Stacy Vogan, MPH, CHES; Amy Smith, MPH; Heather Lusk; Alice Gandelman, MPH; Gail Bolan, MD

1. The Role of Adjunct Trainers in STD/HIV Prevention Integration: Utilizing a Training of Trainers Program to Build Local Capacity Presented by CA STD/HIV Prevention Training Center Stacy Vogan, MPH, CHES; Amy Smith, MPH; Heather Lusk; Alice Gandelman, MPH; Gail Bolan, MD

2. Background • As HIV and STD rates continue to increase, so does the demand from Health Departments, CBOs and CPGs for skills-based, capacity building in the role of STDs in HIV prevention. • To meet this demand, the CA STD/HIV Prevention Training Center implemented a comprehensive STD TOT program October 2003.

3. Program Goals • To Develop Local Capacity in Partnering Regions IX and X in the role of STDs in HIV prevention • Alaska, Washington, Idaho, Oregon, California, Nevada, Arizona, Hawaii • Increase collaboration between STD and HIV programs.

4. Program Methods • Recruit prospective adjunct trainers to participate in the TOT Program; • Provide training to adjunct trainers in CA STD/HIV PTC courses; • Provide mentorship and support to adjunct trainers.

5. Recruitment • Criteria • practical field experience in community or public health setting • some training experience • presentation skills - interpreting and delivering information • facilitation skills • can represent or see different perspectives • embraces participatory training approach • organized • flexible • committed

6. Follow up & Feedback Conduct training on own Co-facilitate with PTC trainer Attend Specific Course Training Attend Trainer Skills course Attend specific course as participant A Six Step Process

7. Skills Training • Attend specific course as a participant • Attend Trainer Skills Course (Part A) • two way evaluation and decision to continue with TOT program or not • Attend Specific Course Training (Part B) • Set up training and co-facilitate with PTC trainer on site • Conduct training on own • Follow-up training to share experience and feedback with other adjunct trainers

8. Mentorship and Support • Throughout TOT structure, on-going mentorship, support and feedback from PTC trainers will occur • co-training • observation • written/verbal feedback

9. Evaluation and Quality Assurance • Recruitment Process • Trainer skills evaluation • evaluation of potential adjunct trainer skills (group process, facilitation, stay on task, work effectively with co-trainer, etc.) • decision as to whether or not to continue program • Evaluation of understanding of course content • Evaluation, feedback and support from ‘Mentor Trainer” • Follow-up evaluation and feedback for skills development and course improvement

10. Results • Adjunct trainers conducted 28 courses and trained 467 participants. This is almost 21% of the CA PTC Behavioral Intervention trainings and over half (51%) of the “STD Overview for Non-clinician” courses during the same time period. • Seventy-three percent (73%) of Adjunct Trainers integrated this course into their work. • Post course evaluations showed acquisition of skills and knowledge by participants attending an adjunct trainer facilitated courses to be consistent with those of CA PTC training course evaluations.

11. Key Components andThings to Consider • One point person for contact in administering agency. • Mentorship program was key • Materials support

12. Conclusions • Conducting a TOT Program can be a strong capacity building component for local agencies and assist them in meeting local training needs.