Achievements & Lessons Learned-Q: SUNY Health Science Center

Knowledge Item: CA-Initiative Impact-99Q
Major Achievements and Lessons Learned: 1994-1999

State University of New York Health Science Center at Brooklyn

The State University of New York (SUNY) at Brooklyn project has increased counseling and voluntary testing of pregnant women and access to perinatal AZT protocols.

In 1999, the Evaluation and Dissemination Center asked each project to state its major achievements and the lessons it had learned from conducting the project. Those stated achievements and lessons learned are reproduced here (with minor editing) as reported to the Evaluation and Dissemination Center. The summary statements given here are those aspects of the program's experiences that the Project Director wished to emphasize.

Achievement 1: The MAPS program trained over 300 prenatal and pediatric providers in a specialized curriculum called “Quickie HIV Counseling and Testing for the Busy Clinician."
Key Elements for Success: The Principal Investigator (Dr. Howard Minkoff) used the results of a needs assessment to determine barriers the barriers to offering counseling and testing. Subsequently, the training agenda was developed to target those specific problem areas, particularly time restraints.	Factors that Limited Success: The trainings needed to be longer but couldn’t because of grand rounds scheduling limitations. Staff could have been more involved in follow-up and technical assistance.	Factors that Ensured Success: Sufficient resources were directed towards training activities, word-of-mouth referrals increased requests for trainings, many sites were re-trained over the five year project.

*Achievement 2:* The three network hospitals achieved virtually 100% counseling and testing rates of their prenatal patients.
Key Elements for Success: The AIDS Institute as a regulatory institution made site visits to the hospitals to assess compliance with Department of Health regulations.	Factors that Limited Success: Difficulties were encountered due to lack of project control over clinic operations and administration was slow to prioritize counseling and testing.	Factors that Ensured Success: All the hospitals are designated HIV centers, the individual HIV counselors were invested in their work, sufficient funding for designated counseling staff, the project was persistent in re-working the system to reach more clients.

*Achievement 3:* The establishment of four HIV/GYN co-located clinic sessions for women.
Key Elements for Success: The clinics were integrated into existing services, the space and clinicians were already available.	Factors that Limited Success: There has been limited outreach and marketing to attract new patients.	Factors that Ensured Success: Clinicians have enough time to spend with their patients, low staff turnover, low patient attrition rates.

*Achievement 4:* National presentations and published articles, specifically “Establishing a Successful HIV Counseling and Testing Service” in Obstetrics and Gynecology Clinics of North America.
Key Elements for Success: The vision of the Principal Investigator and Project Director (Jill Rips) in creating a unique model of perinatal transmission reduction and documenting all project activities.	Factors that Limited Success: No limitations.	Factors that Ensured Success: The Principal Investigator’s international reputation in women and HIV, travel money and graphic support to develop and present project findings.

*Achievement 5:* The outreach unit of MAPS has provided health education and AIDS prevention to over 2,000 high risk individuals in central Brooklyn.
Key Elements for Success: Recruiting consumers (people living with HIV) and culturally appropriate staff who are familiar with the population and community.	Factors that Limited Success: Difficulty evaluating effectiveness with anonymous outreach, supervision is time-consuming.	Factors that Ensured Success: Outreach workers’ communication skills and success in developing trusting relationships with community based organizations.

1. Lesson Learned: The request for trainings and number of attendees probably would have been higher if MAPS had offered CEUs and CME credits. Also, our collaboration with the AIDS Institute to deliver trainings to their funded sites occurred late in the project (1998) and could have been established sooner.

How related to achievements: Not specified.

2. Lesson Learned: The outreach component might have been more effective if a larger number of peer educators were hired to work fewer hours, as opposed to having only two outreach workers. A standardized training program with a manual also would have been helpful for the peers and supervisors.

How related to achievements: Not specified.

3. Lesson Learned: Implementing infrastructure change was difficult because the project required collaboration from the three sites whose staff was not under our authority. Financial incentives for the three clinic sites and a stronger investment in the goals and objectives of the project by hospital administration could have made the process easier.

How related to achievements: Not specified.

4. Lesson Learned: An outside evaluator should have been involved for the duration of the project, particularly in setting up databases to collect information required from multiple funding sources. An evaluator could have suggested improvements or additional methods of project-specific data collection, provided continual feedback on our services, and written and published more peer review journal articles.

How related to achievements: Not specified.

5. Lesson Learned: When a project is subsumed under a larger entity, natural tensions emerge. Staff may be distracted from project-specific activities when responding to other demands within the parent organization. On the other hand, resources are plentiful, particularly in terms of academic/clinical expertise. Also, activities can be continued after the project is de-funded because there is an infrastructure for applying for new monies and project staff can be shifted to other grants.

How related to achievements: Not specified.

Completed by: Cathy Rohweder, M.P.H.
Last Updated: July 1999

Project Resource Page

SUNY Health Science Center at Brooklyn

Evaluation Data

Service Population Demographics

Training Characteristics

Trainee Characteristics

Last Updated: August 02, 2001; data through June 15, 1999; analyses conducted January 2000.

Knowledge Base Citation: The Knowledge Base and this Knowledge Item were designed and authored by G. J. Huba, Ph.D.; in collaboration with Lisa A. Melchior, Ph.D.; A. T. Panter, Ph.D.; and the staff of The Measurement Group. Cite this work as "Huba, G. J., Melchior, L. A., and Panter, A. T. (1998 - 2001). The Measurement Group Knowledge Base on HIV/AIDS Care. On the World Wide Web: http://www.TheMeasurementGroup.com."

Questions or Comments: Contact The Measurement Group.

Use of Knowledge Base Information: Acceptable Uses and Limitations.

Collaborators from Participating Projects: Cooperative Agreement Steering Committee 1999.

Participating Projects: This Knowledge Base is based on the service delivery experiences of 27 Cooperative Agreement Projects on Innovative Models of HIV/AIDS Care. These projects and the Evaluation and Dissemination Center which produced this Knowledge Base were funded by the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau (HAB) as Special Projects of National Significance (SPNS) between 1994 and 1999.

Why This Evaluation was Conducted: Editorial.

More Information: Design of this Knowledge Base.

Recommended Citation Format for Web Materials: American Psychological Association Publication Manual Section, Revised 2001.

Work on the Knowledge Base and the cross-cutting evaluation was supported in part by Grant Number 5 U90 HA 00030-05 from the Health Resources and Services Administration (HRSA), HIV/AIDS Bureau's (HAB) Special Projects of National Significance (SPNS). The contents of this Knowledge Base are solely the responsibility of The Measurement Group and do not necessarily represent the official views of HRSA or HRSA/HAB's Special Projects of National Significance nor may they represent the positions of the individual grantees whose projects are included in the cross-cutting evaluation.