This document provides an overview of the development and implementation of WILLOW, the CDC's first HIV prevention intervention specifically for HIV positive women. It discusses the curriculum and materials development process, which included input from the target population and facilitators. It also covers training considerations and challenges, such as identifying and selecting peer facilitators. Implementation issues are reviewed, including the roles of the facilitator and mental health counselor. Personal reflections from peer facilitators and trainers are shared.

1. Launching WILLOW – The CDC’s
First Intervention Specifically
for HIV Positive Women:
Pilot Lessons Learned
Carolyn P. Parks, PhD
G. Chezia Carraway, MSW
Dana P. Williams
Joan R. Ferguson
2011 National HIV Prevention Conference
August 16, 2011
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Place Division name here

2. Presentation Outline
 Background and Overview
 Curriculum and Materials Development
 Training Considerations and Challenges
 Implementation Issues and Reflections
 Personal Reflections of WILLOW from Peers
 Questions and Answers

3. Dr. Carolyn P. Parks, Behavioral Scientist, Capacity Building
Branch, Science Application Team, Division of HIV/AIDS
Prevention, Centers for Disease Control and Prevention
BACKGROUND AND OVERVIEW

4. Background and Overview
Background
 Intervention Researchers and Research
 Intervention Purpose
 Intervention Theory
 The Intervention
Women
Involved in
Life
Learning from
Other
Women

5. Background and Overview (Cont.)
The Continuum of HIV Interventions for Women
SISTA
African American
Young Adult Women
Ages 18-29
SIHLE
WILLOW
African American
Women Living with
Female Teens who are
HIV/AIDS
Sexually Active
Ages 18-50
Ages 14-18

6. Background and Overview (Cont.)
Session 1: Gender Pride and Social Support
 Enhance personal self-worth and female pride
 Identify positive attributes of being a woman
 Identify and prioritize personal values
 Establish short- and long-term goals

7. Background and Overview (Cont.)
Session 1: Gender Pride and Social Support (Cont.)
 Distinguish among informational, emotional and practical forms
of social support
 Enhance existing social support networks
 Identify new social support networks

8. Background and Overview (Cont.)
Session 2: Healthy and Unhealthy Relationships
 Identify characteristics of healthy and unhealthy relationships
 Define relationship abuse
 Identify types of abuse
 Identify ways to cope with abuse in a relationship

9. Background and Overview (Cont.)
Session 2: Healthy and Unhealthy Relationships (Cont.)
 Understand the importance of good communication for positive
relationships
 Know the differences between assertive, non-assertive and
aggressive communication styles

10. Background and Overview (Cont.)
Session 3: Condom Use
 Demonstrate increased knowledge about STDs and HIV
reinfection
 Identify high, low and no risk sexual activities
 Understand the importance of condom use for each sexual
experience

11. Background and Overview (Cont.)
Session 3: Condom Use (Cont.)
 Demonstrate and practice proper condom use skills
 Demonstrate and practice negotiating condom use with partner
 Identify benefits of using condoms
 Dispel common myths about using condoms
 Develop more positive attitudes towards using condoms
consistently and correctly

12. Background and Overview (Cont.)
Session 4: Coping Skills
 Define stress and stressors
 Identify the effects of stress on health
 Identify personal stressors

13. Background and Overview (Cont.)
Session 4: Coping Skills (Cont.)
 Identify ways of managing stress
 Perform stress reduction activities
 Apply effective decision-making strategies for stress
management

14. Background and Overview (Cont.)
Session 4: Coping Skills (Cont.)

15. Background and Overview (Cont.)
Session 4: Coping Skills (Cont.)

16. Background and Overview (Cont.)
Willow Activities
 Mini-lectures  Case study scenarios
 Small group discussions  Personal contracts and
assessments
 Role-plays
 Demonstrations
 Games
 Skills-building practice sessions
 Quizzes
 Writing exercises
 Goal-setting
 Thoughts for the Day

17. Background and Overview (Cont.)
Staffing for WILLOW
 One Full-time Female Facilitator
 One Female Facilitator Living with HIV/AIDS
 Program Coordinator
 Mental Health Counselor/Professional

18. Background and Overview (Cont.)
Other Required Resources
 Space
 Funding – About $121K for 8 cycles
 Intervention materials and supplies
 Incentives, childcare, transportation
 “Nutritional Supplements”

19. Background and Overview (Cont.)
WILLOW Diffusion Activities
 WILLOW did not go through the REP process
 Six pilot trainings conducted between 2008-
2010
 Three CBAs funded for WILLOW training and
TA
 One TOT conducted in 2010
 Nine CBOs funded for WILLOW
implementation
 Four CBOs funded for WILLOW evaluation
(CMEP)
 TOFs began in January 2011

20. Background and Overview (Cont.)
WILLOW Diffusion Activities (Cont.)
 As of August 2011 (all total):
 Have conducted 12 TOFs (6 pilots)
 Have trained staff from over 20 CBOs, 4 HDs, and 3 medical
centers/health clinics
 Have trained approximately 170+ facilitators from 16 states and DC
 Over 50% of facilitators are women living with HIV/AIDS
 WILLOW TOFs have a 97% attendance rate

21. G. Chezia Carraway, Public Health Educator, Capacity Building
Branch, Training and Development Team, Division of HIV/AIDS
Prevention, Centers for Disease Control and Prevention
CURRICULUM AND MATERIALS
DEVELOPMENT

22. Curriculum and Materials Development
Curriculum Development
 Target population considerations and context for curriculum
development activities
 Walk-through conducted with Master Trainers
 Dry-run conducted with women living with HIV/AIDS
 Expanded activities and exercises based on
target population and intervention needs
 Initial pilots indicated need to alter training
curriculum from a 4-day to 5-day format
 Initial pilots indicated need to switch sessions
two and four of the training
 Three subsequent pilots on 5-day training

23. Curriculum and Materials Development (Cont.)
Materials Development
 Target population and facilitator considerations
and context for materials development
activities
 Initial draft developed by researcher and staff
 Extensive reviews and revisions by Technical
Monitor and Diffusion Team
 Connected handouts to activities and
exercises
 Intervention package revised for 5-day format
 Heavily scripted Implementation Manual to
assist novice facilitators

24. Dana P. Williams, Co-founder and Executive Director, The
Community Wellness Project, St. Louis, MO – WILLOW Master
Trainer
TRAINING CONSIDERATIONS AND
CHALLENGES

25. Training Considerations and Challenges
Training
 Identification and Selection of Peers
 Facilitation Skills
 Impact of Training
 Challenges with Training
 Identification of a Peer Trainer
 CBO Implementation Planning
 Program Budget

26. Training Considerations and Challenges (Cont.)
Agency Capacity
 Agency Resources
 Agency Infrastructure
 Agency Funding Sources
 Community-based (CBO)
Readiness to Implement

27. Training Considerations and Challenges (Cont.)
Challenges
 Adaptation Issues
 Resources and Experience to Adapt
 Evaluation

28. Joan R. Ferguson, Independent Public Health Consultant, Lucid
Communications, St. Louis, MO – WILLOW Master Trainer
IMPLEMENTATION ISSUES AND
REFLECTIONS

29. Implementation Issues and Reflections
 Specific Considerations for the Peer Facilitator
 The Role of the Mental Health Counselor/Professional
 Mental Health Challenges with Peers and Participants
 Cultural Competence and HIV/AIDS
 Cultural Competence and WILLOW

30. Implementation Issues and Reflections (Cont.)
 Implementation Experiences
– St. Louis WILLOW Facilitation

31. PERSONAL REFLECTIONS ON
WILLOW FROM PEERS

32. Conclusion
 Personal Reflections from a WILLOW Peer Trainer

33. Conclusion
 Personal Reflections from a WILLOW Peer Facilitator

34. Acknowledgements
Members of the SISTA, SIHLE, WILLOW Diffusion Team
of the Capacity Building Branch
 Dr. Miriam Phields, Diffusion Team Lead
 G. Chezia Carraway
 Dr. Arlene Edwards
 Jacqueline Elliott
 Andrea Kelly
 Jasmine Minaya
 Dr. Carolyn P. Parks
 Patricia Patrick
 Alberto Santana

35. Acknowledgements
The WILLOW Trainers
Joan and Dana with Kneeshe Davis
Joan with Carolyn
Massey and Ashley
Ramsey – The Balm
in Gilead
Dana with Traci
Joan and Dana with
Bivens and LaVera
Kneeshe Davis
Anom - APLA

36. Contact Information for WILLOW
Dr. Carolyn P. Parks, WILLOW Technical Monitor
1600 Clifton Road NE, MS E-40, Atlanta, GA 30333
Telephone: (404) 639-8166
Fax: (404) 639-0964
E-mail: cup8@cdc.gov
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Place Division name here

37. Thank You!
Questions?