HRSA SPNS Border Health Initiative

All Projects Conference Call

November 5, 2001 @ 10:30 am

 

 

Participants:  Bob Smith, Marisa Olivares, Sandi Duggan, Kari Maier, Veronica Harding, Michelle Valverde, Yvone Roachor, Rodrigo Chavez, John Wiebe, Alisa, Ken Burton, Steve Trujillo, Anthony Estrada, Tim, David Barney, Betty Duran, Herman Curiel, Saleem.

 

 

Project Reports:

 

Camino de Vida:

 

Updates:

1) Camino de Vida has just celebrated its 2-year Anniversary

2)  Provider assessment completed with BAHC on 10/31/01

3)  Re-working logic model, then update work and evaluation plans in preparation for site visit 11/09/01

4)  Meet next Wednesday with Dr. Crespin, Medical Director LCDF

5)  Attended the Farmworkers Justice Fund monthly meeting

 

Local Evaluation:

1)  IRB application under development; consent form (s), qualitative piece, CdV client satisfaction survey and client understanding of disease management assessment

2) Individuals living with HIV – data collected (Camino de Vida) – Exploring training two students (MSW. BSW) to collect HIV+ data.  Having some difficulty with no shows for appointments and are working to solve the problem.

3)  Outreach data collected – a) Group outreach data received;  b) Updated outreach modules 5 & 6 (used to be 2 & 3).

4)  Preparing for site visit; feedback re: Evaluation plan and IRB application

 

Data Collection:

 

Outreach:                                                       Group Outreach:  Total # of Contacts = 38

FY-01 Number of HIV Tests = 90                Number in both sessions = 10

FY-02 Number of HIV Tests = 43                Number of appointments = 0

                                                                        Number tested = 6

 

Number of interviews and data collected on HIV+ clients = 21

 

Centro de Salud Familiar La Fe:

  1. RN/Care Managers will participate in the ANAC Conference in Minneapolis.  Will complete course and testing for certification as AIDS Nursing Specialist.
  2. Client flow continues to average 180 clients a month versus 40-65 per month last year.
  3. Missed appointment rate continues to be high (40%) due to high security measures at the bridge.  Many clients will appear as walk-ins due to extensive delays at bridges.
  4. Received 4 new positives this month and all enrolled in the program.
  5. Communication with AETC continues for training on mental health and nutrition.  Training is scheduled for this month.
  6. Evaluation-Dr. Weibe:  Working with Dr. Galindo on AETC training on services and crisis management.  Data collection – encountered some difficulty with inconsistency in data bases at clinic.  They are working with Tony Chavez to correct the inconsistencies.

 

Arizona Border HIV/AIDS Care Project:

 

Met with collaborating partners on Friday, November 2, 2001.  Updated them on site visit with Centro de Evaluacion, specifically on administration of Quality of Life module at intake and at 90 days.  Also discussed importance of Inferred Assessment  (Var. 126 – Demographics Module).  Group has agreed to develop a form to solicit information from clients that will assist in completing the inferred assessment.

 

Trainings:  The training for dentists scheduled by the AZ AIDS ETC was well attended in Nogales 2 dentists, 6 dental hygienists, 1 receptionist and in Sierra Vista 43 attended the in service.  The AZ AIDS ETC will begin the in service training at Sunset Clinic on November 14th and schedule an in service every month.

 

Out Reach Activities:  Yuma County – The program coordinator, Flor Redondo, for Puentes de Amistad resigned as of 11/2/01. Campesinos Sin Fronteras the new promotoras program has contact the project.  Steve plans to attend Dia del Campesino Health and Information Fair on December 1, 2001.  The fair is sponsored by Campesinos and the Yuma County Health Department.  Steve will schedule a meeting with Emma Torres the Associate Director of the Division of Health and Human Services for Campesinos Sin Frontera.  Steve will stay abreast of the situation in Yuma and remain in contact with Albert Moreno of the Border Health Foundation.  

 

Yuma County Health Department has begun to test in the field.  They are planning to have testing at the Dia del Campesino Health and Information Fair.

 

Santa Cruz County – Platicamos Salud and the teen program had their Haunted House October 29th through the 31st approximately 400 people went through the haunted house.  OU site team visited the haunted house.

 

Mariposa/Platicamos Salud continues to work with their community and have their support in planning events for World AIDS Day.  They have the permission and support of the owners of the truck stops to distribute HIV/AIDS information.  The produce trucking season begins mid-November through March.  Platicamos Salud plans to contact Centro de Información para la Salud (CISAL) a prevention agency in Sonora, MX to assist in outreach to the truck drivers. 

 

Cochise County – The Cochise County Health Department is training the promotoras (2) at the Chiricahua Community Health Center on outreach skills to the targeted populations of the project.  CCHD continues their outreach from their outlying counseling and testing sites.

 

ADHS Funds:  The CDC TOT for counseling and testing training is scheduled for December 4-7, 2001 in Portland, OR arrangements have been made.  These individuals will train the curriculum in Spanish to project promotoras who then will conduct the pre-counseling in the fields.  The additional CBC funds will fund a part time person at the county counseling and testing program to educate individuals testing positive for HIV on primary care, medications, medication adherence and enroll individuals into the state ADAP.

 

Dissemination Activities:  Barbara Estrada presented with the SPNA Projects at the APHA conference in Atlanta, GA.

 

Project Enrollment:  No new enrollments.

 

Local Evaluation:  The OU site visit scheduled on October 29/30, 2001 went well, good discussion on local and multi-site evaluation occurred with suggestions to improve data collection.

                                               

Data on counseling and testing has been received from the Arizona Department of Health and Human Services.  The data shows that 145 individuals were tested as a result of the outreach efforts of the project.  Two (1.3%) tests returned as positive for HIV infection.  Two test results were inconclusive.

 

Health Provider’s Assessment surveys were returned to the project evaluators and information will be shared with AZ AIDS ETC for training purposes.

 

San Ysidro Health Center:

                    

·         Progress on the development of the local social marketing campaign – Rosana is working with Les Papas of San Diego on this effort.

 

·        Preparation for Centro de Evaluación site visit on November 12-13, 2001

 

·        Data Collection Update/current outreach and multi site module numbers

As of the end of October 17, 2001:

 

Module A        294

Module B        291

Module D       324

Module E        85

Module G       42

Local Modue 4   35

 

·        Evaluation data collection training update.  Conducted training with staff at Alma Latina in which 13 persons were trained on November 1, 2001.  The newly trained personnel will target MSM’s in rural areas.

·        Border crossing still affecting attendance at clinic.  Anticipate it will also affect the number of US citizens who attend the US/Mexico Health Conference in Tijuana on November 14-16, 2001.  Delays at the bridge are approximately 4 hours. 

 

 

Valley AIDS Council:

 

SYSTEM LEVEL INTERVENTION ACTIVITIES

·        Clinical precepting between Dr. Sinclair and Project physicians at Nuestra Clinica del Valle and Brownsville Community Health Center took place on October 18th and 19th in Pharr and Brownsville Texas.  Dr. Jain (Pharr back up physician) joined Dr. D’Lima, new Project physician and Dr. Nuchovich, physician at Brownsville. Patients were seen and medical charts were reviewed and studied. Project evaluation staff continue to observe and systematically document the process.

1.      Recognizing HIV across the Spectrum

2.      HIV Treatment for the Non Specialty Provider

3.      Antiviral Resistance Testing

4.      Antiviral Resistance Testing Workshop

5.      Adherence:  Why Reductionist Thinking Fails in HIV

·        Local evaluation will begin routine contact (e-mail and/or telephone call) with Project physicians for the purpose of systematically assessing needs and satisfaction with the Model of HIV clinical training and specialty consultation.   Findings will be used to refine the training work plan as needed and as supportive documentation for reports and writing efforts.

·        Michelle Rowe, FNP, the University of Texas Health Science Center at San Antonio, has been identified as the proposed trainer for the Project nurse care coordinators.  Plans for incorporating a nursing model, similar to Dr. Sinclair’s model of physician HIV clinical training and precepting is underway. Local evaluation of this intervention will focus on assessing the impact training will have on nurse care coordinators’ role (HIV nursing skills, supportive counseling, educating patients on medication, etc…).  In addition, local evaluation will work with Michelle Rowe to develop an evaluation of the training. Findings will be used to further identify training needs and develop a training model for nurses new to HIV care.

 

PROJECT DATA COLLECTION ACTIVITIES

·        On October 18th, Dale Schweers, Project Management Information Specialist traveled to McAllen for the purpose updating input tables related to the Medical Health Form, a local evaluation measure (includes CD-4 and Viral Loads)..

 

·        Project data collection activities continue at a steady pace.  As of October 26, 2001, there are 60 records in the Local Database, comprised of 9 from United Medical Centers in Eagle Pass, Texas and 51 from Brownsville, Harlingen and Pharr, Texas combined.

 

·        As of October 26, 2001, a total of 173 forms have been entered in the multi site database: 

50   Demographic A Project Implementation Date: 030101

45   Lifestyle B Project Implementation Date: 030101

44   Risk Factor D Project Implementation Date: 070101

16   Barriers to Care F Project Implementation Date: 110101

12   Quality of Life E Project Implementation Date: 070101

06   Client Satisfaction G Project Implementation Date: 070101

 

·        The Project Data Manager gave notice of part time status effective immediately and the Case Profile Developer returned to the Project full time, late October 2001. Evaluator and project staff will track impact on data timeliness and quality.

 

OTHER EVALUATION ACTIVITIES

·        A sample structured qualitative interview with Project clients who access medical and dental care in Mexico has been submitted to IRB. Qualitative work is anticipated to begin early 2002.

·        Evaluation staff is collaborating with Dr. Sinclair to develop a “white paper” that will focus on AETC experiences in providing clinical training to physicians in low seroprevalence urban areas.  Working title: ‘Meeting the educational and consultation needs of low volume providers of HIV care in rural areas’ 

 

Multi-site Evaluation:

•           Betty has requested clarification from HRSA as to how they would like for the multi-site evaluation to include a strong collaboration with AETC in evaluating the training being provided to the border projects.  All projects will be advised as to when a conference call will be held to discuss AETC evaluation issues.

•           Tim advised that the OU server has down for a week or so, therefore the Centro de Evlauacion has been unable to process any data submitted by sites during the last week.  He will be working on data today.

•           David advised that Barbara Estrada has worked on the acculturation scale and it is now available as a syntax file on the web page under the multi-site data link.  David advised that there is some redirection on three variables and suggesting using a backup file for analysis.  Barbara and Tony will provide a brief training on the use of the acculturation scale at the Grantees Meeting in San Diego.  The web file name is SPS.  John Wiebe advised that those not familiar with SPSS, the reverse coding can be tricky.  He suggested that people run data analysis by using a backup file.

 

 

Dissemination:  David advised that the presentations at APHA in Atlanta went very well.  We have received positive feedback from HRSA, AETC, and other persons who attended the presentation.

 

HRSA Issues:  None

 

Other:   Kurt suggested that we include an update on the Bi-National Health Initiaitve at the next grantees meeting in San Diego in Jaunary 2002.  Betty asked Kurt if he would be willing to lead this presentation.  Kurt will review the materials and coordinate with Betty for a time slot on the meeting agenda.

 

Next conference call on November 19, 2001 @ 10:30 am.