1 From Evidence to Action Replicating and Adapting Evidence-Driven Interventions at the Local Level Shannon Thomas Ryan David Lewis-Peart

2 Black CAP Our Mission  To reduce the spread of HIV infection in the Black communities.  To enhance the quality of life of Black people living with or affected by HIV/AIDS. Founded in 1989, the Black Coalition for AIDS Prevention (Black CAP) has worked to meet its mission in our Black communities. Our work is also guided by our motto, ‘Because All Black People’s Lives Are Important’, and it stands as a reminder of the importance of our commitment to our community.

3 Black CAP Programs  Support  Community Outreach  Peer Education  Gay Men’s Outreach  Women’s Prevention  MSM Prevention  Roots of Risk  Volunteer Program  Mate Masie – Kwanzaa Yoga Youth Program  PHA Settlement  LGBT Settlement  LGBT Peer Education  Anti-homophobia  Prevention for PHAs  PHA Youth

4 Why Are We Looking To Evidence Before We Implement New Programming?  Guided by one of the directions identified in our Strategic Plan  Direction Develop systems and structures for program and service development, monitoring and evaluation. 2.1a - Implement new programs and services to meet emerging needs based on a program expansion plan and evidence-based program models

5 Why Are We Looking To Evidence Before We Implement New Programming?  Black CAP has gone through significant organizational change over the past three years  Black CAP was an agency that typically considered internal knowledge and evidence before developing new programming  Programs were often developed on the fly (i.e. “It sounds like a good idea so let’s do it!”) and often without the benefit of external consultation or research  Black CAP had very limited capacity for research and effective program development  Organizational expectation that we include evidence in every aspect of program design and delivery  Many benefits to this approach – especially in relation to program impact and access to new funding

6 Gathering Evidence  In 2006, we initiated two parallel processes to build on our understanding of women and BMSM at risk for HIV  Two reports were produced in mid that helped clarify the scope of the issue Led by stakeholder panels and Black CAP staff A total of 50 semi-structured stakeholder interviews Incorporation of epidemiology and other data Review of best practice  Development of recommendations to guide program expansion and implementation  Prepared us to look to external models prior to developing new interventions  Stronger sense of local reality

7 How Are We Implementing New Programming?  Developing internal knowledge and capacity for research over time  Looking to other organizations to provide capacity building and technical assistance support – for instance with GMHC, ACCHO, TPH, etc.  Taking the time to develop models and adequate time for planning  Recognizing that externally developed interventions are a starting point  A continued focus on research and evaluation after implementation

8 Interventions  Popular Opinion Leader (POL) – Implemented in our Roots of Risk Program  Comprehensive Risk Counselling Services (CRCS) – Implemented in our Support Program  Many Men, Many Voices (3MV) – Implemented in prevention programming for gay, bisexual and straight-identified men who have sex with men  EXPLORE – To be implemented prevention programming for gay, bisexual and straight- identified men who have sex with men

9 Popular Opinion Leader – Social Diffusion  The POL model is based on the theory of Social Diffusion and uses opinion leaders within targeted social groups to disseminate risk reduction information around sexual health.  This model was initiated at the Center for Disease Control and was developed specifically for at-risk MSM, but has since been implemented with various high risk target groups.  A POL modeled program uses identified target community leaders trained to deliver accurate sexual health information to their peers conversationally in informal settings.  Central in the development and delivery of our Roots of Risk program – POL model mixed with health marketing approaches  Implemented in 2008 and continuing into 2010

10 Comprehensive Risk Counselling Services (CRCS) – Risk Reduction Counselling  The primary goal of CRCS is to help HIV-positive and HIV- negative persons who are at high risk for HIV transmission or acquisition and struggle with issues such as substance use and abuse, physical and mental health, and social and cultural factors that affect HIV risk.  To reduce risk behaviours and address the psychosocial and medical needs that contribute to risk behaviour or poor health outcomes.  Included in our support programming through individual and group supports  CRCS/PCM agency guidelines developed  Implemented in 2009

11 Many Men, Many Voices (3MV) - Behavioural Self- Management and Assertion Skills  Many Men, Many Voices (3MV) is a 7-session group-level intervention program to prevent HIV and sexually transmitted infections among Black gay bisexual, questioning and straight-identified men who have sex with men.  The intervention addresses factors that influence the behavior of Black MSM: Cultural, social, and religious norms Interactions between HIV and other sexually transmitted infections Sexual relationship dynamics The social influences that racism and homophobia have on HIV risk behaviours  Implemented in our BMSM Prevention Program in 2009  Modified to include other components

12 EXPLORE - Information-Motivation-Behaviour Skill Model /Social Learning Theory  EXPLORE is a ‘best evidence’ intervention that consists of 10 core counselling sessions delivered one-on-one to participants. The first 3 sessions are intended to establish rapport between the counsellor and the participant, and to provide personalized risk assessments. The remaining 7 sessions cover topics such as sexual communication, knowledge of personal and others’ HIV serostatus when making sexual decisions, and the role of alcohol and drug use in risk behaviour.  To be implemented in late 2009 in our BMSM Prevention Program

13 The Implementation and Delivery of 3MV  The 3MV model  Delivery  Program modifications  Initial outcomes  Unintended outcomes  The role of secondary evaluation

14 Challenges  Gaps in our capacity to understand and implement research driven interventions  Investing in staff capacity  Identifying staff with appropriate skill sets – research, program development and evaluation, facilitation, etc.  Committing the time for essential planning and not rushing into programming  Budgetary

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