HomeMy WebLinkAbout972463.tiffRESOLUTION
RE: APPROVE HIV AT -RISK GRANT PROPOSAL AND AUTHORIZE CHAIR TO SIGN
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, the Board has been presented with a HIV At -Risk Grant Proposal between
the County of Weld, State of Colorado, by and through the Board of County Commissioners of
Weld County, on behalf of the Health Department, and the Colorado Department of Public
Health and Environment, with terms and conditions being as stated in said proposal, and
WHEREAS, after review, the Board deems it advisable to approve said proposal, a copy
of which is attached hereto and incorporated herein by reference.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of
Weld County, Colorado, that the HIV At -Risk Grant Proposal between the County of Weld,
State of Colorado, by and through the Board of County Commissioners of Weld County, on
behalf of the Health Department, and the Colorado Department of Public Health and
Environment be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said proposal.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 26th day of November, A.D., 1997.
ATTEST:
Weld Co
BY
eputy Clerk of e Board
AP
G�c //t
BOARD OF COUNTY COMMISSIONERS
WELD UNTY, COLOO7
George E. Baxter, Chair
nstance L. Harpert, Pro-Tem
Barbara J. Kirkmey
W. H. ebster
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HL0023
State Of Colorado
Colorado Department of Public Health and Environment
4300 Cherry Creek Drive South
Denver, CO 80222-1530
HIV Prevention Services:
HIV At -Risk Grant Proposal
Applicant's Name:
Address:
Contact Person:
Phone:
Amount Requested:
Date Submitted:
Weld County Health Department
1517 16th Avenue Court
Greeley, CO 80631
Misti Aas, HIV Educator
Karen Spink, Health Promotion Program Supervisor
(970) 353-0586
$ 8,330.00 from January 1, 1998 to December 31, 1998
November 24, 1997
Weld County Health Department
Weld County Board of Commissioners
JohryS`. Pickle, M.S.E.H. /Chariman
D ector
(/ �-`f62
Date /
Date
11/26/97
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I. DESCRIPTION OF ORGANIZATION
The Weld County Health Department (WCHD) was established in 1938; the
second health department in the state of Colorado. WCHD serves the 144,000
residents of Weld County which includes 29 incorporated towns and
encompasses 4000 square miles. WCHD employs approximately 75
individuals who work in three separate divisions; Administration, Preventive
Health Services, and Environmental Protection. The mission of the WCHD is to
preserve, promote and protect a healthy life and safe environment for all people
in Weld County. Financial support of WCHD consists of the following; county
funds - 37.4%, fees for services - 31.6%, contracts and grants - 28.7%, and
misc. funding - 2.3%.
The governing Board of Directors for WCHD is the County Board of
Commissioners and Public Health Board (see attachment ). The HIV
Educator/Program Coordinator has no control of gender or ethnic make-up, or
selection of the persons constituting this Board.
WCHD houses a STD clinic and also serves as both an anonymous and
confidential HIV testing site. In addition, WCHD is the lead fiscal agency in
Northern Colorado for the management of the Ryan White Care Act.
The HIV Education program is under the umbrella of the Health Promotions
Section of Preventive Health Services at WCHD. In 1997, public information on
HIV/AIDS prevention and awareness was provided to approximately 780
people in Weld County through community events and educational
presentations to organizations and schools. Upwards of 75,000 persons were
reached through press releases, purchased ads, radio PSAs and interviews.
WCHD is the lead agency for the Weld County AIDS Coalition (WCAC) with the
HIV Educator serving as coordinator. In addition, individual HIV prevention
counseling was provided on a weekly basis through the STD Clinic.
WCHD houses an audiovisual and other educational media supply room.
These supplies include over -head projectors, slide projectors, a portable
TVNCR, flip charts w/markers, an HIV virus model, and a variety of videos on
health -related issues including HIV/AIDS. The HIV Educator has ready access
to all equipment. Condoms and HIV -related brochures and information is
stored in the office of the HIV Educator.
The HIV Educator at WCHD has been involved in HIV Education for eleven
years through UNC, WCAC, and currently WCHD. She is a member of the
Board of Directors for the AIDS Coalition for Education. She holds a Masters
Degree in Agency Counseling and is a Licensed Professional Counselor and
has facilitated the HIV/AIDS support group for the past five years.
II. TARGET AUDIENCE
For the intended scope of work to be completed, the target population will be
women who have sex with men, with the inclusion of youth, women of color and
women with disabilities/hearing impairment.
The intervention applied will be group -level intervention, specifically ongoing
6 -week cycling risk -reduction workshops, followed by peer -educator training to
further outreach efforts.
A 90 -minute focus group of 10 women ranging from 25 to 46 years of age (6
Anglo, 2 Latino, 1 Asian, and 1 African -American) was facilitated by WCHD's
HIV Educator in order to assist in the planning process. In addition, a voluntary
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survey on HIV knowledge and personal condom usage was distributed at
targeted agencies of participant recruitment; A Woman's Place, Sunrise
Community Health Center, Planned Parenthood, Greeley Transitional House,
UNC Health Center, and WCHD STD/Family Planning Clinic. A written survey
approach was used in order to receive feedback from a larger section of the
target population, as well as to increase truthfulness in responding through the
anonymity factor. Results of this survey are particularly useful in identifying
barriers to practicing safer behaviors, as well as assessing any deficits in basic
knowledge of HIV/AIDS.
Participants will be recruited primarily through the 6 aforementioned
agencies (as well as through other health care providers, women's groups, and
mental health counselors), with emphasis placed on the two agencies
collaborating with WCHD; A Woman's Place (a shelter for battered women) and
Sunrise Community Health Center. Recruitment will involve fliers for upcoming
workshops, as well as through word of mouth from agency providers and former
workshop participants. In 1998, an estimated 105 women will be reached
through seven 6 -week risk -reduction workshops. In addition, upwards of 2500
women will be reached through peer education efforts.
Risk -reduction workshops will be held at 2 alternating locations, both fully
accessible for the physically -challenged. Interpreters for the hearing impaired
can be acquired through the Northern Colorado Center for Deafness with 3 -day
advance notice.
CWT District 2 recommended that the greatest urgency of priority be placed
on unsafe sexual contact, partners of opposite sex, among people of all races
and ethnicities. Women was the specific population chosen for this project, due
to the unique issues of empowerment and self-esteem that influence the
practice of safer behaviors, as well as the increase in new infections among this
population. AIDS is now the third leading cause of death in American women
aged 25 to 44. Women are one of the fastest -growing groups among people
diagnosed with AIDS, accounting for 20% of newly reported cases in the United
States and 42% of cumulative cases worldwide. In the US, between 1991 and
1995, the number of women diagnosed as having AIDS increased by 63%,
more than any other group of persons reported as having AIDS, regardless of
race or mode of exposure to HIV.
The HIV Educator who will coordinate this program and facilitate all training
activities is a woman.
III. CULTURAL COMPETENCE AND PROFICIENCY
Because one individual is coordinating this project, the "organization" will be
referred to as the "HIV Educator". The HIV Educator is committed to the ongoing
process of cultural competence and proficiency. The HIV Educator will attend
any trainings offered through the state (or locally) on furthering cultural
competence and awareness, continue to pursue Spanish language classes,
and will read books specifically addressing unique concerns and needs of
various ethnic backgrounds served through the intervention. At the beginning
of each 6 -week risk reduction workshop, the HIV Educator/Trainer will assess
where each individual and the group is on a cultural spectrum. The said Trainer
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also has an ethnically diverse group of friends and acquaintances who help
promote ongoing growth in cultural sensitivity.
The focus group used in the planning process of this intervention was
ethnically diverse, including Anglo, Latino, African -American, and Asian
women. Unique cultural needs were heard and integrated into the operational
plan of the program.
The HIV Educator/program coordinator will assess her cultural competence
and proficiency through ongoing feedback of program participants and
technical assistance through CDPHE.
IV. OBJECTIVES
By December 31, 1998, women participating in risk -reduction workshops will be
able to describe 3 high -risk behaviors that increase their chances of HIV
transmission.
By December 31, 1998, 25% of women participating in workshops and peer
presentations will be able to demonstrate how to correctly put on a condom.
By December 31, 1998, increase by 10% the number of women participating in
risk -reduction workshops who use condoms.
V. OPERATIONAL PLAN
The intervention to be implemented will be a group level intervention,
specifically a cycling 6 -week (90 minute weekly sessions) risk -reduction
workshop, titled "Relationships 201", open to any interested woman over 15
years of age. The desired number of participants for each workshop is 15
individuals.
The first 6 -week workshop will be given to the ongoing women's support
group at A Woman's Place. This open group of 10-15 women meets on a
weekly basis to discuss relationship and life struggles and triumphs and is
facilitated by an on -staff counselor at A Woman's Place. For the purposes of the
risk -reduction workshop, the group will become a closed group for the alotted 6
weeks (new members will not be permitted to join the workshop after the
second session and existing members will be briefed on the importance of
attending all 6 sessions). Initially providing the risk -reduction workshop to an
already existing group enables the first intervention to begin earlier in the year
in order to reach a greater number of the target population, while concurrently
recruiting participants for future workshops (as outlined in the Target Audience
section). If there are more interested women than available space in the risk -
reduction trainings, the possibility of a second concurrent workshop will be
considered.
The location of the risk -reduction workshops will alternate at each 6 -week
cycle between the two collaborative organizations; A Woman's Place and
Sunrise Community Health Center.
Behavior change is still the only available means to avoid contracting HIV
infection, and encouraging individuals to avoid risk behaviors remains the only
effective HIV -prevention strategy. Only a few behavior changes are needed to
eliminate or lessen risk for HIV infection: Having sex only in a monogamous
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relationship with an uninfected partner; consistently using condoms if sexually
active in any other circumstance; and for injection drug users (IDUs), not
reusing uncleaned needles.
The risk -reduction workshops will place a high degree of emphasis on
attitudes towards condoms and condom usage. According to the Siecus Report
Fact Sheet Volume 24, Number 10, Oct/Nov. 1995, using a condom is more
than 10,000 times safer than not using a condom during intercourse, and
condoms are 98% effective when used correctly with some reports indicating
they are 100% effective. Studies show that for individuals to wear condoms,
they must not only believe that sex with a condom can be enjoyable, but trust
their technical ability to use condoms in a confident way.
The proposed risk -reduction workshop, "Relationships 201", will include and
address the following important factors that influence behavior change:
Risk education - Accurate understanding of behaviors that confer risk,
behavior changes needed to reduce risk, and the rationale underlying risk -
reduction changes.
Perceived personal vulnerability - Personalization of risk; believing
oneself to be potentially vulnerable for contracting HIV/AIDS.
Behavior change intentions - Readiness for change and committing
oneself to risk -reduction effort.
Self -efficacy - Believing oneself capable of successfully making risk -
reduction behavior changes, and perceiving that this change will protect against
HIV/AIDS.
Implementation skills - Behavioral competence in areas necessary for
change implementation including condom use or other safer sex practices,
sexual assertiveness skills to refuse risk pressures, and safer sex negotiation
skills.
Reinforcement of behavior -change efforts - Positive rather than negative
outcomes associated with behavior -change efforts, including positive partner
response, self -praise and reinforcement, and belief that behavior change is
consistent with peer group norms.
"Relationships 201" Curriculum
Session 1:
Session 2:
Introductions and ice -breaking activities.
Initiate discussion on basic HIV facts (HIV 101) in order to
clarify information and clear up misconceptions.
Identify attitudes, concerns, fears, and states of mind which
participants may have brought to the workshop.
Initiate a process of acceptance and/or validation of
participants' feelings about their sexual choices.
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Session 3:
Session 4:
Session 5:
Session 6:
Associate different sexual practices with the level of risk for
HIV infection.
Stimulate creativity with respect to identifying non -
penetrative sexual practices.
Identify and discuss barriers to practicing safer sex
(i.e. partner issues, condom acquisition/use issues).
Discuss facts/myths surrounding condoms.
Increase comfort level and develop positive attitudes in
regards to condom use through practice and fun activities
using condoms (homework assignments may be utilized;
e.g. condom acquisition).
Identify factors inhibiting ability of persons to discuss/agree
upon safer sex practices with partners.
Practice assertive communication/negotiation skills for
discussing/agreeing upon safer practices.
Address gender differences in communication.
Relate the effect of alcohol and drugs to the difficulty of
establishing agreements with sex partners regarding safer
sex.
Explore how cultural and family learning uniquely effect
relationship patterns.
Explore how self-esteem, relation of co-dependency, and
sexuality have influenced attitudes toward practicing safer
behavior.
Identify and practice self -nurturing behaviors.
Provide participants the opportunity to consider the
importance of committing themselves to the struggle against
HIV at both a personal and community level (e.g. peer
education opportunities).
Complete evaluation.
Closing.
Expected Outcomes
1) Behavior modification (e.g. increased safer sex activity, such as using
condoms and maintaining monogamous relationships, decreased high -risk
sexual behavior, decreased alcohol/drug use (determined by survey analysis).
2) Heightened self-esteem, and understanding of one's sexuality among
participants.
3) Recruitment of a cadre of volunteers to become peer educators.
The second component of this group -level intervention is a peer education
program. Women who have completed a "Relationships 201" workshop will be
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eligible to become peer educators. Any woman who is interested will be
required to go through a screening process to determine her level of
appropriateness and be required to complete an additional 4 hours of training.
An on -staff counselor at A Woman's Place will assist the HIV Educator in on-
going supervision of the peer educators. The peer -educators will provide
condoms, educational materials, and peer presentation to other women who
have a similar shared identity (age, ethnicity, language, cultural norms, etc.).
The presentations given by the peer educators will be fun and informal billed
as "HIV Prevention Parties" and will be held at organizations that serve women
and at women's homes. Peer educators will provide fliers at presentations on
the upcoming "Relationships 201" workshop. Peer educators will be able to
inspire and encourage their peers to adopt health seeking behaviors because
they are able to share common weaknesses, strengths, and experiences.
Peer educators will receive compensation for their efforts and hard work
through material incentives of gift certificates to restaurants or other area
merchants. These will be awarded either in smaller sums every month or in a
large sum at an end of the year appreciation celebration.
Time -Line
By January 31, 1998, the first 6 -week risk reduction workshop will begin
(workshops will continue throughout the year with a one -week break between
each).
By January 31, 1998, area health clinics, mental health counselors, and other
organizations that serve women will be provided with information regarding the
"Relationships 201" workshop.
By June 30, 1998, the first peer educator 4 -hour training will be completed.
By September 30, 1998, the second peer educator 4 -hour training (for new peer
educators) will be completed.
By December 31, 1998, the third peer educator 4 -hour training will be
completed.
By December 31, 1998, a total of seven risk -reduction workshops, facilitated by
the HIV Educator at WCHD, will be completed.
By December 31, 1998, a minimum of twelve presentations (HIV Prevention
Parties) - 2 each month between 6/30/98 and 12/31/98 - will be completed by
the trained peer educators.
CWT District 2 recommended Group Level Intervention as having primary
importance in prevention activities surrounding unsafe sexual contact, partners
of opposite sex....(Statement 4).
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VI. COLLABORATION, COORDINATION AND NON -DUPLICATION:
The HIV Educator at WCHD will collaborate with two separate agencies to
implement this group level intervention; A Woman's Place and Sunrise
Community Health Center.
A Woman's Place is a resident shelter for battered women and their children.
The organization also provides counseling and case management services to
women who have experienced a domestic violence situation. According to the
Centers for Disease Control, women who are raped, sexually abused, or
survivors of domestic violence have lost the power to make decisions about
whether or not to engage in sexual activity and about personal safety, and are
thus at risk for unprotected sexual activity. This unprotected act puts women at
risk for being infected with HIV.
Sunrise Community Health Clinic provides medical, dental, and some mental
health services. The WIC (Women Infant Child) Program is housed at Sunrise
as well. In addition, Sunrise Clinic is a confidential HIV testing site.
Both of these agencies will play a major role in recruiting participants for the
risk -reduction workshops. The site for the workshops will alternate between
these two agencies. An on -staff counselor at A Woman's Place will assist in
ongoing supervision of the trained peer educators.
There are currently no other service providers in Weld County providing HIV
risk -reduction workshops or peer educator presentations. All components of
this program are new and innovative for Weld County.
VII. EVALUATION
Formative evaluation through the implementation of a focus group (described
in the Target Audience section) was utilized. The two primary questions
discussed by the focus group were; 1) What do you see as the issues of primary
importance to be addressed in a relationship (risk -reduction) workshop? and 2)
What are barriers to protecting yourself sexually (safer sex practices) that you
have either experienced or perceived? Responses to these questions were
incorporated into the workshop design/curriculum. Responses to a survey
(described in the Target Audience section) were also used in program planning.
A pre- and post-test questionnaire will be administered to participants at the
beginning and the end of the 6 -week risk -reduction workshop. The
questionnaire will collect demographic data on the participants and ask
questions about sexual practices (including condom usage) and drug and
alcohol use. An instrument measuring self-esteem will also be utilized.
Additionally, participants will be asked to provide feedback on each of the six
sessions on a general evaluation sheet. Participants will be given the
opportunity to comment on time allotment, facilities, educational themes and
other aspects of the workshop. Women will also be asked to describe 3 high -
risk behaviors that increase their chances of HIV transmission. These
techniques will serve as a form of process evaluation and assist in the
completion of outcome evaluation.
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The number of workshops, participants, peer education activities, and printed
materals and condoms will be tracked and submitted to the CDPHE
Epidimiology Dept. on a quarterly basis. A narrative detailing general activities
and accomplishments toward the outlined objectives will be included in the
quarterly HIV prevention progress report to the Contract Supervisor.
A Professor in the Community Health Department of UNC has offered his
assistance in conducting an outcome evaluation through statistical analysis of
collected data.
VIII. BUDGET
HIV Educator
(8 hrs. x $14.23 x 52 wks.)
Fringe
(10% of total personnel requested)
Indirect
(13.2% of total personnel requested)
Peer Educator Incentives
Travel
(10 Denver trips)
Conference Registration Fees
TOTAL FUNDING REQUESTED
$5919.68
$591.96
$859.53
$440.00
$348.83
$170.00
$8330.00
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ist*gt;
11111De
COLORADO
Memorandum
TO: George E. Baxter
Chair, Weld County Commis #AV\
I0n T:4_
DATE: November 24, 199
FROM: John Pickle, M.S.E.H.
Director, Weld County Health Department
SUBJECT: HIV At -Risk Grant Proposal
Enclosed for board review and approval is a proposal for a contract between the Weld
County Health Department and the Colorado Department of Public Health and
Environment to implement an HIV prevention project targeting women in Weld County.
This project will focus on group risk -reduction education. The Weld County Health
Department will provide on -going workshops for women. The workshops will provide
educational interventions that promote and reinforce safer behaviors, and training on
interpersonal and negotiation skills The Weld County Health Department will be
collaborating with Sunrise Community Health Center and A Women's Place to provide
these risk -reduction workshops.
The grant request is for a one year period beginning January 1998 and ending in
December 1998. We are asking for $8330.00 to implement and maintain this project.
I would recommend your approval of this proposal.
If you have any questions, please feel free to contact me.
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