HRSA SPNS Conference Call

March 11, 2002 @ 10:30 am

Participants: Mari Zuniga, Rosana Scolari, Steve Trujillo, Ken Burton, Antonio Estrada, Kari Maier, Veronica Salcido-Harding, Yvonne Roacho, Michelle Velvarde, Elias Cantu, Alex Westbrook, Enery Mendoza, Nora Rodriguez, Carol Ibarra, Libby Benavidez, America Jones, Tony Chavez, John Wiebe, Sandi Duggan, Yolanda Cantu, Michael Tarter, Kurt Organista, Robyn Schulhof, Ledia Martinez, Adan Cajina, David Barney, Tim Brittingham, Saleem Ahmad, Betty Duran

Project Reports:

Arizona:

Trainings: Dr. Carmichael conducted a four (4) clinic at Sunset Clinic (2/21) in Yuma with Dr. Wang and saw 6 patients. On 2/28 Dr. Carmichael conducted scheduled clinic at Mariposa Clinic and saw one (1) patient with Dr. Peña, training was provided to the medical staff. In the afternoon Dr. Carmichael conducted an educational in service for the Nogales and Rio Rico fire fighters on HIV and universal precautions.

Out Reach Activities: Yuma County – The Yuma County Health Department (YCHD), Puentes de Amistad, and Campesinos Sin Frontera are working with the foremen of the farms to use the buses for HIV counseling and testing. YCHD has requested that a tent, table and chairs be purchased by the project to conduct counseling and testing where buses are not located. Outreach continues to be coordinated between YCHD, Puentes de Amistad and Campesinos Sin Frontera.

Santa Cruz County – Platicamos Salud hired Johnny Galindo as a promotoras who is replacing Conchita Somoza and is being trained in outreach. Ana Dutram completed HIV Counseling and Testing and Starter Facts. Their activities for condom week were well received outreach was conducted to 20 establishments (bars, hotels, truck stops, etc.) and 1300 condoms were distributed. Staff was asked by more than half of these establishments to continue to provide materials to them.

The police and fire departments have decided that they should no longer provide condoms and information from their stations. Staff of Platicamos Salud spoke to the chiefs of the departments and were informed that the incident at the Olympics have caused them to reevaluate their position. Staff is planning to speak to the mayor of Nogales.

Cochise County – Cochise County Health Department (CCHD) continues to conduct outreach from their sites and is working with the project to identify and recruit physicians in private practice.

Collaborators were asked to identify patients to participate in key informant interviews in April.

Dissemination Activities: none to report.

Project Enrollment: The project enrolled two additional patients in Cochise one of these patients may not be positive patient was sent to lab to be retested. Now that Dr. Carmichael has started clinics at the CHC’s project patients are informed of the option to transfer their care to the CHC in the area. Total patients enrolled in border project to date is 62.

Qualitative Study: Steve advised Centro de Evaluación staff that their project has teleconferencing capability that can be used to conduct key informant interviews with their clients if acceptable to OU. Betty advised this is a possibility and she will pursue this with Steve.

Local Evaluation: Impact Consultants review the revised local evaluation forms with the project collaborators at the 3/8/02 meeting. New local change form developed. Steve advised that they failed to incorporate into the form a name change variable. Would like to discuss with David Barney to ensure that it is incorporated into multi-site form.

Camino de Vida:

Programmatic: (Veronica)

o Presentation a Binational Health Council (Palomas, Columbus, & Juarez) on Feb. 22

o Co-trained HIV Testing and Counseling on Feb. 27 & 28 (New promotor was trained)

o March 23 the Promotores will attend a Promotores Forum sponsored by the Farmworkers Justice Fund in El Paso

o Providers training

o Dinner on April 23rd CMEs will be provided

o Second Training for BAHC on April 24th

o Rescheduling Training for LCDF was scheduled for April 17th

Local Evaluation: (Michelle)

• We are lining up the key informant interviews (site, participants, etc.). A date in April will be best, prefer if possible April 15-19, 2002.
• Yvonne and I went to Anthony on Thursday and trained the Promotores on the new module that assesses the attitudes of high-risk individuals toward knowing their HIV status; Promotores will begin using these next week; the training went well.
• Yvonne is compiling all of the codebooks for the Promotores; we are finalizing the formatting of the Spanish versions.
• Veronica and I will begin working with the Clinical Director and the new Medical Social Worker in a couple of weeks to launch the client understanding of disease management module.
• Dr. Frehill from NMSU and I have started to work out a plan for a graduate student who will be heavily involved in the research piece; the student will begin in July or sooner.
• Veronica and I are scheduled to present to the CdV staff on Friday, the 15th.

Data Collection:

OUTREACH:	Individual Outreach
	Total Number of Contacts Number of Tests to date	268 182
	Group Outreach
	Total number of contacts Number of group outreach sessions Number of appointments made Number tested	69 4 0 16
	Total number of contacts (individual & group)	321
IN-HOUSE:	Number of interviews and data collected on HIV+ Clients:	55

Centro de Salud:

• Enrolled 2 new clients in February and 3 client transfers from another agency
• National Council of La Raza is conducting a study on the Perceptions of HIV/AIDS along the Border and Centro de Salud will participate. The interviews are scheduled for March 27-29, 2002 in El Paso. Plan to interview both HIV positive and negative persons (focus groups)
• Have interviewed a third Nurse Case Manager – plan to make position offer today
• America Jones advised Camino de Vida staff that she will attend the Farm Workers Justice forum on March 23^rd in New Mexico
• Wiebe advised that data collection is caught up and are completing some follow-up activities with clients
• Appointment tracking has been systematized, permitting accumulation of baseline data on appointment attendance. The specifics of the intervention for increasing attendance were discussed at a project meeting today.

Valley AIDS Council:

• SPNS Coordinator position filled effective February 25, 2002 by Elias Cantu, Jr.
• Key Informant Interviews with qualitative consultant, Ms.Maria Ivonne Rivera of Washington, DC are pending scheduling dates for the month of March or April.
• SPNS Staff participated in AETC training at Nuestra Clinica Del Valle on February 21, 2002.
• SPNS Staff participated in AETC training at Brownsville Community Health Center on February 22, 2002.
• SPNS Staff participated in AETC training held at Treasure Hills Country Club sponsored by Abbott Laboratories on February 21, 2002. Presentations were done by Dr. Sinclair and Michelle Rowe, Nurse Practitioner.
• Participated in AETC Evaluation meeting with Barbara Blake after AETC Training at Nuestra Clinica del Valle.
• Scheduled conference call communications with SPNS Evaluation Coordinator, Sandi Duggan for March 6^th and March 13^th.
• Charles Smith, Project Director will be presenting at the National HIV/ AIDS Update Conference in San Francisco on March 19^th.
• Carol Ibarra (Data Profiler ) will not be collecting Medical Health Form. This needs to be collected by nurse/ clinician and needs to be addressed at next VAC manager’s meeting.
• Gina Holt ( Data Entry) reports she has not encountered any barriers or problems with the data that Carol has submitted to her. To date, everything is running very smoothly.
• Nora Rodriguez (Case Manager) reports some barriers at Nuestra Clinica Del Valle.
• Problem with telephone answering after 10 to 13 rings has been corrected ever since she complained about the problem. They now answer after 3 or 4 rings which makes it a lot easier to get in touch with nurse Belinda Zamora at Nuestra Clinica Del Valle.
• One patient experienced rash due to possibly reaction to HIV medications or treatment for STD.
• Another SPNS patient will possibly be opting to see his primary physician, Dr. Juarez instead of SPNS physician ( Dr. DeLimas) because he feels more comfortable going to Dr. Juarez since he already knows his medical history and also because of transportation problems.
• Third patient reported by Nora was having problems with getting on the ADAP Program because of communication errors between nurse Belinda Zamora and fax transmission to Nora. This patient also had to be re-drawn due to the original lab specimens were lost thus causing delays in obtaining lab results in a timely manner. This needs to be followed up on and cannot be occurring anymore.
• Enery Mendoza ( Case Manager) reported everything going well with the majority of the patients at Brownsville Community Health Center.
• One patient, is being referred to Dr. Soleja for biopsy of a lesion on his neck. This patient is on his third stage of Hepatitis C as well.
• Second patient, may possibly be leaving SPNS due to job transfer.
• Third patient, was hospitalized after intake was done by VAC and prior to being seen by SPNS physician (Dr. Nuchovich) and missed his scheduled nursing assessment appointment with BCHC on 2/7/02. Patient will be scheduled to return to VAC to be seen by Dr. Garcia due to BCHC not accepting new referrals due to recent resignation of SPNS physician. Enery has already scheduled patient for nursing assessment on 3/11/02 at 10:00 AM and doctor appointment with Dr. Garcia is scheduled for 3/20/02 at 3:00 PM. This patient died on March 1, 2002.

Brownsville Community Health Center:

• SPNS Staff from BCHC participated in AETC training on February 22, 2002. The AETC training was done by Michelle Rowe, Nurse Practitioner from University Health System. The precepting/ consultation was done by Dr. Gary Sinclair, AETC Consultation Specialist.
• Dr. Nuchovich (SPNS Physician) at BCHC will still continue to see existing SPNS patients during this transition period; however, no new referrals will be accepted until a new SPNS Physician is assigned by BCHC directors/ board.
• Jim Odom (Registered Nurse) reports everything is going well and is satisfied.
• Participation in AETC was definitely satisfactory and was something that was needed for himself and physician as well as SPNS staff.
• Recently participated in PCPE certification with Texas Department of Health and that was also very educational and satisfactory.
• Would like to see more communication from SPNS Coordinator and BCHC which was non-existent until now. He is glad that new SPNS Coordinator sends E-mails and contacts via telephone communications. Looks like everything will go smoothly from here on out.
• Requested new SPNS Coordinator to speak a little about himself and HIV background / knowledge and education at the next SPNS Meeting.

United Medical Center-(Eagle Pass):

• Connie Villareal ( Program Coordinator ) reports concerns regarding AETC training was not coordinated properly.
• There was lack of communication and the agenda was received late.
• All meetings with VAC have been total chaos for some time now and this problem needs to be addressed and corrected or they will not be driving numerous hours to Harlingen anymore just to be going around in circles and not be given the correct dates and locations of hotels and meeting sites.
• Diana De la Rosa (Nurse) reported concern regarding Hepatitis A vaccine.

They are not available to their HIV patients and needs to know where to order them from and how to obtain them. The Hepatitis A vaccines were a topic that was covered at the AETC training they received at Nuestra Clinica Del Valle in Pharr. SPNS Coordinator will follow up with Linda Ortiz and find out where she is getting the Hepatitis A vaccines for VAC.

Also, Diana will be out next week on annual leave and will return on the 18^th of March.

Nuestra Clinica Del Valle-(Pharr):

· Belinda Zamora (Nurse) reported everything is fine with SPNS. Voiced no concerns or barriers and directed my phone call to Dr. DeLimas.

· Dr. DeLimas (Physician) could not be reached for comment.

San Ysidro Health Center:

Programmatic/Dissemination

· A recent study was published in the San Diego Union Tribune on the very high incidence of HIV in young Latino males. Rosana was interviewed locally on this issue by KPBS radio and the interview will be aired this morning. Topic of discussion includes addressing AIDS in Latino gay/bisexual men in the border region.

Study consisted of 394 Hispanic high risk males (249 in Trijuana, Mexico and 145 in San Diego). A cross-sectional study of 19-29 year old males. 19% test HIV positive in Tijuana and 35% tested positive in San Diego. Mari gill obtain an original copy of the article and send it to all the border grantees.

· On March 14, Mari will be giving a lecture at the Universidad Autónoma de Baja California School of Medicine on the epidemiology of HIV/AIDS in the border region.

Evaluation

· Data collection training will be held today with field and clinic data collection staff. Allows for touching base on QA issues as well as exchange between clinic staff of challenges & what seems to work.

Multi-site Data as of 3/7/02

· Outreach Numbers:

Individuals outreached = 2,625

Complete outreach info available for 2,613

Gender of outreach contacts: 38% men, 41% women

73% referred to HIV testing & counseling

· Focus Group Analysis Update: Had phone conference call between Robyn Schulhof, Madeline Colon & Mari Zúñiga regarding computer—produced NVivo software report. Madeline will provide a summary report of project findings in a couple of weeks. The item that appears most commonly mentioned by female focus group participants is no surprise, various barriers to accessing services were mentioned 34 times, as well as services not being acceptable—outside of San Diego. Once Madeline’s report is received, Mari will write the final report for dissemination & will collaborate with Robyn & Dr. Kurt Organista on a paper.

Centro de Evaluación:

• Qualitative Study – Maria Ivonne Rivera of Washington, DC has been contracted with to conduct Key Informant Interviews at all five projects. Currently working on scheduling interviews at sites. The University of Oklahoma will provide $25 incentives. We will send our participant consent form to project staff so that they can provide to participants beforehand in order to assure that they fully understand their rights. David wants to schedule conference call with each project on Friday, March 15, 2002 to discuss study, selection of participants, and schedule interview dates.

• Grantees Meeting in Washington, DC – Grantees names have been provided to the DoubleTree Hotel in Rockville. The hotel will provide us with room confirmation numbers which we in turn to sent out to participants. When participants receive their confirmation number, you will need to call the hotel to provide a credit card to secure your room. A conference room has been reserved for the Grantees Meeting by HRSA at the Parklawn Building (Potomac Conference Room). We need agenda items from all projects as well as a list of HRSA speakers you would like to invite to present at the meeting. No focus group will be conducted at this meeting.\

• Site Visits: Need to schedule site visits between now and May 30^th. Please advise when project would like to schedule. It is possible we could schedule in conjunction with qualitative interviews. Robyn advised that site visit are only necessary if border sites determine they require technical assistance or if deemed necessary by HRSA and OU staff. She stated that is a site visit is scheduled with any grantee that a comprehensive agenda needs to be developed.

HRSA Updates: None

Other: None