[ top ]Strategies:
The Alaska TPED Project conducted trainings in different areas of Alaska on aspects of HIV/AIDS care and service, tailoring each training to its unique regional audience. Additionally, in collaboration with the Alaska Native Health Board, TPED developed and produced key educational tools, including three videos focusing on health/HIV-related issues, produced with and for Alaska Natives/American Indians in Alaska, and an educational tabletop flipchart for providers to use when discussing HIV with rural AN/AI clients.
The Project Advisory Committee, comprised of key Alaska organizations, identified distance learning activities as key to overcoming geographic barriers in Alaska. Many Alaskan villages and hubs are accessible only by air, making travel to trainings both time and cost intensive. The Project affirmed a need for educational resources and tools that could be used with very little training to address the high turnover rate throughout rural Alaska and the need for more providers to deliver health care provider services related to HIV/AIDS and to teach about HIV/AIDS. As part of its broader distance learning strategy, the TPED Project created the videos and educational flipchart mentioned above and also held two-and-one-half day intensive HIV/AIDS workshops at hub sites in all four quadrants of Alaska, allowing for attendance by providers from rural Alaskan villages. These methods proved successful per evaluation feedback on their usefulness.
Model:
The Alaska TPED Project utilized a collaborative, community-based, culturally respectful model that melded the perspective of Western HIV/AIDS health care treatment into culturally relevant and appropriate trainings. The Project was a true collaboration with the Alaska Native Health Board (ANHB) and other AN/AI cultural gatekeepers (i.e., AN/AI healers/spiritual leaders and HIV-infected AN/AI persons), Alaska providers, and representatives from HIV/AIDS organizations in Alaska. A key principle of the model was the integration of AN/AI people and culture in all aspects of the Project, including conducting needs assessments; planning, promoting, and implementing the training program; planning and developing the videos and flipchart; and evaluating the Project.
The Project relied heavily on the ANHB, during the first two years, and ASE and representatives from Regional Native Health Corporations, in the last year, to ensure that cultural protocols were honored when approaching smaller hub communities as potential intensive training sites. AN/AI collaborators (not outsiders) visited the communities to determine their special HIV/AIDS training and education needs, assess their readiness for HIV/AIDS training, and gain the support of the elders and the community before training occurred. Cultural customs such as the involvement of elders, prayers, and music were integrated into the trainings, as was content pertaining to the AN/AI culture (e.g., AN/AI food and its preparation; alternative treatments). The Medical Director for the NW AETC presented the content on HIV diagnosis and treatment because no highly experienced AN/AI clinicians with excellent training skills were identified. Experienced AN/AI speakers from the Alaska regions were used whenver possible to speak about mental health/substance abuse and HIV, cultural foods and HIV treatment, and local HIV resources.
The model acknowledged the importance of community support in allowing trainings to occur and in allowing HSSP in smaller communities to talk to the community about HIV infection and transmission. Many AN/AI communities are not aware that HIV infection is in their communities and do not believe they are at high risk for the disease. Much shame and fear of the disease reside in the AN/AI communities: shame of the community when someone in the community is infected; shame on the part of the family and the individual infected; and fear that the infection will decimate the population in much the same way that diseases have decimated AN/AI communities in the past. The model therefore included a culturally sensitive educational video for the community to dispel the myths about HIV transmission, to correct the misinformation, and to foster support for the HIV-infected individual.
Trust is extremely important to AN/AI populations, given the promises that have been made to Native Americans by the United States government and other institutions throughout history and then subsequently broken. AN/AI trust is typically built through person to person contact and getting to know individuals in the community. Trust for the Project was built via the site visits by the Alaska Native Health Board (ANHB), ASE Consultants, and Native Health Corporation representatives to establish training needs and community readiness. Because it is considered disrespectful for outsiders to fly into a smaller community, conduct a training, and then leave, TPED staff spent extra days in the intensive training locations to interact and socialize with community members. Personal contacts and genuine interest in the AN/AI culture helped gain the trust of the community and elders.
Lastly, the model incorporated the principles of adult learning theory (e.g., adults learn by doing) and the oral tradition (i.e., story telling) of Native Americans. The learning modalities varied to include didactic presentations, interactive skill building, and story telling in educational videos and in-person sharing by HIV-infected Native people, elders, and others at trainings.
TPED Trainings by Date and Location
Training Description Interactive workshop (2.5 days) Skills building workshop (3 hours) Skills building workshop (3 hours) Skills building workshop (3 hours) Skills building workshop (3 hours) Interactive workshop (2.5 days) Interactive workshop (2.5 days) Skills building workshops (2 at 1.5 hours) Dinner; 1.75 hour video/discussion Interactive workshop (1 day) Skills building workshop (3 hours) Interactive workshop (1 day) Interactive workshop (2.5 days) Dinner; 1.75 hour video/discussion Interactive workshop (1 day) Interactive workshop (2.5 days) Interactive workshop (2.5 days) Skills building workshops (2 at 1.5 hours) Interactive workshop (3 days) Skills building workshop (1.5 hours) Interactive workshop (2.5 days)
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