1. JSI Research & Training Institute
Viral Hepatitis Education & Training Partner
VHET Workshop
National Hepatitis Coordinators’ Conference
Integration of Services for the Prevention of Viral Hepatitis

2. Who is JSI Research & Training Institute?
Established in 1978
Health care consulting and research firm
Provides consulting, research, training and educational services to health and human service organizations
Offices in Boston, MA (headquarters); Denver, CO; Arlington, VA; and Concord, NH; satellite offices throughout the world
Areas of focus:
Implementation of improvements in health care delivery
Health care financing and managed care
Information systems
Health policy
Public health
Environmental health.

3. Region VIII Viral Hepatitis Training Project
FOCUS:
Part B of the Cooperative Agreement to Test, Disseminate, and Evaluate Training Programs Concerning Prevention and Control of Viral Hepatitis
Target Audience:
Healthcare practitioners (MDs, NPs, PACs, RNs, health educators or counselors) in family planning, primary care, rural health, and migrant health clinics.
JSI serves as the grantee to develop a training program which will address the current gaps in the dissemination of Hepatitis prevention information as well as increase awareness of Viral Hepatitis among health professionals

4. Region VIII Viral Hepatitis Training Project
Over the course of the three year project, JSI conducted a needs assessment to determine the current status of knowledge, skills, and barriers to providing viral hepatitis services in family planning, Title X, rural health, & primary care clinics as well as community health centers throughout PHS Region VIII.
OVERVIEW
Pilot phase March 2001 to April 2001
Final phase May 2001 to July 2001
Mailed out 489 surveys, 251 responded (51%)
(add FP results)
FOCUS
Training topics
Level of services currently being provided
Barriers to providing services
Best training modalities
Sent reminder letters at one month intervals.
Offered an incentive to return needs assessment
data was analyzed in SPSS

5. Needs Assessment: What Next?
Aided the development of guiding principles for curriculum development
Guided in the identification of curriculum modules
Aided in the prioritization/targeting of the marketing/delivery training
RESULTS: WHO RESPONDED:
82% of the responders were direct health care providers
Top three were
33% Physicians
24% Nurse Practitioners
25% Physician Assistants
PREVIOUS ATTENDEES OF HEPATITIS TRAINING:
47% had ever attended
75% had attended recently
TYPES OF SERVICE PROVIDED:
Top three services provided for Hepatitis A,B,C were:
Educational Materials (68.9%, 73.3%, 67.3%)
Risk Reduction Counseling (64.1%, 73.7%, 70.1%)
Testing (86.1%, 88.4%, 86.5%)
POTENTIAL TRAINING TOPICS
Top three topics identified as very useful:
71% Treatment for hepatitis B & C
61.8% Interpretation of serology tests
47.4% Client-centered counseling
PREFERRED TRAINING METHODS:
Three most preferred modalities were:
80% Conferences
73% Lectures
68% Self-study Module

6. Curriculum
Based on the results of the needs assessment, JSI began development of a training program. JSI assembled a team of subject matter experts, instructional designer, and a review team. The end result is the training curriculum, VIRAL HEPATITIS: An Integrated Approach to the Prevention, Screening and Treatment of Hepatitis (HAV, HBV and HCV),which is comprised of five training modules:
PROCESS
Assembled a development team
Instructional designer (ID)
Subject Matter Experts (SME)
Assembled a review team
Hepatitis B & C Coordinators
HCET VHET Partner
CDC
AETC
GUIDING PRINCIPLES
Training materials should include:
Accurate and current information on hepatitis.
Clear risk reduction and client-centered behavior change message.
Appropriate cultural, sexual and age information.
Training materials should reflect:
Clear goals and objectives.
Incorporate objectives of Healthy People 2010.
Training strategies that are clearly outlined.
Variety of teaching methods.
DESIGN FORMAT
For Trainers
Trainer’s guide
PowerPoint presentation
Other supporting materials
For Participants:
Participants’ guide/workbook
Job aids

7. CURRICULUM Module 1: General Overview Module 2: Testing
This introductory module will give any provider who takes care of people who are infected with or at risk for viral hepatitis information about the following: important liver functions and the effects of liver disease on hepatic function; current epidemiology of HAV, HBV and HCV; risk factors; procedures for and goals of reporting hepatitis cases; and basic virology of HAV, HBV and HCV, including natural history, transmission modes, signs and symptoms, chronicity, and basic treatment and vaccine options.
Module 2: Testing
The Testing module provides in-depth information about testing for MDs, NPs, PAs who will be providing medical management of patients, plus lab personnel who desire an update.

8. CURRICULUM Module 3: Medical Management
The module has been created to provide primary care providers and their clinic staff (including physicians, physician assistants, and nurse practitioners) with up-to-date information about viral hepatitis and an overview of the inter-relationship between HIV and hepatitis.
Module 4: Counseling and Education
This module provides practitioners with essential tools for educating and counseling patients, an understanding of the challenge of behavior change, and practical approaches to interacting with patients to support their willingness and capacity to make those changes.

9. CURRICULUM
Module 5: Integrating Hepatitis Services into Existing Public Health Programs
The module provides information, skills and practice opportunities for administrators to determine a rationale for including prevention, screening and care management of viral hepatitis in the clinic program and to appropriately plan for these services by reviewing:
What services need to be provided (e.g., diagnostic tests, patient education/ counseling, referral, treatment); what forms, equipment, are needed;
What processes need to be established; what personnel will be involved
Infection control precautions to prevent transmission of viral hepatitis to clinic personnel

10. CURRICULUM
The next phase of the program is pilot testing the modules of the curriculum.
The first pilot training for Module 1: General Overview was scheduled December 19, 2002.
The target completion date for piloting is mid April 2003.
The pilot trainings are being conducted with a family planning clinic in Boulder, CO
Module 1 Pilot Test Results: Demographics:
16 Total Participants
1 Manager, 1 MD, 4 NPs, 2 RNs, 3 CNMs, 1 Counselor/Educator, 5 Cas
Evaluation Feedback: Feedback on:
quality of materials
ability of instructor
usefulness of content
course relevance to job
practice or Q/A sessions
fulfillment of learning objectives
meeting of training needs
course organization
overall impression

11. CURRICULUM Module 1 Pilot Test Results: 9 Evaluations Returned
22% “Excellent”
45% “Good” to “Excellent”
33% “Fair” to “Good”
0% “Poor”
In addition to a comprehensive pilot testing of the curriculum, a thorough evaluation plan has been developed to assess knowledge and skills mastery and retention and transfer to the job
Module 1 Pilot Test Results:
A few comments:
Organize info by virus type (HAV, HBV, HCV) in table format
Format needs to be more consistent
Content covered was appropriate for “general overview”
Need to add glossary of terms

12. CURRICULUM & PROJECT NEXT STEPS
Finalize modules from pilot testing
Go to final print by May 2003
Distribute to VHET Partners
PROJECT
Market and provide training throughout Region VIII
Evaluate, evaluate, evaluate
Pre and post test, on-site observation, comparison of subsequent needs assessment results for level of service provided, and barriers identified