Achievements & Lessons Learned-T: University of Texas Health Science Center

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

University of Texas Health Science Center at San Antonio

The University of Texas has helped positively impact changes in the service delivery systems for families living with, or affected by, HIV/AIDS.

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 development of a modified core data set in 3 agencies across 47 counties in south Texas of which partners have agreed to continue the collection of a modified data set beyond the funding cycle.
Key Elements for Success: a) Quarterly partnership meetings. b) Previous working relationships with the partners. c) The provision of training, technical assistance (TA), financial support of key personnel for family case management & data collection activities, & the eventual buy-in of key personnel & staff.	Factors that Limited Success: a) Poor integration of data requirements by various funding streams (same question asked a multitude of ways). b) Added burden of data collection on direct service providers (clinical, medical, and psychosocial). c) Frequent staff turnover.	Factors that Ensured Success: a) Partner subcontracts. b) Provision of analyzed data to partner agencies used to: obtain additional funding and as an agency needs assessment. c) Lead agency provision of ongoing training, easy access to TA and financial support of case management & data collection activities. d) Quarterly partnership meetings

*Achievement 2:* Affected policy change at state and agency levels.
Key Elements for Success: a) Provision of training and easy access to TA. b) Capacity building.	Factors that Limited Success: a) Affecting change at agency level more likely within traditional project period (3-5yrs); change at state level more time consuming. b) Policy changes occurred initially within the agencies, which prompted agencies to also address state policy.	Factors that Ensured Success: a) Continued availability of lead agency staff for TA and training to new employees of partner agencies. b) Partners’ lead administration awareness of need for training and policy updates. c) Quarterly partnership meetings. d) Cross training. e) Education of partners RE: broader public health issues.

*Achievement 3:* Enhancement of services to underserved populations and rural areas (women, children and families); thus, increased responsiveness of existing HIV care system to the needs of WCF.
Key Elements for Success: Established informal work partnerships among key agencies across 47 counties in South Texas; eventually formalized based upon need and service gap in the community.	Factors that Limited Success: Great distance between service agency and target pop. (Approximately 100 miles), lack of coordinated support services within the community, limited financial and professional resources, and lack of physician willingness to serve particular population.	Factors that Ensured Success: a) Committed Partners. b) Quarterly partnership meetings. c) Subcontracts led to capacity building within partner agencies.

*Achievement 4:* Project development of training curriculum specific to women, children and their families living with HIV/AIDS in south Texas.
Key Elements for Success: a) Designation of curriculum development in Project goals and objectives. b) Partnership created in developing the training curriculum for women, children and their families living with HIV/AIDS.	Factors that Limited Success: Limited funds for replication and dissemination at local, state, and national levels.	Factors that Ensured Success: a) Committed partners. b) Collaboration of partners in developing the curriculum (a team effort). c) One partner agency (CPS) integrated the curriculum into their Orientation and Basic Skills Training for new employees (caseworkers & social workers). d) Disseminated to adjoining states.

1. Lesson Learned: Must have “buy-in” from those in leadership positions (within partner agencies) in order to affect change. “Buy-in” in the behavioral sense, beyond signing a memorandum of understanding. Executive directors and others in leadership positions must actively attend meetings, not delegating down, so that top administration is aware of needs, activities and capabilities at the service delivery level.

How related to achievements: Agreement of partner agencies to continue to collect modified data set beyond project funding; therefore, will continue to have characteristics of HIV as it affects Women, Children, and Families across 47 counties in South Texas.

2. Lesson Learned: Must give site specific analysis of data to partner agencies in a timely manner.

How related to achievements: Lead agency provides site specific analyzed data to assure that data is used practical ways (IE, agency needs assessment) to improve the nature of agency work. Thus, resulting in enhanced provision of family centered care and easier access to care for Women, Children, and their Families. Data can also be used to secure additional funding.

3. Lesson Learned: When developing a collaborative across broad geographic regions, it is necessary to change venues so that each partner agency gains an understanding about similarities and differences across the areas.

How related to achievements: Despite high turnover, the Salud collaborative has been dedicated, committed to attending meetings, and follow through with work and data collection activities. In addition, the valuable exchange of ideas and group commitment has led to successful attainment of Salud Project goals.

4. Lesson Learned: In developing partnerships, partners should be aware that initially clarified roles may evolve over time, and are many times driven by external factors that affect the internal organization. The collaborative is consistently learning about the capacity of agency partnerships over time. Also, should have implemented an evaluation measure for partnership meetings.

How related to achievements: 1) Partner flexibility; 2) Partner willingness to accept multiple roles/tasks, 3) Alternate meeting sites and co-facilitate meetings to assist other partners to develop their capacity to moderate a meeting.

Completed by: Victor German, M.D., Sandi Duggan, M.A.
Last Updated: July 1999

Project Resource Page

University of Texas at San Antonio Health Science Center

Evaluation Data

Service Population Demographics

Training Characteristics

Trainee Characteristics

Technical Assistance

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.