HRSA SPNS Border Health Initiative

Conference Call Notes

March 12, 2001

 

 

Participants

David, Betty, Herman, Saleem, Ledia, Robyn, Luiza, Jennifer, Barbara Estrada, Ken, Steve, Bob, Marisa, John, Chris, Mike, Kurt, Yolanda, Mari, Alisa, Rosana, Joao 

 

Dissemination

Dissemination page will post abstracts for APHA conference. Herman presented suggested format for posting dissemination activities for each project.  The proposed format will be used to report dissemination efforts that have been completed and resulted in a final product (written presentation, brochure, journal article, newspaper article, etc).  Barbara suggested adding a column for authors.  David advised that lead author will be recorded in actual dissemination with a link to their e-mail address.  Local dissemination plan will also be posted on web without author.  These will be posted as two separate tables.  

 

Project reports

Arizona Border HIV/AIDS Care Project:  Project staff met with collaborating partners on March 2nd. to discussed local and multi-site data collection.  Continue to interview potential clients and complete data modules.  They propose to provide clients with an incentive to complete data modules and will submit request to Robyn to allow use of funds for incentives.  Reported that about half of the clients cannot read Spanish and are concerned with ability to complete Client Satisfaction.  David advised that forms will be available in Spanish & English for self administration or can be read by staff for clients who are unable to read.  Question about how modules are administered.  The majority of the modules are intended to be completed by project staff with only Client Satisfaction and Quality of Life have the option of being self-administered or completed through a staff interview.  Client Satisfaction is not confidential and was agreed to in San Francisco.  Program Support no longer exists.

 

Centro de Salud Familiar La Fe:  John reported for Ray Stewart as he and Tony are attending another meeting.  Advised that translation of local instruments will be completed this week.  Four nurses took baseline knowledge assessment on Friday and tests were mailed to UTEP.   La Fe is meeting with Director of FONSIDA (Dr. Cravioto) to discuss binational efforts for HIV services, they will review SPNS Mexico proposal to HRSA with Dr. Cravioto.  La Fe and Texas Dept. of Health Region 10 will conduct workshop at Texas HIV/STD Conference in mid-April, subject will be border HIV services.  The Texas Department of Health made site visit to La Fe last week, they are very interested in the disease management model developed by La Fe.  John asked whether incentives will be standardized across all sites.  David not important to standardize across sites because projects need to work at client level to ensure access to services and with new clients incentive may not be as important as actual services.  Steve said for his patients the incentive is not as critical because they are currently receiving medical care and would complete anyway, whereas new clients would be concerned with confidentially and could be motivated to complete data modules if provided an incentive.  New Mexico anticipated that it could be beneficial to enhancing participation.  Yolanda said her experience is that incentives are a motivator and really enhances data collection.  She suggested HRSA should consider allowing use of grant funds to provide incentives.  John in El Paso suggested that it may not be needed in year one with existing clients but should be considered for future years when new clients will be the primary focus of data collection.  Robyn said projects must use existing allocations in budget and may submit a request to HRSA requesting authorization to use funds for incentives.  Robyn advised that incentives cannot be issued in the form of cash.  No extra funds will be available for this grant period.  David asked Yolanda what was best incentive.  Yolanda said food vouchers which are plastic credit cards.  They have used $25 vouchers.  Harlingen estimates 120 participants costing about $5,000 - $7,000 annually.  Barbara advised they have used Walmart  vouchers that allow clients to purchase food or other goods.  Rosana asked if they request authorization to use project savings to purchase incentives for the next grant period?  Robyn advised end of year reports typically also address carry-over of funds.  Michael raised question about the impact of  incentives in regards to measuring program impact – difficult to determine is incentives produced change or some other factor.  Believes it is important to clarify what is the impact of incentives.  San Ysidro project sites will be using incentives ranging between $5-7 and will ask a question on data forms as to whether a client received an incentive.  Michael asked if clients are being asked anything regarding the importance of incentive to them as an individual.  Mari advised not at present and added that they do not have sufficient environmental control that would enable them to tease out influencing factors.  Michael stated knowing level of incentive provided could be useful.  Mari said ranges of incentives can be provided by projects.  John cautioned that incentives are only to complete questionnaires and not to return to services.  Barbara said incentives would not be provided beyond baseline.  For the present, each project will determine how they track incentives provided to their clients.

 

Camino de Vida Center for HIV:  Promotes are now working in soup kitchens and cantinas.  Have tested six new clients and will know results in about six weeks.  Advised that HIV testing clients complete the NM bubble form and multi-site risk factors module at same time.  When client returns for results, they then complete the rest of the data forms.  Very elusive population with the potential that many will not return for results.  Will wait and seek what works best with their population. 

 

Valley AIDS Council:  The agency Data Profiler started on March 5th and has begun data collection.  Some potential SPNS intakes this week.  Dr. Sinclair has scheduled three visits this month for health staff.  Agency has agreed to a temporary limit of 2 client referrals per month to health clinics.  Yolanda advised they are completing work on the data base for local evaluation.  Also working on evaluating role of AETC.

   

San Ysidro Health Center:  Alisa advised they are dealing with how best to collect data.  They have trained 25 staff persons from all the collaborating sites.  Used same format as used in Norman and found that there was limited consistency on how questions were being asked.  Developed a local protocol to clarify multi-site protocol to ensure consistency in data collection among their sub-sites.  They have Translated local instruments.  Presently they are working on focus group information and development of barriers model.  Start up date is set for March 19th.  Mari said they are working documenting any potential contamination of baseline by trying to document what other activities are occurring in SD that may affect their data.  Rosana had a question regarding participation of in-kind staff - is there an incentive that can be provided to these staff?  Kurt recommended that all projects reach some agreement as to the amount of type of incentives that will be afforded to clients for completing data modules, this would allow for some consistency across all sites.  He made a motion that all sites provide client incentives for completing data modules and agree on a set range of incentives,  Joao asking whether we are measuring if the incentives are affecting data collection?  Michel stated it is important to study incentives as a co-variate.  Lots of variability across projects (Barbara) in which some clients really need the money and other do not.  John asked projects what is the response rate they are expecting from their clients?  He believes it should be a high response rate based on the type of services being provided to clients.  Steve said they clients are willing to participate but the issue is how the modules are presented for completion.  The motion was second by Bob.  Kurt asked that a vote be postponed until the next conference call, in the meantime he and Michael with correspond with grantees to further clarify the research issues.  Group agreed to table this  to next meeting.


Multi-site evaluation issues

 Spanish Translations:  UTEP has completed the Spanish Translations which have been sent out the Translations Committee.  Initial response from committee members have been positive.  David advised group that Yolanda chairs the Translation Committee and all comments should be sent to her for review with the entire committee.  The committee will summarize recommendation and get information back to David for dissemination to grantees.  Everyone must submit information to Yolanda by the end of this week.  John recommended that sites closely review the code book because it was not back translated.  Yolanda will arrange a conference call with committee members. 

 

Update on web page – Betty advised group that Sudhir has been working on updating the Evaluation Center web page and asked that everyone take time to review it and make recommendation on how to improve it or provided general feedback.

 

Adobe PDF entry – David advised it is now available on our web page for completing data forms on the computer.  Presently there are three ways to submit data (paper, web page, Adobe PDF).  David advised that the modules will also be available in Spanish shortly after the Translation completes their review and provides their recommendations to the group for final approval.  Joao asked about how errors in data are to be corrected?  David advised project should send an e-mail advising about the errors and then submit a revised data form.  Group was informed that no data has been received to date from any sites. 

 

 

HRSA issues

 

None 

 

Other

 

Joao advised they have adolescents asking to be HIV tested, wanted to know if the adolescents could be counted in project, and what are issues of informed consent?  That is a local IRB issue that must be reviewed locally.  John in El Paso has presented a similar request to the UTEP - IRB which granted consent to test adolescents and include them in services.  The UTEP - IRB looked at the Texas code for testing and then approved process.  Mari said they were approved based on use of the URN number which maintains client confidentiality.

 

Grantees Meeting:  The group agreed on the dates of August 2-3, 2001 for a next grantees meeting to be held in Washington, DC.  Polling of sites for lodging needs include:  NM (5); SY (3); AZ (3); and Valley AIDS (4)