HRSA SPNS All
Project Conference Call
Conference Call 12-10-01 @
10:30 am
Participants: Ken Burton, Steve Trujillo, Tony Estrada, Rosana
Scolari, Mari Zuniga, John Wiebe, Veronica Salcido-Harding, Michelle Valverde,
Marisa Olivares, Yolanda Cantu, Sandi Duggan, Robyn Schulhof, Adan Cajina,
Herman Curiel, Tim Brittingham, David Barney, Saleem Ahmad.
Project
Reports:
Trainings: The AZ
AIDS ETC did not conduct any trainings during this period. Robert Castrillo has
contacted the Sunset Clinic in Yuma to reschedule the HIV 101 training for the
nursing staff. The training will be
rescheduled for January 16th.
The CHCs returned their completed Health Provider Assessment
surveys to Impact Consultants at the November 4th collaborators
meeting. Mariposa Clinic will mail
their surveys to Impact consultants.
Out Reach Activities:
Yuma County – The Yuma County Health Department (YCHD) and Campesinos
Sin Frontera, Puentes de Amistad and 30 other community providers participated
in el Dia del Campesino Health and Information Fair on December 1, 2001. The health fair drew approximately 3400
people. The Yuma County Health
Department counseled and tested 56 people the results of the tests should be
back to the health department by December 19th. Puentes de Amistad scheduled an orientation
for prospective promotoras 13 people have signed up. The orientation occurred December 6th. Nena Garcia has been assigned as the
coordinator of the ABHAC Project for the Border Health Foundation. Ms. Garcia will set up trainings for the
promotoras as soon as they are selected.
She will contact AZ AIDS ETC, Yuma County Health Department and the
Farmers Justice Fund for training.
Santa Cruz County – Platicamos Salud reported that the events
for World AIDS Day were well attended.
The churches in Nogales rang the bell 20 times at noon to signify the 20
years of the epidemic of HIV.
Platicamos Salud participated in the Christmas parade as part of the
Mariposa Clinic float. They had 25 staff
and community members walk with candles along side the float. The administrative staff of the clinic made
a quilt for the patients of the clinic that have died from AIDS. The quilt hung in the clinic during the week
and was carried in the parade. They
plan to send the quilt to the Quilt Project to be part of the National Quilt
Project. The counseling and testing
site at the clinic had 25 people show up for testing.
Cochise County – Cochise County Health Department had events
in Bisbee and Douglas 30 businesses hung red ribbons on their doors to show
their support and provided informational materials on HIV/AIDS. There were candle light walks in both Bisbee
and Douglas with 20 people participating in Douglas and 15 in Bisbee. The churches in both towns rang the bells at
noon 20 times. The Cochise County
Health Department is working to obtain the support of the Southern Arizona HIV
Consortium to assist in next years World AIDS Day activities.
ADHS Funds: The
contract from the state for the Congressional Black Caucuss funds is still
being awaited by El Rio.
Three representatives from the three counties (Gabby Leon
(Yuma), Sonia Guerrero (Santa Cruz), and Anna Salazar (Cochise) attended the
CDC Trainer of Trainer in Portland, OR.
Dissemination
Activities: None to date
Project Enrollment:
The project enrolled six patients in Cochise County. Four enrollment packets have been sent to
Impact Consultants and two are yet to be submitted. The addition of the new enrollments will bring our total
enrollment to 52
Local Evaluation:
Steve reviewed with the therapist the inferred problems on module A and
made corrections where applicable.
Corrections were submitted to Impact Consultants. Steve also addressed the issues with project
enrollment staff at collaborator sites.
Issue will also be addressed to the collaborator meeting on January 4,
2002.
q Updates/Changes:
o Promotores: Hired a new Promotor to work with MSM
population
o Farmworkers
Justice Collaboration still in progress, continue to build a working
relationship with them.
o NMAETC: Hired a new Program Manager: Pat Carter who has her MPH
o CHC’s:
·
BAHC: Working on
collaboration to improve dental services for clients
·
LCDF
o NMCHIP
(New Mexico Comprehensive Health Insurance Pool): Premiums have increased.
NMCHIP is for those who have been rejected for medical coverage by the private
health sector. This is currently affecting 10 of the clients. Efforts are being
made to make up the differences.
o At the
CHC, a client missed taking her AIDS medicine by a week due to miscommunication
between a pharmacy and the agency that faxes her prescription to the pharmacy.
This is being looked into in order to avoid any other such problems in the
future.
q Local
Evaluation:
o Yvonne is
overseeing data collection efforts among the team of 7, including herself: 158
tested in outreach (68 year 2)/ 40
interviews (modules) collected on HIV+ clients (34 entered, 6 to be entered)
o Data was
collected from 5 clients in Silver City last week
o 1 more
outreach group conducted (17 people in a group)
o Shortage
of incentives, so trying to troubleshoot this problem
o QA with
one of the Promotores has been very time consuming for several weeks
o Some data
was lost from Module 6—Yvonne will be working on getting Tim the information he
needs
o IRB
application is done and ready to be submitted, except for the modification,
development, and/or adoption of several instruments
o Logic
model was approved by Robyn with final review on 01/03/02
q Technical
Assistance Needs: N/A
Programmatic
·
Roll over funding is being used to
fund New HIV Testers at two clinic sites-Clinicas de Salud del Pueblo and Vista
Community Clinic
·
Progress on the development of the
local social marketing campaign. The Director for the social marketing agency
was here about two weeks ago, and he conducted site visits to each of the
clinic to get a feel for the challenges ahead.
·
There might be a survey on what the
clients are hearing during the campaign to analyze its effectiveness.
Evaluation
·
Data
submission to Centro will change from internet entry to fax-in entry once the
details can be finalized
·
Data
Collection Update/current outreach and multi site module numbers
As
of the of December 7, 2001:
Module A 322
Module B 317
Module D 505
Module E 104
Module F 14
Module G 51
HIV Positive preSPNS
(June 30 2001) = 53
HIV Positive postSPNS
(July 1 – Dec 7) = 94
Total individual outreach
contacts to date: 2533
LOCAL EVALUATION SYSTEM LEVEL
INTERVENTION ACTIVITIES
·
Routine
evaluation contact (e-mail and/or telephone call) with Project physicians and nurse
care coordinators to systematically assess needs and satisfaction with the
Juntos Project process reveal the following:
1. Physician
concern regarding the significant amount of in and out of clinic time and
effort involved in providing HIV primary care. Project physician reported that
in addition to providing medical care for a complex disease and providing in
patient hospital care, must act as an advocate and work the system on behalf of
the patient (i.e., calling the hospital pharmacy to make sure medicine is
available). In conclusion regarding
this issue, the physician stated that the additional work is burdensome, was
not set as an expectation at the inception of the Project and this type of work
is outside the scope of practicing as a medical provider.
·
Critical Incidents
Negative - RE: Project physician’s patient hospitalized at Valley Regional Medical
Center in Brownsville, reported 11-19-01, hospital did not have Amphotericin B
(gold standard treatment for this particular case). Fortunately, Project
physician is trained in provision of HIV care well enough to know liposomal
ampho is a viable alternative, although more expensive and less experienced in
use for this particular anti fungal infection.
This case highlights significant barriers physicians face in caring for
HIV infected patients in the Valley.
Negative – RE: above patient. Did not
get Crixivan for several days due to the fact that the hospital pharmacy
temporarily ran out. The Project physician acknowledges that additional time,
outside of clinic responsibilities and direct medical care, is required in
order to care for his patients. He
plans to address these incidents with the hospital CEO, further evidence of
significant barriers physicians face in caring for HIV infected patients in the
Valley.
Positive - The doctor on call at Brownsville
Medical Center in Brownsville referred a patient to the local Project
physician. He knew of the physician’s
work in HIV due to the fact that he is also a physician employed at BCHC. This is the Project physician’s second
‘hospitalized in patient admission’ case in Brownsville and provides evidence
of the impact of the system level intervention.
Positive – Patients being referred to
Brownsville Project physician by sources other than VAC; as mentioned above,
his colleague from BCHC and a private Infectious Disease physician from
Brownsville.
PROJECT DATA
COLLECTION ACTIVITIES
·
Project
data collection activities continues.
As of December 7, 2001, there are 93 records in the
Local Database, comprised of 9 from United Medical Centers in Eagle Pass, Texas
and 84 from Brownsville, Harlingen and Pharr, Texas combined.
·
To
date, a total of 177 forms have been entered in the multi site database:
53 Demographic A Project Implementation Date: 030101
52 Lifestyle B Project Implementation Date: 030101
51 Risk Factor D Project Implementation Date: 070101
0 Barriers to Care
F Project Implementation Date: 110101
13 Quality of Life
E Project Implementation Date: 070101
08
Client
Satisfaction G Project Implementation
Date: 070101
·
The
local database indicates that 4 women delivered 5 children since June 01. A
total of 7 children under 13 are currently being tracked in the local data
base. We may want to discuss if we want to develop evaluation around women and
children as well. Doing more research
on the mothers since we cannot link the child case to the mother at present.
·
Quality
of Life and Barriers to Care are lagging.
Project staff will be meeting to discuss this.
OTHER EVALUATION ACTIVITIES
·
Conducted
a local evaluation presentation with the local evaluation team from the El Paso
Project at the Texas-Mexico Border Health Conference, El Paso Texas on November
29, 2001.
·
Michelle
Rowe, NP provided clinical nurse training on December 6, 2001 in Harlingen
Texas. Two nurse care coordinators from
partner CHC’s were in attendance.
Baseline pre and posttest measures (developed by Michelle Rowe)
assessing knowledge and AETC Module 7 were collected. Follow-up training sessions are scheduled for February 2002 and
quarterly thereafter. Evaluation of
this activity will be on-going.
Training was very well received with nurses attending stating it was
very necessary to increase their comfort level in providing care to the
population living with HIV/AIDS.
·
Plan
to complete qualitative interviews with project staff in February
·
Planning
for qualitative interviews with clients are underway.
* Data collection and entry are progressing.
* At the moment, we have five parallel database run by
different employees at the clinic
and we are trying
to put them together. We have assembled a comprehensive patient
list and are
actively recruiting those who have not yet been assessed.
* Tony is not available for this meeting because Dr.
Galindo, a psychologist who works
with the
AETC is visiting La Fe for needs
assessment and training.
* We did a cooperative presentation with Sandi Duggan
from South Texas at
the UT Pan-American Texas/Mexico
Border Health Meeting on Nov. 29th. Joe
Baldi was in attendance.
Multi-site
Evaluation Issues:
David: Reminded everyone about the next meeting in San Diego
(January 7-9, 2002).
Herman: Reminded everyone about making reservations for the
meeting (Holiday Inn in Old Town – San Diego)..
Tim: The Evaluation Center held an open house for World AIDS Day and it was well attended by University staff and students, Centro de Evaluación felt it was a successful event. Centro staff also collaborated with the Latino Community Development Agency, and other University Campus organizations with sponsoring an AIDS booth at the Student Union throughout the day.
Herman: Tim and Herman made a presentation about the project
at the National Association of Social Workers meeting held in Oklahoma City.
HRSA
Issues:
Robyn reminded everyone that Grantee Semi-Annual report is
due at HRSA by January 31, 2002. If
anyone has not received their packet with instructions or has any questions,
they should contact their HRSA project officer.
Other: None