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HRSA SPNS Border
Health Initiative Conference Call
Notes March 12, 2001
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.
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.
None
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)
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