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IM for HIV-related stigma-reduction in Health Care (Step 4 - Program…
IM for HIV-related stigma-reduction in Health Care
consequences
social
consequences
less social support
reduced social network
social isolation
psychological
consequences
depression
anxiety
lower self-esteem
health
consequences
testing delays
poor adherence
non-disclosure
Processes
underlying HIV-stigma
1) Cognition
Stereotypes
perceived contagiousness
perceived severity
perceived responsibility
norm violation
2) Affect
Prejudice
Fear
increases
Anger
increases
Compassion
decreases
3) Behavior
Stigmatization
socially and culturally constituted process
person labelled as different
devaluation
status loss & discrimination
Step 1
- Needs assessment & Logic Model
Tasks
establish
planning group
conduct
needs assessment
describe
context for intervention
(population, setting, community)
state
program goal
to optimize interactions between people living with HIV and Health care providers
Step 2 -
Program Outcome & Objectives
Performance objectives
explicate what people need to do to perform the behavior stated in behavioral outcomes (in substeps)
a)
apply the same precautions with all patients
b)
protect patient's confidentiality
c)
do not ask how person acquired HIV
d)
acknowledge detrimental impact of stigmatizing behavior
change objectives
outline the kind of changes that need to happen in a determinant for people to successfully do performance objective
a)
be aware that risk of infection is minimal
b)
be nonjudgmental regarding responsibility for infection
c)
express self confidence to protect confidentiality
Step 3
- Selecting methods & practical applications
generate program ideas
themes, scope, components, sequence
identify methods
method
= general process for influencing changes in determinants of behavior and environmental conditions
to optimize interactions & reduce stigma
modeling, persuasive communication, consciousness raising, framing, goal setting, shifting perspective, social comparison, stereotype inconsistent contact, interpersonal contact (contact hypothesis)
select & design practical applications
practical application =
practical technique for applying methods in ways that fit with intervention group & context in which intervention will be conducted
Step 4
- Program Production
prepare
plans for program
materials
refine program structure
draft
messages, materials & protocols
pretest, refine, and produce
materials
Website "positief zorgt"
--> 2 entrances for HIV-individuals & HCPs
Step 5
- Program Implementation Plan
state program use otucomes & performance objective for program use
identify potential implementers
construct matrices of change for program adoption, implementation and sustainability/maintenance
design implementation interventions
adoption
= decision to use program
implementation
= use of program
sustainability
= maintenance & institutionalization of program
Step 6
- Plan for Evalution
write
effect
and
process evaluation
questions
develop indicators & measures
for assessment
specifiy
evaluation design
complete evaluation plan