JSI Research & Training Institute

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

3. Region VIII Viral Hepatitis Training Project • FOCUS: • Part B of the Cooperative Agreement to Test, Disseminate, and EvaluateTraining 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.

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.

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

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:

7. CURRICULUM • Module 1: General Overview • 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

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

12. CURRICULUM & PROJECTNEXT STEPS • CURRICULUM • 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