Learning Group Approach to HIV Integration

CHT has designed and evaluated a highly-effective process in which we train, coach and support leadership teams from a limited number of agencies to increase HIV integration within their own agencies. Leadership teams consist of three-to-four agency staff who represent a range of staff roles such as management, clinical, education, and support staff. Teams meet with one another and with the CHT team a number of times over a year, for several days each time. In these meeting/training sessions, they learn assessment strategies, develop training skills, and practice problem-solving and strategic action planning. They then return to their agencies and with CHT support, assess their agencies' current situation specific to HIV Integration and Client-centered Care. They provide any needed staff training, identify problems, generate solutions, and enact Action Plans.

This process is based on several educational/management philosophies, including: Learning Organizations, Radical and Popular Education, Action Learning, Leaders' Circles and Self-Managed Teams.

Outcomes

CHT has worked in this format with over twenty agencies from three states. In-clinic observations were made before, during, and after the intervention. Pre-observations indicated that staff were conducting little to no HIV or STD risk assessment and prevention and very seldom using any client-centered skills. Post-observations and interviews with staff revealed that not only did client-centered behaviors-such as use of open-ended questions-increase, but HIV prevention messages were more often offered to appropriate clients. Also, staff reported that they were more satisfied with their jobs. Apart from improvement in staff behavior we also registered very valuable improvements in clinic flow. Contact time with clients increased while client wait time decreased.

Leadership teams have gone back to their clinics and made changes to their systems that resulted in measurable improvements to services. Some of the changes that these leadership teams made included:

• Increased number of HIV tests by 37%.
• Decreased "no-show" rates for all visit types, including HIV tests.
• Increased number of HIV/STD risk assessments.
• Increased all staff's knowledge of HIV basics, through pre/post-testing and training.
• Improved overall clinic environment and client satisfaction ratings.
• Improved communication skills and staff morale through interactive staff meetings.

Questions?

Contact Sandy Rice for more information - srice@jba-cht.com