Healthy Love Training of Facilitators National Center for HIV/AIDS, Viral Hepatitis, STD & TB Prevention Division of HIV/AIDS Prevention

Healthy Love Training of Facilitators Welcome Introductions – Name – Agency – Current role – Favorite sexy outfit and one word besides sexy that describes how that outfit makes you feel Training Expectations 2

Healthy Love Training of Facilitators (TOF) Goal To prepare facilitators to implement successfully Healthy Love with the target population in their community. 3

Healthy Love TOF Learning Objectives Use the Healthy Love Implementation Manual to plan, implement, and facilitate Healthy Love with fidelity Describe two behavioral theories that serve as the theoretical foundation for Healthy Love Identify the core elements and key characteristics of Healthy Love Describe the basic small-group facilitation skills needed to deliver successfully the Healthy Love intervention 4

Healthy Love TOF Learning Objectives (cont.) Describe the activities included in the 3-4 hour Healthy Love intervention and the purpose of each activity Use facilitation knowledge and skills to implement the intervention Demonstrate the condom-use skills taught in the intervention Demonstrate the delivery of one activity of the Healthy Love intervention Describe how to maintain fidelity of Healthy Love 5

Introduction to Healthy Love

What is Healthy Love? Single-Session (3-4 hours) Group-Level (5-14 participants) STD/HIV prevention intervention Help participants identify risk behaviors for acquiring STDs/HIV Gain skills to adopt protective behavior 7

Who is Healthy Love for? African American women 18 years or older Not pregnant and do not plan to become pregnant in the next 6 months 8

Goals of Healthy Love Decrease the HIV/STD risk behaviors – unprotected anal, vaginal, and/or oral sex Reduce a person’s number of sexual partners Increase sexual abstinence 9

Goals of Healthy Love (cont.) Increase the consistent use of condoms (for vaginal, anal and oral sex) and other safer sex tools (i.e., dental dams/cut latex condoms for oral sex, finger cots) Increase the number of women who get tested for HIV and obtain their test results Promote positive attitudes about sex and sexuality 10

Healthy Love Objectives Increase participants: Knowledge of HIV/AIDS and STDs, modes of transmission/risk behaviors, and prevention (including HIV testing) Knowledge of the prevalence of HIV/AIDS among the African American community, especially among women Ability to assess personal risk of contracting HIV and STDs 11

Healthy Love Objectives Increase participants: Level of self-efficacy to engage in protective behaviors, including condom use Use of male and female condoms Positive attitudes about sex/sexuality, condom-use and HIV testing 12

Original Research Healthy Love was developed in 1989 by SisterLove Inc., a community-based organization in Atlanta, GA. Between March 2006 and June 2007, with the support of the CDC’s Innovative Interventions Project, SisterLove evaluated the efficacy of Healthy Love. 13

Research Results Participants in the study group were found to have greater improvements in: – Condom-use self-efficacy – Attitudes toward condom use – HIV knowledge 14

Theoretical Foundation of Healthy Love Health Belief Model (HBM) and Social Cognitive Theory (SCT) provide the basis for – The link between the behavioral determinants and intervention activities – Rationale for Healthy Love activities – Rationale for intervention success and desired outcomes 15

Theoretical Foundation of Healthy Love (cont.) The behavioral determinants of the Health Belief Model are – Perceived susceptibility – Perceived severity – Perceived benefits – Perceived barriers 16

Theoretical Foundation of Healthy Love (cont.) The Social Cognitive Theory constructs or factors that collectively attribute to achieving behavior change include the following: – Knowledge – Expected outcomes – Skills – Self-Efficacy – Observational learning 17

Core Elements Required elements that represent the theory and internal logic of the intervention and most likely produce the intervention’s main effects Types: – Content – WHAT is being taught by the intervention that is believed to change risk behaviors – Pedagogy – HOW the intervention content is taught – Implementation – Characteristics of an intervention that relate to some of the logistics that set up a conducive learning environment 18

Content Core Elements Provide basic HIV/AIDS and STD education Provide basic facts about condoms and other safer sex tools, correct usage, and condom negotiation Provide information on correct male and female condom application steps and condom negotiation techniques 19

Pedagogy Core Elements Normalize attitudes toward sex and sexuality through open communication to reduce sexual stigma Conduct a personal risk assessment to increase participants’self awareness of personal risk behaviors Provide demonstration and practice opportunities to build skills for correct condom use 20

Implementation Core Element Implement Healthy Love with a skilled group facilitator who: Is the same gender as the target population Possesses a cultural understanding of and can relate to the group receiving the intervention Has advanced training and experience in HIV/AIDS and STD prevention, sexual/reproductive health, and health education Can demonstrate use of safer sex materials/tools and facilitate role-plays and skills practice taught in Healthy Love 21

Implementation Core Element (cont.) Implement Healthy Love with a skilled group facilitator who: Is engaging, energetic, and fun Can create a safe, culturally appropriate, and nonjudgmental environment to facilitate open discussions about sex and sexuality 22

Implement Healthy Love with pre-existing groups of individuals. Implement HIV testing services in conjunction with Healthy Love. Key Characteristics of Healthy Love 23

Basic Small – Group Facilitation Skills

Creating a safe space is important because it provides an environment where everyone feels comfortable and safe. Attending involves presenting yourself in a physical manner that communicates interest and attention. 25

Basic Small – Group Facilitation Skills (cont.) Managing involves control of the content delivery, the participation process, the pace, and the environment. Observing involves watching the group and how the information is being received. 26

What Are Her Face and Body Saying? 27

What Are His Face and Body Saying? 28

What Are Their Faces and Bodies Saying? 29

What Are His Face and Body Saying? 30

Responding to Observations

Basic Small – Group Facilitation Skills (cont.) Listening involves confirming the information you heard and demonstrating that you understood the participants’ perspective. Active listening involves paraphrasing and asking additional questions to gather more information. Questioning is conducted to determine how much information the participants already know and what information they are retaining. 32

Asking Questions (cont.) What is your favorite flavor of ice cream and why? How do you know Joe? What was your high school experience like? What type of decorations are you going to have for the holidays? 33 Would you like some vanilla ice cream? Have you meet Joe before? Did you like high school? Are you going to decorate for the holidays? Closed:Open: Below are a series of closed and open questions:

Asking Questions

Teach-Backs

Teach-Back Information Teach-Back Assignments Teach-Back Instructions – Facilitate 20 to 25 minutes of a specific activity – Cover the main points of the activity in the allotted time – Prepare materials and practice your assigned activity – Ask a fellow participant to serve as your co-facilitator, if needed – Make sure all the materials you need to facilitate this activity are ready before you begin your facilitation 36

Teach-Back Information (cont.) Teach-Back Instructions – Deliver the entire activity as scripted – Bridge from the previous activity as a lead-in to your activity – Demonstrate the basic small – group facilitation skills from Day 1 – Engage the group! Have fun! 37

Teach-Back Information (cont.) Remember: Trainers will make notes during your presentation to help provide feedback; don’t be alarmed You’re not expected to be perfect; just do your best! If you’re uncertain of something while doing your teach- back, move on as best as you can. This will be discussed during the feedback session. If you don’t know the answer to something, say, “I don’t know;” but let the participants know that you’ll find out for them. 38

Overall Teach-Back Debriefing How did the teach-backs go? What did you learn from the teach-back experience? – What would you do the same? – What would you do differently? Were there any activities that were particularly challenging? Remember to refer to the Facilitator Tips and write your own notes to help as you prepare to implement Healthy Love. 39

Wrap-up of Healthy Love Training of Facilitators Training Summary Training Evaluation Thank you! 40