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Assessing Training Needs Related to the Care of Sexually Transmitted Diseases (STDs) Perspectives of Medical Providers Working Among American Indian and.

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Presentation on theme: "Assessing Training Needs Related to the Care of Sexually Transmitted Diseases (STDs) Perspectives of Medical Providers Working Among American Indian and."— Presentation transcript:

1 Assessing Training Needs Related to the Care of Sexually Transmitted Diseases (STDs) Perspectives of Medical Providers Working Among American Indian and Alaska Native Populations (AI/ANs) Cheryl Mason, MPH, Laura Shelby, BA, Rachel Pacheco, RN Indian Health Service, National Epidemiology Program, Albuquerque, NM ■ Sharon Adler, MD, MPH, Jolie Pearl, RN, MPH California STD/HIV Prevention Training Center, Berkeley, CA ■ Teri Anderson, MT Denver STD/HIV Prevention Training Center, Denver Public Health, Denver, CO ■ Candace Nelson, MA Kaiser Permanente, Denver, CO

2 Background From 1996 to 2002, Chlamydia rates among AI/AN were consistently 3 times that for non-AI/ANs From 1989 to 2002, rates for gonorrhea, primary & secondary syphilis declined among AI/ANs but at markedly lower rates than that for non-AI/ANs

3 Background (cont.) Assess STD training needs among medical care providers working with AI/ANs Content areas evaluated: Skills needed or challenges in STD care Training logistics Learning modalities

4 Methods Sampling Convenience sample 14 healthcare facilities 63 in-person structured interviews Data analysis Transcripts analyzed using ATLAS*ti Data coded by major content areas and common themes Common themes reported

5 Common needs or challenges in STD Care Prevention Diagnosis Treatment Partner management

6 Common needs or challenges in prevention Patient education is a challenge Need effective patient education tools good pamphlets or educational material pass onto patients addresses risks

7 Common needs or challenges in diagnosis Training on “less prevalent” or “rare(r) diseases” syphilis chancroid Training on diagnosis updates Training on HIV/AIDS

8 Common needs or challenges in treatment Training on HIV/AIDS Difficulty in locating patients is a challenge getting people in for follow-up/testing finding them after a positive test Training on treatment updates

9 Common needs or challenges in partner management Getting partners into clinics is a challenge Prescribing medications for partners is a challenge tempting to just give a prescription for the partner...but dangerous legally and medically how do you cover and protect your patient and that partner? Locating partners is a challenge

10 Training logistics Previous training & duration of training Factors influencing training attendance

11 Previous training & duration of training Previous training General medical training, 71% (n=45) STD-specific training, 18% (11) Duration of training Previous trainings attended lasted 1-5 days Ideally, general medical training should last 2-3 days Ideally, STD-specific training should last days

12 Factors influencing training attendance Funding and time allocated Funding varies by facility and provider type Average physicians’ annual training funds, $1500 Average non-physicians’ annual training funds, $500 Allotted 1 week of ‘educational’ leave Onsite v. offsite 65.1% (n=46) preferred ‘onsite’ training Definition of ‘onsite’ varies by location of facility CME/CEU credits and advance notice are essential

13 Learning modalities Best available learning modalities Desired learning modalities Computer-based learning

14 Best available & desired modalities Best available modalities by rank 1Lecture/update/conference 2Reading 3Slides/visual aids 4Hands-on training 5Facilitated discussion 6Handouts/notes/workbook 7Internet/computer CME 8Small group learning 9Peer team learning 10Roleplaying Desired modalities by rank 1Lecture/update/conference 2Hands-on training Slides/visual aids 3Facilitated discussion 4Handouts/workbook 5Peer team learning 6Case studies 7Internet/computer CME 8Reading; videos 9Roleplaying

15 Computer comfort level Most providers & administrators are comfortable using computers What they like about computers: Quick, easy access to information Onsite, does not require travel Offers variety of resource material What they don’t like about computers: Too complicated Crash/too slow Work solo/don’t benefit from group discussion No time

16 Computer/Internet access at work Availability of computers/Internet 88.9% (n=56) have access to computers 38.1% (n=24) have access to the Internet Actual utilization of computers 23.8% (n=15) actually utilize 15.9% (n=10) actually utilize, but too busy to do when want 57.1% (n=36) don’t utilize, too busy 7.9% (n=5) don’t utilize, lack computer skills

17 Summary What training is needed? Updates on diagnosis & treatment (changes/latest techniques) Emphasis on “rare(r)” diseases (i.e. syphilis and chancroid) & HIV/AIDS Training logistics General medical trainings widely attended Trainings that are onsite, offer CME/CEU, and advance notice are preferred Training modalities Lecture/updates/conference is a common way to learn Although computers are available at work, utilization is difficult

18 Next Steps Provide training that addresses needs assessment findings Updates Rare(r) diseases (i.e. syphilis and chancroid) & HIV/AIDS When developing training, one should consider: Incorporating training into existing, widely attended medical conferences Combine lecture/updates/conference & hands-on training with other desired ways of learning Computer-based learning has potential, but implementation and acceptance may prove challenging Further exploration Provider survey Determine consistency & strength of these findings in other settings

19 Acknowledgements Project participants IHS: James Cheek PTCs: Kitty Corbett, Mabel Davis, Tom Davis, John Fitch, Alice Gandelman, Maxine Haytin, Terry Lee, Anne Meegan, Kees Reitmeijer, Dodie Rother, Terry Stewart, Debbie Tripp, Stacy Vogan


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