Implementation Plan

Program Planning Model/Theory

Using MAP-IT as the foundation for our program, our group will utilize the steps:

mobilize, assess, plan, implement, and track, towards implementing a successful program of

reducing the incidence and prevalence rates of HIV among LGBT adults in Long Beach.

MAP-IT is being used because it involves sectors of the community to come together for a

successful program to occur. Our program will begin with mobilizing by organizing a team of

volunteers, health educators, and staff to help us address this problem of HIV. Our group will

obtain data from local, and county resources to assess the problem. The planning part will

involve crafting interventions that result in a behavior change. Our goal is to reduce the

incidence and prevalence rates of HIV, each intervention is planned to address a specific change

in participants behaviors regarding HIV prevention to provide some knowledge or skill they will

be able to use to reduce their risk of getting HIV. After implementing our interventions, data will

be collected and HIV testing centers in Long Beach will be monitored to track the rates and see

how many new cases occur compared to before the program.

Behavioral Model/Theory

The transtheoretical model has the ability to integrate a number of aspects into a behavior

change plan that will help focus on LGBT adults with HIV in Long Beach. For each of the six

steps in the model: precontemplation, contemplation, preparation, action, maintenance or relapse,

and termination, our program has formatted a step based off of the National HIV Curriculum’s

Model for HIV Care Continuum, to apply efforts towards reducing the incidence and prevalence

rates of HIV among LGBT adults in Long Beach (Roscoe & Hachey, 2017).
 For precontemplation, our participants will not be aware of their risks of having HIV and

will move to the contemplation stage when they first become aware of those risks after

participating in one of our intervention strategies. The participants then move forward into the

preparation stage when they report they are receiving some sort of care related to HIV

(counseling, advice, clinics) for the first time. Next, they move into the action stage in which

they will begin receiving HIV care (screenings) regularly. Participants move into the

maintenance stage after continuous, repetitive HIV care. It is possible for participants to move

into the relapse stage at any point in the event that they break their pattern of receiving care, or

end care all together. Lastly, participants reach the termination phase if they have changed their

behavior and attitude towards HIV screening care. This model was selected as the foundation for

our program because it demonstrates a path for participants to follow, guiding them towards

success, and it shows health educators where participants fall and how far they are from the

program goal.

Original Concept 1 - Intervention to Promote Behavior Change

Objective: By July 2020, 50% of participants will be screened for HIV at a local clinic.

The purpose of this intervention will be to educate participants about the dangers and

consequences of practicing unsafe sex as well as provide them with the necessary motivation

required to go out and get tested for HIV. Participants for this intervention will be recruited

through program flyers placed in nightclubs, local clinics, and local LGBT centers. Required

resources for this intervention will include a place for the seminar to happen, a health educator,

an on-site phlebotomist, a pamphlet informing participants of the topics to be covered, and

complimentary drinks and food to thank them for attending.

 The seminar will begin with the educator assuring participants that they are in a safe

space in which they are free to speak openly without judgement, and not required to answer any

questions they do not feel comfortable doing so. Then, the question, “How many of you at this

exact moment know your current HIV status,” will be presented. This question may make a few

people uncomfortable, but in seeing fellow peers willing to participate and answer questions, it

may ease the tension and encourage intervention participation. The inquiry will be followed with

an ice breaker that will ask participants to talk to the person next to them about why they did or

did not raise their hand. Next, a short informative video about contracting HIV and the

possibility of other sexually transmitted infections from engaging in unsafe sex will be played.

The anticipated outcome of this portion of the intervention is that participants are more aware of

the many infections out there and are more inclined to ask in depth questions about ones that

they were curious about. At the end of the video will be a testimonial from an individual living

with HIV who can attest to the daily hardships they endure and provide a real life example of

possible consequences of practicing unsafe sex. The anticipated outcome of this aspect of the

intervention is that the audience will be so moved by the story teller’s compelling narrative that

they again are eager to ask questions, know more, and possibly get tested themselves.

The last component of the intervention will involve a motivational conclusion detailing

how easy and beneficial getting tested is. The educator will inform the audience that it’s better to

know your HIV status and be able to do something about it than to not know and not receive

treatment. Participants will be asked to spread the word about the seminar in hopes of increasing

program participation. In addition to providing resources for the participants about where they

can go to get tested, the intervention will have an on-site phlebotomist available for anyone who
wants t​ o get tested at that moment. The anticipated outcome of this component is that

participants will have a “Why not?” attitude by this point in the intervention and go ahead and

get tested. The resource pamphlet will provide other testing locations and numbers to call for

support.

Best Practice 1 - Intervention to promote skill level

​Objective: By December 2020, 20% of participants will report consistent use of condoms.

The second intervention is an online program called “1 step 2 know”. This concept was

originated by an online program called ​Cuidate​, developed as an original intervention that was

based off the social cognitive theory. The tailoring of this intervention included interviews within

the target population. Researchers have found this program very effective in advocating and

reducing HIV rates in universities and in community outreach programs like clubs and fairs

where high risk individuals typically attend (Lescano, 2009). The outcome data collected during

multiple times over the 12 month period demonstrated that participants in the HIV prevention

were less likely to report unprotected sexual intercourse and multiple partners.

The intervention will consist of 5 modules that will teach participants the proper way to

put on a condom and the risks of having unprotected sex. The videos will have step by step

demos on how to properly put on a condom, how to dispose of it properly, small group

discussions, and games about practicing condom use and safe sex. It will also talk about the

consequences of having unprotected sex and share real life stories of individuals who are HIV

positive. Participants will sign up via their email and will receive a demo kit with a foam penis

and condoms, then the videos will be sent through a link to the email that was provided. Towards

the end of the program, participants will receive a certificate of completion with their names on
it. Health educators will be posted inside community outreach locations including gay clubs,

health fairs, universities where high risk individuals are most likely to attend. Being posted in

these community outreach location will be beneficial for some of the barriers we face such as

accessibility. This program will have a social media page where participants can sign up at a

later time and pay a small shipping fee so the demo can be delivered to them. There will also be

a promotion that if a participant refers a friend to sign up for the program, the participant will

receive an incentive of a $5 gift card. There will also be free screening whether you sign up for

the program or not. The goal of this program is to increase participants’ skill level, self-efficacy

in communicating with their sexual partners about condom use, increase HIV screenings, and

reduce HIV rates and risk by effective advocating.

Original Concept 2- Intervention to promote knowledge:

Objective: September 2020, 70% of participants will know at least 3 HIV prevention methods

For this intervention, participants recruited through outreach events will receive short

three minute video clips via text message hyperlinks. These five minute video clips will be in the

form of informational commercials that will be developed by the health educators. Over the

course of five months during the program, video clips will be sent out once every month. The

aim is to show video clips that are entertaining while also being informative and persuasive. The

first clip will inform participants on condom use for prevention. The second clip will talk about

getting tested and where to obtain testing. The third clip will inform on PrEP and PEP as a

prevention method and resources on where to obtain PrEP or PEP. The fourth clip will be geared

to injection drug users or people who know someone who injects drugs and will inform on

syringe exchange programs available to prevent HIV transmission. Finally, the fifth clip will
advocate for prevention while sharing the story of someone living with HIV, and their social and

personal struggles. These five clips will be sent over text message and will include a three

question assessment before and after watching. As an incentive for watching and completing the

questions to each quiz participants will be given a virtual raffle ticket once all five clips have

been marked as watched and responses submitted. The raffle will include one gift card with a

$20 value. We anticipate that participants will increase their knowledge after watching the

informational commercials.

Best Practice 2 - Intervention to promote positive attitude

Objective: Objective: By June 2020, 55% of participants will report positive attitudes towards

the use of PrEP

This program is one that encourages the use of Preexposure Prophylaxis among Black

and Latinx gay and bisexual men. The program is called Empowering PrEP (E-PrEP) and

involves peer led social media based intervention. The theoretical method that was used in the

program was Diffusion of Innovation (DOI). The intervention in our program will be called “Get

PrEPared”. It would include partnering with local LGBT centers to obtain peer leaders who

would then lead the intervention activities with the LGBT adult participants involved. The social

media networks that will be utilized will include Twitter, Facebook, Instagram, and gay and

bisexual dating sites for men. The resources that will be needed are social media apps, and

phones for each of the participants that have access to the internet. Individuals in the program

will be. recruited through the online networks on dating websites and will be screened in order to

determine if they have negative attitudes towards the adoption of PrEP uptake. The participants

that are approved and able to access online networks such as these will then be assigned to either
a Twitter, Facebook, or Instagram(whichever one majority of the participants used) private group

page created by the peer leader who they are somewhat familiar with and identify with in local

community. The anticipated goal of the activity is to increase positive attitudes on the use of

PrEP uptake in order to reach the overall program goal which is decrease the HIV prevalence and

incidence among LGBT adults.

The intervention will include posting daily post to the group page at least three times that

each participant is apart of, that is administered by the peer leader. The peer leader will post a

variety of campaign slogans that combat HIV unsafe practices among the target population.

There will also be other posts that will include HIV and PrEP education and the dangers/risks of

not adopting safer sex practice methods. Lastly, the majority of posts will be discussion posts

where there will be a different topic from 3 to five times a week on certain days where most

people are on the social media networks. The discussion post will discuss topics such as culture,

stigma, and the barriers that these men come into contact with on a daily basis that relate the the

use of PrEP in the prevention of HIV. The discussion posts will allow each participants to not

only communicate with the peer leader, but also with the other participants within the social

media group to facilitate a sense of community and familiarity. In order to prevent any uninterest

in the subjects, the peer leaders will post other trending topics in pop culture and news related

incidents to regain relevancy and entertainment, which would encourage motivation to stay

involved and active with the post. The group page will also include posts that will provide

resources such as healthcare, local clinics to get screened, how and where to access PrEP, and

also LGBT resources. After each weeks (7 days), the peer leaders will individually message each

participants and ask them what they thought of the posts and discussions on the group page, and
whether or not this would have any influence on their motivation to adopt PrEP uptake or

improve the self efficacy of it. In order to measure this, there will be a pre and post test

conducted to test knowledge, attitude, self efficacy and motivation.

Volunteer Strategies for Recruiting, Training, Monitoring, and Rewarding

For our program, volunteers will be recruited by posting flyers on the California State

University Long Beach campus in search of people looking to help towards HIV efforts in Long

Beach. By recruiting volunteers on campus, our group will have a large group of people to

promote to and hopefully recruit. Our group will also reach out to the Health Science professors

to see if they can advertise to their class about our program to let students with some background

in health education have the opportunity to participate in a health program and receive

experience. Since volunteers will be coming from CSULB, it is assumed they have the ability to

be trained since they are students, they have some secondary education behind them making

them competent to volunteer. Training will be simple: each volunteer will receive proper

education on appropriate HIV information and will be required to promote this education to

participants. Volunteers will be monitored by having one member from the group in each

location our volunteers are sent to. Volunteers will be rewarded by receiving community service

hours and will have a program to include on their resumes. Other rewards for volunteers to keep

them dedicated for the duration of the program will be incentives such as lunch being provided

on occasion, and snacks frequently.

 References

Lescano, C., Brown, L., Raffaelli, M & Lima, L. (2009). Cultural Factors and Family-Based HIV

Prevention Intervention for Latino Youth. ​ Journal of Pediatric Psychology (10)3​ 4,

1041-1052.

National Minority Aids Council. (2018) Expanding Practice to Biomedical Prevention: Tailoring

Approaches for Effectively Serving Communities of Color. Retrieved from

http://www.nmac.org/wp-content/uploads/2018/04/Expanding-Access-to-Biomedical-HI

V-Prevention-brief-final3.pdf

Patel, V. V., Ginsburg, Z., Golub, S. A., Horvath, K. J., Rios, N., Mayer, K. H., ... & Arnsten, J.

H. (2018). Empowering With PrEP (E-PrEP), a Peer-Led Social Media–Based

Intervention to Facilitate HIV Preexposure Prophylaxis Adoption Among Young Black

and Latinx Gay and Bisexual Men: Protocol for a Cluster Randomized Controlled Trial.

JMIR research protocols​, ​7​(8).

Program Success Center for Sexual Reproductive Health. (n.d). Cuidate. Retrieved from

https://www.etr.org/ebi/programs/cuidate/

Roscoe, C, & Hachey, D. M. (2017). National HIV Curriculum. ​Retention in HIV Care.

Retrieved from

https://www.hiv.uw.edu/go/basic-primary-care/retention-care/core-concept/all