Rural Community Outreach Program
Description of Program
What is the intervention/program/project?
The program consists of providing ongoing HIV/HCV education to rural and remote Yukon First Nations communities through a community workshop series. For five years, Blood Ties Four Directions Centre has maintained a consistent presence in communities around HIV and Hep C prevention education.
Because funding is project-based, it consists of different interventions. In the past, trainings and interventions have focused on specific populations. Some educational posters were produced in several Yukon traditional languages.
What is the goal/objective of the intervention/program/project?
- To prevent the acquisition of new HIV and HCV infections among vulnerable populations in rural Yukon First Nation communities;
- To decrease the stigma associated with HIV in rural Yukon First Nation communities;
- To raise the capacity of key players in rural communities in providing help and care, including community health representatives, and elders.
Why was the intervention/program/project originally developed?
Before obtaining funding, the organization was limited in its ability to provide education in rural communities. Visits were limited to communities who had sufficient resources to bring the organization on-site. These infrequent visits – and other research – indicated a substantial need for prevention knowledge in rural communities. Many reported high levels of stigma and a lack of understanding of HIV and Hep C.
Blood Ties took initiative to scale up efforts and establish better connections with more vulnerable people in rural and remote communities. The program also aimed to build the capacity of health and social service providers in communities in terms of their ability to provide care and support for people who were HIV and/or HCV positive.
How was the intervention/program/project developed?
The program developed organically. Initially, the idea was to develop a program that would entail travel to communities, offering a workshop, meeting with community members to establish better connections, and then leave. As the program was implemented over the years, evaluations indicated that the model did not work well. It was suggested that conducting topical workshops addressing specific knowledge areas, gaps and capacities, on a frequent basis would produce stronger results. The program has developed to consist of shorter stays in communities but more frequent (ie. several times/year) visits. Different workshops are constantly offered, targeting specific deficit areas or populations (e.g. youth, women, elders) and information gaps (e.g. HIV and the Law, prevention resources, addiction and HCV). Communities are now regularly visited by outreach workers and engaged in conversations around HIV/HCV prevention.
OrganizationBlood Ties Four Directions Centre
- Resource development
- Indigenous peoples
Yukon-wide. The goal is to operate in all rural Yukon First Nations communities (12 communities). The program travels to different communities.
Project ResourcesMost resources are produced by CATIE and CAAN. Resources that the program developed, including posters, resource binders for community health representatives on HIV and Hep C, and evaluation reports, can be shared upon request but are Yukon-specific.
Resources for Program
- Culturally relevant and meaningful educational resources. Some resources were developedby the agency, and some by CAAN and CATIE.
- A poster translated into Yukon Fist Nations languages.
- A translation of HIV criminalization law into a plain language document for communities.
- A substantial travel budget to accommodate the long distances that community Outreach Workers must cover.
- The rural communityitself must have a willingness to work with program staff.
- A liaison person – such as a health representative, health and social development staff, or some form of champion in the community – within the community.
- A dedicated staff person to fulfill the objectives and goals of the program, with guidance and supervision from the Executive Director.
- A steering committee made up of health directors from rural communities to oversee the project.
DurationProject-based (year-to-year) funding.
The program is evaluated each time funding is renewed. Evaluation is built into delivery and is ongoing throughout the year.
Audience/client feedback and satisfaction
- The Community Outreach Worker observes and documents engagement of workshop participants. Participatory and paper surveys for workshops are conducted. Participants who complete the evaluation are entered in a draw for a gift certificate.
Outcome evaluation (e.g., pre/post evaluations using surveys or interviews, community-level impact)
- Evaluations identify whether workshop objectives were achieved(effectiveness) and whether the program reached the target population (relevance).
Process monitoring or evaluation
- Number of people enrolled in workshops, staff time.
Evaluation TermsAudience/client feedback and satisfaction, Outcome evaluation, Process monitoring or evaluation
- A strong human resource base in the community – such as a health representative, health and social development staff, or a “champion” – is integral to the program. It is essential to have someone who will hang up posters before program staff arrives, open the community hall, advise staff where to host a workshop, and work with the program. These human resources can be built over time. If this piece is not in place at the beginning, it must be a project goal in order to achieve long-term success.
- One might assume that all rural First Nations communities would have same similarities in terms of their capacity and needs, but each can be in very different places with regards to their willingness to talk about HIV, HCV and stigma; whether they recognize it as an issue, if they make HIV a priority, etc. Once a program is in place, a degree of flexibility must be maintained in terms of which communities the program staff will travel to, who will come to the table, and what can be accomplished. A program needs broad strokes and ideas, but must be flexible about what can be accomplished.
- Because the initiative is project-funded, staff never expected the program to last more than one year. If the organization had known that the program would run for at least six years, it may have adopted some different approaches. The year-to-year funding produces a degree of frustration because program renewal is not guaranteed and changes must be integrated into every new proposal.
- There is a high level of turnover in rural communities in terms of staff. The program often establishes a good relationship with a health representative in one community, who contributes to successes in a given community but then leaves. The incoming health representative may or may not be as engaged or a champion, or their capacity around HIV prevention work may be lower. This means that key stakeholders in the communities are on a constant learning curve.
- Capacity building is a great concept but difficult to operationalize when discussing rural and remote communities because it is based on the premise that people stay put. In remote rural communities in Yukon, people often leave including key stakeholders such as health directors and community health workers. It is important to be aware of what capacity building can and does look like in rural remote settings.
- Trying to persuade communities to engage in HIV and HCV prevention when they have so many other health related challenges to deal with can be difficult. Communities often face multiple health and social issues, and HIV must compete for attention.
- Strategic partnerships enhance the program. Blood Ties works very closely with the Council of Yukon First Nations, and the partnership has been a program strength.
- Although program success is limited if planning can only be year to year, success grows when a community sees that it can rely on a program. Whatever organization delivers HIV prevention programming must be seen as a reliable, accurate source that knows how to work with Aboriginal communities.