FOCUS AREA TWO (NATIONAL) PROJECT

The BHF’s Migrant Project Migrant Project Core Competency Trainings Highlighted EBIs for the Migrant Project What is Capacity Building Assistance What are Evidence Based Interventions Migrant Populations Accessing Migrant Project Services Additional Information

The Border Health Foundation’s Migrant Project:

The Border Health Foundation’s Migrant Project is funded by the Centers for Disease Control and Prevention (CDC) to provide capacity-building assistance (CBA) to community-based organizations (CBOs) and Health Departments (HDs) serving Migrant populations in all 50 states, the District of Columbia, and 8 U.S. territories.  As a Focus Area 2 CBA Provider, our goal is to strengthen HIV prevention for Migrant communities by improving the capacity of CBOs and Health Departments to implement effective HIV interventions that specifically target Migrant populations.  In order to achieve our goal, we provide trainings and technical assistance on a few evidence-based interventions (EBIs) and on skill areas necessary to more effectively plan, adapt, implement and evaluate HIV prevention programs, including interventions. 

Migrant Project Core Competency Trainings:

Adaptation & Effective Interventions: The goal of this training is to prepare a participant in the principles of adaptation so that they can effectively adapt an evidence-based intervention for their target population. By the end of the training, participants should be able to:

• Describe the basic principles of effective interventions including terminology;
• Identify appropriate steps for assessing a local community and an evidence-based intervention;
• Understand the efficacy of different evidence-based interventions for a local community with regards to core elements, internal logic, and different levels of the interventions (community, group, and individual);
• Demonstrate a basic knowledge of the necessary skills to prepare a community-appropriate intervention; and
• Identify components of a successful pilot

Group Facilitation: This training was designed to provide participants with information regarding the skills needed for effectively facilitating groups and an opportunity to practice some of these skills. The training will:

• Provide a basic understanding on the characteristics and role of a facilitator in a group setting that can influence the response to and delivery of HIV prevention service;
• Discuss various facilitation styles, scenarios and situations;
• Discuss how cultural factors can impede as well as strengthen the group facilitation process towards meeting the needs of group members;
• Increase familiarity with group processes and the role group dynamics play within the scope of HIV education and risk reduction interventions;
• Increase familiarity with the leadership skills that enable providers to foster positive group interaction for group members;
• Provide an orientation to the role theoretical models have in the process for developing capacity to provide effective group facilitation for HIV prevention; and
• Provide an opportunity to practice skills and techniques that encourage participation

HIV 101: The goal of this training is to teach participants 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; and
• Instill a caring and supportive attitude towards people living with HIV/AIDS

Logic Model Development: This training was designed to help participants understand the basic process and principles behind logic model development. By the end of this training, participants should be able to:

• Describe ways to structure and develop a logic model
• Identify components and categories of a standard logic model; and
• Begin the development of a workable logic model

Needs Assessment: The goal of this training is to present some techniques on how to begin and complete a needs assessment. By the end of the training, participants should understand:

• What a needs assessment is;
• Why needs assessments are important;
• The six components of a needs assessment;
• The nine recommended steps for conducting a needs assessment; and
• Some basic pointers on how to conduct surveys, focus groups, key informant interviews, and other data gathering techniques

Outreach & Recruitment: The goal of this training is to provide some key techniques for conducting outreach including strategies for effectively accessing populations for the purposes of enrolling them in prevention programs. This training will allow participants to better:

• Define outreach and its key characteristics;
• Understand why outreach is conducted;
• Understand the Do’s and Don’ts of effective outreach;
• Understand the ethical dilemmas associated with outreach; and
• Understand the importance of referral services

Overcoming Communication Barriers: The goal of this training is to highlight the necessity of appropriate and effective communication within relationships between providers and consumers.  The training will provide:

• An overview of basic communication constructs;
• Common contributing barriers and pitfalls in communication;
• Related behaviors and styles of communication;
• An overview of the influence of cultural factors on communication; and
• Active listening and culturally sensitive skills building techniques

Understanding Culture: The goal of this training is to enhance participants’ abilities to work with people of different cultures as individuals and as an HIV serving agency. The training will:

• Define key dimensions of dynamic interactions and define the role they play in providing effective HIV/AIDS prevention services;
• Define what it means to ‘understand culture’ and illustrate how to effectively include cultural responsiveness into HIV prevention services;
• Demonstrate how culture filters ideas on mode of HIV transmission and how mode of transmission in turn can affect cultural expression;
• Define common structural and environmental factors that influence HIV prevention, how they relate to cultural responsiveness, and what may be their potential impact on delivery of HIV prevention services;
• Illustrate models of cultural responsiveness and illustrate why incorporating theory into practice leads to the provision of culturally and linguistically appropriate care and services; and
• Acknowledge the importance of including theory in HIV prevention services, as well as considering the importance of practice-based theory for continuing the scientific process of learning and advancement of knowledge for purposes of model improvement

Highlighted Evidence Based Interventions for the Migrant Project:

The Migrant Project is able to provide trainings and technical assistance on the following evidence based interventions:

What is Capacity Building Assistance – An Overview:

In the Centers for Disease Control and Prevention’s (CDC) CBA Program Guide capacity-building assistance (CBA) is described as a means of
“Maintaining and increasing the infrastructural systems and resources necessary to support interventions, enhance the abilities of key personnel to plan and implement interventions and activities. It focuses on the development of core competencies, or skills of individuals in both organizations and communities to more effectively deliver HIV prevention services, and to sustain and support infrastructure for HIV programs.”

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 populations;
2. To improve the capacity of CBOs and Health Departments to implement, improve, and evaluate HIV prevention interventions for high-risk racial/ethnic minority populations 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 populations; 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).

Recognizing that organizations and community groups will differ in their level of capacity and areas of need, CDC identified four areas of focus which address the possible variance in need different groups may have and the four goals of their CBA program. These areas are:

Focus Area 1: To improve the capacity of CBOs to develop and sustain organizational infrastructure that support prevention programs and interventions
FA1 CBA Providers provide technical assistance on things like organizational assessment, strategic planning, fiscal management, board development, and grant writing

Focus Area 2: To improve the capacity of CBOs and Health Departments to adapt, implement and evaluate HIV prevention programs and evidence-based interventions
FA2 CBA Providers provide technical assistance on things like population-based needs assessments, adaptation of interventions, recruitment and retention, and cultural competency

Focus Area 3: To improve the capacity of CBOs and communities to implement models that will increase access to and utilization of HIV prevention and risk-reduction services
FA3 CBA Providers provide technical assistance on the Leadership Mobilization Model, Community Guide Model, Promotoras Model, Social Marketing Model, and the Community Readiness Model

Focus Area 4: To improve the capacity of Community Planning Groups (CPGs) and Health Departments to include racial and ethnic minority participants in the community planning process and to increase Party Inclusion and Representation (PIR) on CPGs
FA4 CBA Providers provide technical assistance on member recruitment, process management, prioritizing behavioral interventions, community planning evaluation, and knowledge and understanding of the comprehensive plan

Not only did CDC fund providers to address specific areas of need but to center their attention on specific high-risk minority populations as well.  The result of these combinations is a large number of organizations concentrating their time and skills on specific areas, resulting in an abundance of highly beneficial information and assistance made available to agencies at all levels of development free of charge.

What are Evidence Based Interventions – An Overview:

Evidence Based Interventions (EBIs) are interventions that have been proven to be effective through a process of scientific validation and community appraisal. This process includes the following steps:

• Step 1) Selection – an intervention, identified in scientific literature, is assessed for a) random sampling of target populations, b) a comparison and a control sample group or site, c) pre-test / post-test evaluation, and d) uniform administration of the intervention to each individual within the sample.
• Step 2) Piloting – once passed the first step an intervention becomes eligible for pilot testing in another community, preferably in another state, to monitor the likelihood that a community-based organization can implement the intervention effectively. During the transitional process of taking an intervention from the researcher’s drawing board and into a serviceable but expectantly effective education strategy, the researchers explain why what they did worked for them and the piloting organizations explain how these interventions may be expected to work with other groups. From this process elements of the intervention that embody the theory and internal logic of the intervention and most likely produce the intervention’s main effects are identified and listed as the intervention’s Core Elements. Once an intervention has passed this second step, it is elevated to the status of an Evidence-Based Intervention and listed in the Compendium of HIV Prevention Interventions with Evidence of Effectiveness.

Due to the identification of the intervention’s Core Elements (what makes it effective) and their basis in social behavioral theories each of these interventions has the potential to be adapted for a new population, time frames, and locations.  The adaptability of these interventions makes them useful for agencies looking to provide a program with proven effectiveness. 

Migrant Populations:

The term ‘Migrant’ typically brings to mind an agricultural worker, but the Migrant population is made up of more than farm laborers. Migrants are also employed in construction, cleaning, food preparation, mining, production, installation, and repair to name a few. This population also has a diverse ethnic and racial makeup.  Although the majority of Migrants are of Hispanic/Latino decent, African Americans, American Indians and Alaskan Natives, and Asian Pacific Islanders are part of the Migrant population that works and/or lives within the United States and its territories. Due to the diversity of this group, it is best to broadly define it as people whose lives are influenced and affected by their mobility. 

Despite the different backgrounds of individuals that make up the Migrant Population of the United States, there are certain similarities among this group.  In general, Migrants have demanding work schedules, low income, low educational attainment, and commonly encounter language and cultural barriers.   Due to these issues, Migrants are often less likely to access healthcare services.  In addition, other stressors have been documented for Migrants such as the unpredictable nature of finding work and housing, instability due to constant uprooting, being away from family and friends (lack of emotional support) and difficulties related to migrating to the U.S.

In the realm of HIV/AIDS prevention, information on Migrants is scarce.  This may be due to factors such as difficulties accessing services for general health needs; lack of funding to specifically target Migrants for HIV prevention & research; and the possibility that when Migrants access services, their information is incorporated in statistics according to their race/ethnicity, not their Migrant status.  Data that has been recorded indicates that Migrants are at high-risk for HIV/AIDS.  Studies show the rates of HIV range from 0% to 14% depending on the area and particular Migrant population.   In addition to HIV rates, there are numerous risk factors and behaviors that have been recorded. 
“Risk factors are specific characteristics of a behavior (including the context in which the behavior occurs) that increase the likelihood that transmission will occur, but do not in themselves cause transmission.  Risk behaviors are behaviors that can directly expose individuals to HIV or transmit HIV, if the virus is present.  They are actual behaviors in which HIV can be transmitted, such that a single instance of the behavior can result in transmission”.  

Among Migrants common risk and behavioral factors fall under the following social-behavioral & situational factors: sex with sex workers, sex with other ‘steady’ partners, condom use, male-to-male sex, substance use, needle sharing, sexually transmitted disease, perceived risk of infection, HIV/AIDS knowledge, being unaccompanied, duration of stay in the United States, and access to social support networks. Preventions efforts of reaching Migrant populations should emphasize the importance of culturally and linguistically appropriate information, special efforts to access hard to reach populations, and an understanding of sensitive health topics including HIV/AIDS.

Accessing Migrant Project Services:

In order to receive capacity building assistance (CBA) from the Border Health Foundation’s Migrant Project an agency must submit their request to the Centers for Disease Control and Prevention’s CBA Request Information System (CRIS). How this is accomplished depends on the funding of the agency.

If an agency is directly funded by CDC to provide HIV/AIDS prevention they must:

• Contact their CDC project officer and notify them of their intent to submit a request in CRIS;
• Log on to CRIS and follow the prompts provided to submit a training request.

If an agency is directly funded by CDC (this means they receive CDC money from their State Health Department) or does not receive any CDC funding they should:

• Contact the individual at their state health department’s HIV/AIDS branch who is responsible for scheduling capacity building assistance and notify them that you would like to receive a training from BHF’s Migrant Project;
• Provide the state health department contact with all of the information needed for a CRIS submittal;
• The state health department will submit the request in CRIS on the agency’s behalf.

The following information is needed for your CBA request in CRIS:

• Requested CBA Provider  - (Border Health Foundation)
• Funding Type of Requesting Agency – (either CDC funded CBO, CDC funded Health Department, Health Department funded CBO, Non-Funded CBO or Stakeholder)
• Contact Name – (point of contact for requesting agency)
• Title/Position – (for contact person)
• Street Address – (for the requesting agency)
• City – (for the requesting agency)
• State – (for the requesting agency)
• Zip Code – (for the requesting agency)
• Phone Number – (for the contact person)
• Fax Number – (for the contact person)
• Email – (for the contact person)
• Country – (for the requesting agency)
• Racial/Ethnic Group Served – (list the primary population(s) you serve such as American Indian or Alaska Native, Hispanic/Latino, Asian, Native Hawaiian or Other Pacific Islander, Black or African American, White, Other – if other specify)
• Risk Population Served – (list all populations that are served such as MSM, IDU, Homeless Persons, Incarcerated Persons, Migrant Populations, MSM/IDU, Heterosexual, Mother at Risk for HIV, Youth at Risk for HIV, Transgender Persons, Other – if other specify. In order for the Border Health Foundation’s Migrant Project to be assigned you must serve Migrant Populations)
• CBA Focus Area – (list only one focus area either FA1 – Organizational Infrastructure, FA2 – Enhancing Interventions, FA3 – Community Access/Utilization, FA4 – Community Planning. In order for the Border Health Foundation’s Migrant Project to be assigned you must list FA2 – Enhancing Interventions)
• Describe the training being requested – (specify a training topic and explain why this training is needed for your agency)

As always, please feel free to contact the Border Health Foundation’s Migrant Project if you need more information about CRIS and how to request capacity building assistance.

Additional Information:

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