end+disparities ECHO Collaborative Didactic Presentations

Center for Quality Improvement and Innovation (CQII)

Compilation of recorded didactic presentations from end+disparities ECHO Collaborative affinity group sessions. The purpose of this resource is to expand access to these brief content presentations (usually ~10 minutes in length) for those who have participated in the Collaborative as a refresher and for those who have not participated and want to learn more from these content presentations.

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Topic

Description

1

Plan, Do, Study, Act (PDSA)

This session looks at the Model for Improvement and how to test whether a change idea leads to improvement in quality of healthcare through the Plan, Do, Study, Act (PDSA) cycle.

2

HIV/AIDS Bureau Policy Clarification Notice 15-02

Chepkorir Maritim presents Policy Clarification Notice (PCN) 15-02. Covered in this presentation are the components required for a robust CQM program.

3

Quality Improvement Momentum & Motivation

This session is on how to re-start momentum in quality improvement work by building team participation and engagement and analyzing the 'change activity' environment.

4

Root Cause Analysis: Drilling Down Data

This session is on drilling down HIV patient care data to target quality improvement interventions. Nanette Magnani covers the purpose of drilling down data, drilling down data on a multidisciplinary healthcare team, and the steps to drilling down data.

5

QI Project: Targeted Team Discussions for Viral Suppression

In this session, Margaret Haffey presents on a quality improvement project implemented by Boston Medical Center that used targeted team discussions to improve viral load suppression. The steps they took, including tools used to assess viral load suppression and changes to their team meetings, are covered in this presentation.

6

Evaluating Quality Improvement Projects

This session covers the 'why,' 'when,' 'who,' and 'what' of evaluating quality improvement projects (QIPs) geared toward stakeholders who have implemented a QIP and need to evaluate it in order to plan their next QIP. Adam Thompson presents in depth on how to evaluate a QIP, particularly on the core elements to be reviewed (process, QI team, measurement, documentation, sustainability, and information dissemination).

7

Sustaining and Control Quality Improvement Projects

This session is on how to navigate the sustainability phase of a quality improvement project. Justin Britanik presents on tools, strategies, and lived experience for sustaining and controlling quality improvement activities.

8

How to Take Lessons from One QI Project and Apply Them to Another

This session provides real-world examples of HIV programs applying lessons learned from one quality improvement (QI) project to their next. Three QI projects implemented by Ryan White HIV/AIDS Program providers to improve pap smear rates are presented. 

9

Roadside Assistance in QI

This session outlines the Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV, developed by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), and how best to utilize these guidelines to inform quality improvement work. Included in this presentation is a case study of a Federally Qualified Health Center that refers to the guidelines while using the Plan, Do, Study, Act (PDSA) cycle to improve viral suppression through discussions on HIV with patients.

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11

Managing Resistance to Organizational Change

June 18, 2019

This session covers resistance to change within an organization to improve a process or system. Barbara Boushon presents on what resistance to change looks like, defines it as a "push-back" energy to be harnessed, and how to manage resistance to complex change through team participation and engagement.

12

Empathy Mapping

March 26, 2019

This session focuses on the importance of empathizing with those being serviced as an essential component of the Design Thinking Approach in developing health interventions. This presentation includes a 2018 review by the CDC validating Design Thinking as a viable approach and a case study of the HRS) HIV/AIDS Bureau Building Futures: Supporting Youth Living with HIV Project which identified best practices, incorporating collected feedback from clinical and administrative staff and youth with HIV (YLWH), to enhance services for YLWH.

13

Using Design Thinking in Healthcare

February 12, 2019

This session covers the Design Thinking Approach as a strategy to close the gap between health care intervention development and implementation by incorporating clients' feedback throughout the intervention design process. A 2018 review by the CDC validating Design Thinking as a viable approach is included in this presentation.

14

Design Thinking in Healthcare, Part I: Orientation to the Approach

May 21, 2019

This session is Part 1 of a 2-part series on Design Thinking in Healthcare. This session covers the Design Thinking Approach as a strategy to close the gap between health care intervention development and implementation by incorporating clients' feedback throughout the intervention design process. This presentation includes a look at Design Thinking as an iterative "roadmap" and essential pillars of the approach (empathy, ideation, and experimentation).

15

Design Thinking, Part II: Starting with Empathy

June 4, 2019

This session is Part 2 of a 2-part series on Design Thinking in Healthcare. This session focuses on the concept of Empathy Mapping as a tool to incorporate user insight in the service design process in delivering healthcare.

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16

Immediate/Rapid ART Initiation

September 25, 2018

This session covers recommendations for rapid initiation of Antiretroviral Therapy (ART), benefits and challenges, and evidence in support of rapid initiation of ART for people with HIV.

17

Long Acting Injectable ART to Improve Adherence

March 19, 2019

The session outlines a study that evaluates Long Acting Injectable Antiretroviral Therapy (LA ART) as a solution to countering barriers to HIV care and improving adherence to treatment.

18

Retention in HIV Care and the Max Clinic Model

July 9, 2019

This session gives an overview of the MAX Clinic Model (an open access clinic model) to improve retention in HIV care, and its adapted implementation in different geographic locations.

19

Transportation Services

May 14, 2019

This session takes a look at the transportation-related barriers and facilitators to patient retention in HIV care, and how to set up transportation and recovery services, as demonstrated by the New Jersey Community Health Workers Program, funded under the RWHAP Part B Outreach Service Category. Adam Thompson presents on how this program implemented Transportation Recovery Services, as well as lessons learned.

20

Saferide: Using Medical Transportation Services to Improve Access to HIV Care

September 17, 2019

This session is on using medical transportation services to improve access to HIV care in the context of the University of North Carolina (UNC) Infectious Disease Clinic transportation program. This presentation highlights UNC's transportation assistance (SafeRide) pilot program, including its reach, SafeRide platform, program eligibility, and results.

# Topic Date Description

21

Voice of the Customer Techniques

October 1, 2019

This session dives into the topic of consumer involvement in quality improvement (QI) activities by gaining their input to implement QI projects. Strategies on meaningfully engaging consumers in QI, principles of voice of the consumer techniques, and benefits to both the consumers and clinical quality management (CQM) program of involving consumers are presented.

22

'U=U' for People Living with HIV

November 20, 2018

This session is on the notion of Undetectable=Untransmissible (U=U). Included in this presentation is the evidence behind U=U, its implications for HIV patients, and how to promote U=U among people with HIV (PWH).

23

YGetIt? Project: A Graphic Serial for HIV Outreach and Engagement

February 26, 2019

This session is on the YGetIt? Project, carried out by the New York State Department of Health AIDS Institute, an innovative project that uses graphics via a mobile application to engage young people in HIV care and outreach.

24

House Ball Community

June 25, 2019

This session is on the House Ballroom Community, an underground subculture of sexual/gender minority youth and adults of color. Jennifer Lee presents on the group's history, structure, its intersectionality with social determinants of health and health equity, and the group's role in delivering locally developed and culturally responsive HIV interventions.

25

Storytelling

July 23, 2019

In this session, Cecilia Gentili presents her take on storytelling in the context of the Transgender community. As a Transgender person, she brings her perspective to the importance of storytelling through simplicity and emotion to advocate for Transgender people in the U.S. legal system.

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26

Case Management in Interdisciplinary Teams

October 22, 2019

This session is on how to integrate social work case management in interdisciplinary healthcare teams. Mulamba Lunda covers what it means to follow team-based interdisciplinary models of care, strategies on how to incorporate case management into interdisciplinary models of care, and how case management impacts patient care and outcomes.

27

Integration of Recovery Coaches

October 15,  2019

This session provides an overview of the role that recovery coaches serve in bridging between healthcare services and recovery for HIV patients overcoming substance use. Migdalia Camacho, a recovery coach, presents on what a recovery coach is, social and health services pathways that a recovery coach supports, and how harm reduction assists in the recovery process.

28

Housing and Homelessness

March 19, 2019

This session is on housing and homelessness among people with HIV (PWH), including how to screen for housing emergencies in healthcare settings, and areas of potential action to mitigate homelessness.

29

Mental Health for TGNC Community

June 25, 2019

This session is on mental health services for Transgender and Gender Non-conforming (TGNC) People. This presentation covers a review of the HIV Care Continuum, the Transgender Health Cascade for Transgender People with HIV, and improving access to mental health services for TGNC through services such as counseling, hotlines, and peer support groups.

30

Integrating Mental and Physical Health Services

July 16, 2019

This session is on integrating behavioral health services into medical care. Mental health services are presented as a component of behavioral health and different models are explored to integrate mental health services into the clinical setting.

31

Stigma Index Project

March 5, 2019

In this session, Vanessa Johnson presents methods and findings of the 2018 Stigma Index Project for People with HIV in the U.S., carried out by the Global Network of People with AIDS (GNP+). This presentation lays out the Stigma Index participatory research process, survey framework, project sites in the U.S., and results.

32

Peer Programs

December 11, 2018

This session is on the New Jersey Community Health Worker Program for HIV care, implemented by the AIDS Education and Training Center (AETC) of the RWHAP Part F, in partnership with RWHAP Part B. Adam Thompson presents on their implementation of the Community Health Worker (CHW) model, including the CHWs' activities, partnership between clinical institutions and community-based networks, tools and services provided, and evaluation methods and findings.

33

HIV Support Groups

May 7, 2019

In this session, Dawn Trotter shares her personal and professional experiences of joining and running a Women's HIV support group.

34

Self-Disclosure of HIV Status

August 20, 2019

This session is on disclosure of HIV status by people with HIV (PWH) geared toward HIV care providers and PWH. Dottie Dowdell talks about the concept of self-disclosure as a complex process that is intertwined with various social and human factors, as well as tips and strategies for disclosing.

35

Women & Dating

November 20, 2018

This session covers the topic of sex and dating for women with HIV. Kneeshe Parkinson keys into the concepts of Undetectable = Untransmittable (U=U) and disclosure of HIV status in the context of how issues of sex and dating surface in conversations among women with HIV, how relationship issues affect viral suppression, and how to address sexual health and wellbeing among women.

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36

SMS/Texting

August 14, 2018

This session is on SMS/text messaging from the perspective of Project ARK at the Washington University School of Medicine. Included in this presentation are tools and strategies that assess and reduce potential privacy risks to RWHAP clients while text messaging.

37

Texting/Social Media and Retention

October 16, 2018

This session is on using social media to improve patient retention in HIV care. Mark Thompson presents on practical strategies and points to consider in using social media to engage people with HIV (PWH), including creating a plan, selecting a platform, partnering with organizations, engaging support systems, messaging, platform use analytics, and social media guidelines.

38

Intercultural Communication in Healthcare

August 13, 2019

This session covers intercultural communication and how it may be a barrier to healthcare. Included in this presentation are the concept of cultural borderland, sociocultural barriers to care for racial and ethnic minorities, and how to overcome these barriers through cultural competency.

39

Language: Changing How We Speak about People Who Use Drugs to Decrease Stigma

September 4, 2018

This session is on the importance of moving toward person-centered language in regard to people who use drugs. Dr. Stancliff presents on the relationship between stigma and substance use, suggested terms as person-centered language, and the effects of person-centered language on reducing stigma.

40

Intro to Zoom; Intro to ECHO Structure; Intros to Each Other

July 17, 2018

As part of the end+disparities ECHO Collaborative Men who have Sex with Men (MSM) of Color Affinity Group, this session provides an introduction to the Affinity Group Sessions, including how to use Zoom, the structure of each session, and what participants are expected to learn.

# Topic Date Description

41

Check your Privilege

March 26, 2019

This session looks at the concept of social privilege as a multidimensional continuum, how these dimensions of privilege affect dialogue within communities, and how to "check" one's own privilege.

42

Welcoming Spaces

February 12, 2019

This session is on how to create a welcoming healthcare environment from a gender perspective, particularly for Transgender People. This presentation takes a look at the Trauma Informed Care Approach, understanding contributors to HIV risk among Transgender People, strategies for creating welcoming healthcare spaces, as well as gender aware care by healthcare providers.

43

Culture, Strength, & Resilience

August 7, 2018

This session is on culturally affirmative practice (CAP) to address health disparities among women with HIV. Dr. Clanon presents on the importance of culture as a source of resilience for women and how to leverage this in using CAP tools to engage women with HIV in care.

44

On the Path to Being Gender Aware and Affirming

September 11, 2018

This session provides an understanding of how to better serve Transgender patients through language and awareness of their gender journey. Dr. Heinen presents on Implicit Bias and the importance of considering the Identity Spectrum when providing care to Transgender People.

45

Gender Affirming Care

July 10, 2018

This session introduces sexual orientation and gender. Adam Thompson presents the concepts of attraction, behavior, and identity in relation to sexual orientation as well as gender biology, expression, and identity.

46

Gender Identity

December 18, 2018

This session introduces the concepts that make up gender (biology, expression, and identity).

47

Gender Health San Francisco

October 8, 2019

This session is on Gender Health San Francisco’s work to increase access to gender affirming health care among Transgender (and gender non-binary) People in San Francisco.

48

Sexual Orientation

February 5, 2019

This session provides an introduction to the concepts that make up sexual orientation (attraction, behavior, and identity).

49

Sex Work

April 9, 2019

In this session, Cecilia Gentili shares her firsthand experiences as a Transgender former sex worker and the implications for working with Transgender People.

50

Implicit Bias

December 11, 2018

This session explores what implicit bias is, its real-world impact, and how to break the habit of it.

51

Trauma Informed Care for Women

December 4, 2018

This session is on the Trauma Informed Care Approach for Women with HIV. This presentation takes a look at understanding trauma and related issues among women with HIV and how to adopt the Trauma Informed Care Approach in providing HIV care to women.

52

Trauma Informed Care

January 11, 2019

This session is on how to better care and advocate for Transgender People through Trauma Informed Care. This presentation covers the concept of Implicit Bias, the Identity Spectrum, a glimpse into the experiences of those who identify as Binary vs. Non-Binary Gender (Cisgender vs. Transgender) and understanding trauma and how to provide Trauma Informed Care to Transgender patients.

# Topic Date Description

53

Data for Care

August 6, 2019

This session is on the Data for Care (D4C) Alabama Retention in Care (RiC) Strategy, a clinic-wide quality management approach for people with HIV (PWH) carried out by the University of Alabama at Birmingham Center for AIDS Research (CFAR). Dr. Mugavero from the D4C AL team presents their strategy, which includes risk stratification (evaluating past missed visits to predict future ones), RiC resource allocation to intermediate and high-risk patients through a retention through enhanced personal contact (REPC) intervention, and continuous QI.

54

Control Charts

March 5, 2019

This session is on how to use control charts to decipher data variation. In this presentation, common cause variation vs. special cause variation are defined and how to use control charts to differentiate between these types of data variation is covered.

55

Step Measures

November 5, 2019

In this session, the use of step measures in Plan, Do, Study, Act (PDSA) cycles, used in quality improvement projects, is presented. Lori DeLorenzo introduces the measurement tree and provides examples of step measurement to present the role that step measures play in carrying out PDSA cycles.

56

Performance Report Cards in Quality Improvement

October 8, 2019

This session is on using Performance Report Cards in quality improvement projects. Adam Thompson covers the purpose of Report Cards, how to create and implement a Report Card, and lessons learned from implementing Report Cards.

57

AIDSVu for Transgender People

January 8. 2019

This session provides an overview of AIDSVu, an online mapping tool, and its application in visualizing the U.S. HIV epidemic with a focus on Transgender People.

58

AIDSVu for Youth

January 8, 2019

This session provides an overview of AIDSVu, an online mapping tool, and its application in visualizing the U.S. HIV epidemic, with a focus on youth.

59

AIDSVu for Women of Color

February 5, 2019

This session gives an overview of AIDSVu, an online mapping tool, and its application in visualizing the U.S. HIV epidemic with a focus on women of color.

60

AIDSVu for MSM of Color

January 15, 2019

This session gives an overview of AIDSVu, an online mapping tool, and its application in visualizing the U.S. HIV epidemic with a focus on MSM of color.

61

Overview of Youth Epidemiology

July 24, 2018

This session provides an overview of youth and HIV in the U.S. Dr. Birnbaum presents data snapshots of new HIV cases, prevalence rates, and other key HIV care outcome indicators among youth.

62

Drill Down Data (Case Study)

January 22, 2019

In this session, Kennedy Health serves as a case study that exemplifies the process of drilling down data to understand barriers to HIV care. Adam Thompson walks us through the steps of examining barriers to care - from identifying patients not retained in care, to assessing reasons for non-retention, to tracking barriers identified, and to creating targeted action plans to address the barriers.

63

Transgender Data, Part I: Data Collection/Recommendations 

August 28, 2018

This session is Part 1 in a 2-part series on data for Transgender People with HIV and provides insights into the need to go beyond traditional data collection for Transgender People and incorporate these with HIV/AIDS Bureau data measurement.

64

Transgender Data, Part II: Priorities Driven by Data

October 23, 2018

This session is Part 2 in a 2-part series on data for Transgender People with HIV. Cecilia Chung continues by giving an overview of findings from a 2015 Transgender National Needs Assessment, which looked at barriers to healthcare and wellbeing, and legal and health priorities among Transgender People with HIV.

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65

Transgender 101, Part I

July 10, 2018

This session is Part 1 of a 2-part series on Transgender. Presenter Teo Drake introduces the concepts that make up gender (biology, expression, and identity).

66

Transgender 101, Part II

July 24, 2018

This session is Part 2 of the 2-part series on Transgender. Teo Drake continues with an introduction to the concepts that make up sexual orientation (attraction, behavior, and identity).

67

Transgender Youth, Part I

May 14, 2019

In this session, Dr. Birnbaum, Executive Director of the Health and Education Alternatives for Teens (HEAT) Program at the State University of New York, presents on the scope of HIV among Transgender People served by the Ryan White HIV/AIDS Program, and factors such as homelessness, poverty, and childhood sexual abuse that affect Transgender Youth in receiving HIV care.

68

Transgender Youth, Part II

May 28, 2019

In this session, Dr. Birnbaum, Executive Director of the Health and Education Alternatives for Teens (HEAT) Program at the State University of New York Downstate Medical Center, presents on the scope of HIV among Transgender Adults and Youth served by the Ryan White HIV/AIDS Program, and factors such as homelessness, poverty, and childhood sexual abuse that affect Transgender Youth in receiving HIV care.

69

HIV Care for Transgender Women

December 10, 2019

In the context of the Trans National Study, Erin Wilson presents a study conducted in 2016 that characterized HIV care continuum indicators (including structural factors as barriers to care and HIV care outcomes) for Transgender Women in San Francisco.

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70

Harm Reduction Principles

September 11, 2018

This session focuses on the underlying philosophy and practical strategies of harm reduction for people who use drugs. This presentation defines harm reduction and outlines implications for people who use drugs as necessary change agents in successful harm reduction programs and policies.

71

Substance Use

August 13, 2019

This session is on a 2010 study looking at the patterns of substance use and HIV among Transgender Women in San Francisco.

72

What is success in working with drug users? Abstinence or retention in care

September 4, 2018

This session takes a look at the barriers to care for people with substance use disorders, what has worked for individuals treated for opioid or methamphetamine use, and the balance of goals between HIV and substance use treatment.

73

Buprenorphine in HIV Clinics

October 2, 2018

This session covers chronic pain related to HIV, the effects of opioid use on HIV patients, and the challenges in using buprenorphine in HIV clinics.

74

Substance Use: Methamphetamine Panel Discussion

September 3, 2019

This session is conducted through a panel discussion by RWHAP providers across the U.S. on methamphetamine use among people with HIV (PWH). Speakers fill the discussion with questions and solutions on issues such as keeping HIV patients virally undetectable while using meth, signs that PWH are using meth, the role of promoting Pre-Exposure Prophylaxis (PrEP) when responding to substance use among PWH, and mental health and substance use screening in healthcare settings.

75

Syringe Access

September 18, 2018

This session is on syringe access for people who inject drugs. This presentation includes an overview of the risk of injection on HIV and HCV, syringe exchange services and models, and the role of syringe access in reducing risks.

# Topic Date Description

76

Building Futures: Supporting Youth Living with HIV

December 4, 2018

This session covers the toolkit of the HRSA HIV/AIDS Bureau- funded Building Futures: Supporting Youth Living with HIV Project, which identified best practices for enhancing services to Youth with HIV (YLWH), thereby contributing to improved outcomes in treatment adherence and viral load suppression. Adam Thompson provides a breakdown of the toolkit developed from the project to inform replication of implementation.

77

Barriers to HIV Care among MSM of Color

August 7, 2018

This session provides a look at the barriers to HIV care for black Men who have Sex with Men (MSM) in the U.S. to inform on potential future HIV interventions. The presentation provides an overview of HIV risk for black MSM, barriers to HIV care initiation, and health disparities for black MSM.

78

Research on PrEP for Young Black MSM

May 7, 2019

This session highlights research findings on Pre-Exposure Prophylaxis (PrEP) utilization patterns in relation to diagnosed HIV rates, barriers to PrEP uptake, and PrEP service delivery models for engaging black MSM in taking PrEP.

79

Transitioning from Adolescent to Adult HIV Care

April 9, 2019

This session is on transitioning from adolescent to adult care among HIV infected individuals. This presentation takes a look at the difference between youth who are perinatally infected and behaviorally infected with HIV relating to the scope of diagnosed HIV cases, clinical issues, different HIV care models and life skills needed to transition from adolescent to adult HIV care, as well as best practices in transitioning by the State University of New York Downstate Medical Center.

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