1. Neighbor to Neighbor Lessons learned from a community- based HIV testing partnership: The HIV Minority Community Health Partnership Presented at American Public Health Association Annual Conference October 29, 2008 By Marjie Mogul, Ph.D., Shannon Criniti, MPH, Lucy Yates, Ed.D.

2. Neighbor to Neighbor The HIV Minority Community Health Partnership a grassroots community-based organization (CBO) providing direct services to low income pregnant and postpartum women, using community health workers in a home-visiting model; a faith-based neighborhood CBO based at a large, African-American church; and a comprehensive HIV medical provider affiliated with a major research university.

3. Neighbor to Neighbor Program Objectives 1. Implement the partnership to increase all three organizations’ capacity to coordinate HIV/AIDS outreach, education, and screening efforts 2. Increase the number of individuals who seek and accept prevention and treatment services including use of HIV rapid testing 3. Implement home visiting/group education program for high risk minority individuals; impact knowledge, attitudes & perceptions about HIV/AIDS prevention and safer sex 4. Develop an HIV/AIDS education curriculum that is culturally and linguistically appropriate to our target population

4. Neighbor to Neighbor Partnership Accomplishments Monthly meetings of three partners Launch of an in-home HIV testing program for pregnant and postpartum women and their families HIV education workshops to adults and adolescents at community church HIV testing day event at community church

5. Neighbor to Neighbor Partnership Evaluation Methods  Mixed method approach  Quantitative  survey of representatives from all three organizations  Qualitative  Exploratory focus group  Individual, structured interviews with partnership representatives of each program  Thematic approach used to examine data and identify relevant themes

6. Neighbor to Neighbor Evaluation questions explored these themes: levels of mutual trust, respect and commitment strengths and assets, areas for improvement balance of power and resources communication between partners roles and norms for the partnership feedback to improve the partnership and its outcomes sharing credit for accomplishments

7. Neighbor to Neighbor Partnership Evaluation Results Many issues emerged as both strengths and challenges 1)Organizational Culture 2)Communication 3)Sustainability 4)Research and Practice 5)Cultural Diversity

8. Neighbor to Neighbor Partnership Evaluation Results: Organizational Culture The Partnership is both a major accomplishment and a challenge Relationship-building takes time and patience in learning each other’s cultural norms “ I think the first major accomplishment is the partnership itself. Given the different backgrounds, that we are three such different organizations, I think that’s a really significant accomplishment.”

9. Neighbor to Neighbor Partnership Evaluation Results: Communication Communication Structured, monthly meetings Informal methods e-mail vs. phone collaborative approach can be time-consuming but is essential for success “There are still significant language barriers even when you think you’re speaking the same language.”

10. Neighbor to Neighbor Partnership Evaluation Results: Communication (cont) Disagreements are normal Can be useful and productive – they bring up important concerns and force partners to work harder to address all issues “ There is this kind of norm in the partnership and that is when we are as a group we work together to just get everything resolved, but there are times when people disagree and then we deal first with the disagreement separately and then bring it back in a very productive way to the group.”

11. Neighbor to Neighbor Partnership Evaluation Results: Research and Practice “The amount of information the researchers want us to collect would be very difficult to do in the context of an intervention. I want to establish a relationship and make the client feel comfortable. I can’t be asking them a six-page survey” (service staff) “It’s hard to find a balance in providing an actual service and coming up with a way to evaluate how well we’re providing that service. We think the evaluation is important to make sure that the programs are helpful and we’re making positive changes. It’s just hard to balance the service delivery and the data collection” (evaluation team)

12. Neighbor to Neighbor Partnership Evaluation Results: Sustainability Continuing every element may not be needed “I don’t know whether it’s critical [in-home testing], to be perfectly honest. I think that there are more women being tested when they go for prenatal care.” Capacity-building legacy What elements do partners want to continue?

13. Neighbor to Neighbor Conclusion Different working environments Relationship building takes time Patience in learning each other’s corporate cultures Balancing quality data collection with staff burden Quality data collection is critical to evaluating the program and performing research Must be carefully balanced to prevent interference with service provision Race and cultural competency must be explored and acknowledged not just at the beginning but throughout the partnership process