing more effective interventions.

Group Facilitation
Planning and conducting any or all levels (community-wide; large group; small group; individual one-on-one) of HIV education and risk reduction interventions is important in making an intervention successful. In this training, participants will learn to (a) describe the four levels of intervention implementation; (b) distinguish between the requirements of an intervention and the needs of selected participants; and (c) plan a prevention intervention with effective levels of enhanced evidence-based learning.

Adaptation and Effective Interventions
Adaptation is reasoned modification of a designated intervention to fit a particular community in such a way that none of its Core Elements are changed and none of its scientifically-validated effectiveness is lost. In this training, participants will learn to (a) identify common concepts and techniques [“technology’] related to adaptation; (b) describe the systematic process within which adaptation of evidence-based interventions takes place; (c) utilize assessment information to adapt an original intervention to fit the particular circumstances of the target community, taking into account the capacity and staff availability of the implementing agency; and (d) identify available resource for technical assistance.

Quality Assurance/ Evaluation
Quality Assurance (QA) is the means by which an organization monitors the planning and implementation of its designated interventions, as a means of assuring that their delivery is complete with respect to inclusion of the Core Elements, cost-effective to the organization, courteous and responsive to participants, and effective in scope and outcomes. In this training, the participant will learn (a) how Quality Assurance is related to capacity building; (b) how QA can make beneficial contributions to planning and implementing an agency’s designated interventions; and (c) what recommendations CDC is making on QA/Evaluation.

Overcoming Communication Barriers
Appropriate and effective communication is necessary within all relationships, including those that exist between providers and consumers. With this in mind, the Overcoming Communication Barriers training will provide an overview of basic communication construct, common contributing barriers and pitfalls, related behaviors and styles, cultural factors, active listening and culturally sensitive skills-building techniques. In addition, a five-step problem solving model, which can be used as a guided process to develop skills in order to surpass barriers and maintain cultural competency when working with consumers, is addressed along with the various activities conducted during this training.

1. Introduce and orient client to session
2. Identify client’s personal risk behaviors and circumstances
3. Identify safer goals behaviors
4. Develop client action plan
5. Make referrals and provide support
6. Summarize and close session

Unit Seven closes the course and addresses issues of professional development.
The focus in this course on the steps of HIV prevention counseling is intensive and rather exclusive. The course does not, for example, include an “HIV/AIDS/STD 101” component. Indeed, a basic knowledge of HIV/AIDS/STDs, prevention methods, and antibody testing are prerequisites of this course. In addition, this course does not provide in-depth training in how to:

Outreach and Recruitment
We have relied heavily on techniques and concepts that have been developed over the years by ethnographers, who have worked extensively in settings not unlike those often encountered by Outreach Workers. The aim of this training is to provide beginning and intermediate project staff a few helpful hints for working in HIV/AIDS prevention intervention and social services by offering "practical" tips on utilizing tested strategies for formal and informal outreach techniques, primarily with Latino populations. It is hoped the pointers contained herein will allow students and professionals alike easier access to communities and populations, while permitting them to perform their work with greater success to improve the daily lives of those at risk for the transmission of HIV/AIDS.

HIV 101
The effectiveness of any HIV/AIDS prevention program depends greatly on the knowledge, attitudes, values, skills and commitment of those in the HIV prevention field. In order to support the ongoing efforts to prevent and control the spread of HIV infection, the Border Health Foundation has developed a basic HIV101 course to teach Community Based Organization and Health Department staff about HIV/AIDS and to raise the level of understanding about associated problems. This course is designed to help participants analyze basic information, core messages, values and practices related to HIV/AIDS prevention education while instilling a caring and supportive attitude towards people living with HIV/AIDS. This course is recommended for prevention staff that may require fundamental HIV/AIDS education instruction and is also ideal for those who are interested in a basic refresher course.

Working with IDU Population
Basic understanding on the facets of the facts and challenges that can influence the response to and delivery of HIV prevention services, as well as examine and discuss circumstances and issues surrounding injection drug use that impact effective long term treatment: (1) social attitudes; (2) realities of IDU population identity formulation, social dynamics, injection behaviors and physiological / psychological disease factors; (3) Behavior modification influences and perceptions and (4) barriers relative to unrealistic treatment perceptions and expectations

HIV Prevention and a “Silent” Population in the Hispanic/Latino Community
Transmission of HIV continues to rise for Hispanics / Latinos who engage in high-risk heterosexual contact. This topic focuses on the population that maintains heterosexual relationships but regularly engages in same-gender sex in secret. The presenter will feature cultural, social and historic context; influential cultural, psychosocial, structural and environmental domains that affect this population; what theoretical support is most promising for building capacity to minimize or eliminate cultural barriers; and how services may be selected.

CDC funded CBOs and HDs interested in receiving assistance in intervention adaptation, tailoring, implementation, and evaluation can contact their CDC project officer. This request will be routed through the Capacity Building Assistance Request and Information System (CRIS) for assignment to the appropriate CBA provider. Other programs and community stakeholders can contact one of the above mentioned CBA providers directly to inquire about these services.

To inquire about Capacity Building Assistance or to learn more about BHF trainings, contact us toll free (877) 749-3727.

Capacity Building Assistance for Latino Populations