Burden Statement
General Instructions
Compiling the Intervention Plan Data

Burden Statement

Public reporting burden of this collection of information is estimated to be 0.83 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number.

Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road, NE, MS D-24, Atlanta, Georgia, 30333; ATTN: PRA (0920-0497).

General Instructions

Process monitoring reports reflect basic characteristics of interventions for specific risk populations that were implemented in the previous year in the jurisdiction. These data offer a picture of the HIV prevention efforts that occurred for each risk population. They show the distribution of that effort by type of intervention and offer insight into the coverage provided during the year.

CDC requests that health departments provide aggregate data from their jurisdiction for each of the seven types of interventions4 for each risk population (defined here as a risk exposure category). The jurisdiction-level aggregate data requested by CDC for all intervention types includes counts of

• agencies that provided the interventions, by type (e.g., minority-owned CBO, local health department)
• clients served, by demographic variables (except community-level interventions)
• staff funded with CDC funds
• CDC funds expended

In addition, the following data elements are requested for the specific types of interventions noted in parentheses:

• the number of clients served by setting (individual-level and group-level interventions, outreach)
• number of prevention materials distributed, by type of material (outreach)
• the number of clients receiving only 1, only 2, or 3 or more sessions (individual-level and group-level interventions, prevention case management)
• number of HC/PI interventions by type of agency providing them (health communications/public information)
• average number of prevention case management sessions per client (prevention case management)
• numbers of partners identified, counseled, tested, and found to be HIV-positive (partner counseling and referral services)

Compiling the Intervention Plan Data

In order to aggregate data for reporting to CDC, each jurisdiction will need a mechanism to obtain the relevant data from each provider (either a contracted agency or the health department itself). Once the data are available for each separate intervention, they can be compiled and aggregated for reporting to CDC.

Each jurisdiction should report the data elements in the manner defined on the example report form for each type of intervention. These data may be collected, managed, and analyzed by whichever method is most convenient for the health department. Reports should ensure that the data are presented in the same format (e.g., using the same terms, categories, etc.) as that shown in the example.

Separate aggregate process monitoring reports should be submitted for each specific risk population by type of intervention that was conducted in the jurisdiction over the course of one year. The table on the following pages defines each of these seven types of interventions. Data from numerous interventions may be included in the same report if all interventions were the same type and were provided to the same risk population.

For example, one process monitoring report should include all the outreach that was conducted for MSM throughout the jurisdiction. If the health department funded or provided 10 outreach interventions for MSM, then the one outreach process monitoring report should reflect all 10 of those. Another report would cover all outreach provided to IDUs, and a third would include all outreach that targeted people with heterosexual risks.

Similarly, a separate process monitoring report would be used to describe the implementation of all individual-level interventions for MSM, another for health communications or public information for MSM, and another for prevention case management for IDU.

Data Elements Found on All Forms

The process monitoring data elements requested here reflect the basic characteristics of each particular intervention type. Therefore, unlike the intervention plan reports, there is more variability across the seven intervention types and more data elements unique to each intervention type. The following elements are common to all intervention types and are described in more detail below:

The following categories reflect the major sections of the process monitoring reports for all intervention types. The italicized number and words correspond to the accompanying form. The material that follows provides additional explanation or guidance for obtaining and aggregating the requested data.

Item #1 Jurisdiction ID

This field should be completed with the name of the grantee jurisdiction (state, territory, or directly funded city).

Item #2 Number of interventions this form describes

Report the number of interventions of this type funded by the health department (including those implemented by health department staff) for a particular risk population. It will be assumed that all other data elements on the form will be based on that number of interventions.

Item #3 and #4 Risk Population: Mark the primary risk population this form describes on the list in the left column. If an intervention serves multiple risk populations, choose one primary and one secondary risk population.

Each jurisdiction aggregate process form is designed to capture data about interventions that provided HIV prevention services addressing distinct risk behaviors. The risk populations used here (with the exception of General Population) reflect the routes of potential exposure to HIV that correspond to particular risk behaviors. In this section, the health department notes which risk population(s) is served by the interventions that the current form is describing. Operational definitions for these categories are shown in the following table.

Primary vs. Secondary: CDC recognizes that a single intervention may have addressed more than one exposure risk. If more than one exposure risk is addressed, a distinction between the primary and secondary risk populations may be necessary.

The first way to make this distinction is to consider if one of the populations is the major focus of the interventions. For example, an intervention serving female sex partners of male IDUs and focusing on their sexual behaviors may also provide some needle-related prevention services to their IDU partners. In this case, heterosexual would be the primary risk population and IDU would be the secondary because of the differential emphasis of the intervention.

However, some interventions may address equally two different risk behaviors. For instance, an intervention may be targeted to women who are at risk because of their own injection drug use and their sex partners’ drug use. The content of the intervention may emphasize both drug-related transmission and heterosexual transmission. In this case, the intervention should be reported twice – in the two reports appropriate for each population. While this may slightly inflate the count of unique service units, it will provide a more accurate picture of the prevention efforts being made for particular risk populations. This latter concern is viewed as the most important of the two for CDC’s purposes.

There are two particular exceptions to this general rule. First, interventions serving men with both a history of sexual contact with other men and injection drug use make up a separate category: MSM/IDU. Second, interventions targeting the general population should be categorized using that label, even if people with more specific risks may be reached. Examples of this include school-based interventions where young MSM or IDUs may be reached or education/informational interventions for a particular group in which the risk status of particular audience members may be unknown.

Item #5 Statewide definitions or guidelines for [type of intervention]:

This item is requested to provide a context for understanding the local parameters for the intervention type described by this report. Some jurisdictions have explicitly articulated what their expectations are for providers proposing such interventions (or, in some cases, what will be deemed eligible for health department funding). Sometimes these definitions or guidelines have been developed by the community planning group, other times they are developed by the health department as guidance or as part of the announcement for funding.

If there is a definition or guideline that the health department uses when funding or implementing this type of intervention, provide it here. If there is a document or long definition, a separate form can be submitted. An abridged version of a longer definition can also be submitted.

Not all jurisdictions will have definitions or guidelines. In this case, this item should be noted as “No Definition.”

Item #6 Number of interventions for this risk population to be provided by the following types of agencies (sum should equal total interventions this form describes).

Within the jurisdiction, health departments may have funded many types of agencies to provide a particular type of intervention for one risk population. In addition, health department staff may have implemented that type of intervention. This item will describe the array of service providers who offered those interventions for a risk population during the previous year. An example, using “Jurisdiction K,” is provided below. Jurisdiction K provided a total of 10 individual-level interventions for MSM. The example shows how these 10 ILIs are distributed over various types of providers.

Example: Counting the agencies that provided 10 individual-level interventions for MSM in the jurisdiction.

Four individual-level interventions for MSM were provided by several CBOs. One CBO with a minority board provides one of these interventions, and it is entered on the first line below.

The other three interventions conducted by CBOs are provided by two different non-minority board organizations. Therefore, a “3” is entered on the second line below.

The State Health Department provides one of the individual-level interventions. On the appropriate line, a “1” is entered.

Number of ILIs for this risk population provided by the following types of agencies (sum should equal total interventions this form describes): CBO - Minority Board  1  State Health Department  1  Academic Institution  1  Other __ CBO - Non-Minority Board  3  Local Health Department  4  Research Center Individual __     Other Nonprofit __ Other Government __   __ Total 10

The state also funds three local health departments to provide MSM individual-level interventions. One of the local health departments delivers two of these, and the other two local health departments provide one each, for a total of 4 interventions on the “local health department” line above.

A school of public health at a university in the jurisdiction provides the remaining individual-level intervention, and it is entered in the appropriate line above.

The category research center is used here to describe a stand-alone research facility, a facility so designated within a university or other academic institution, or a for-profit research organization. A research center within a health department should identify itself as a health department (either state, county, or city) rather than as a research center.

Item #7 Clients served with CDC funds

These fields are for noting the numbers of clients who were served during the previous year. The required column and row totals are found at far right of the table. However, if data are available for the crosstabs (age by sex by race/ethnicity) and the jurisdiction chooses to report these, then the last group of cells titled “age data not available” should be left blank. Instead, the first three groups of cells should be completed, entering the number of clients who were served with this type of intervention in each of the following age bracket X sex X race categories. Per guidelines from the Office of Management and Budget (OMB), Hispanic ethnicity is requested separately from other racial and ethnic categories. Regardless of the extent of data available, the column and row totals should be completed, and the sum of the row totals should equal the total number of clients served with this intervention.

Age: If age breakdowns are not available or the jurisdiction chooses not to report these data, complete the group of cells in the far right section of the table. If these data are available and the jurisdiction chooses to report these data, note the ages of clients of each race/ethnicity served by this type of intervention using the first three groups of cells and complete the column and row totals at the far right end of the table.

Ethnicity and Race: The racial and ethnic categories are those used by the U.S. Census Bureau and OMB. All data collected on clients’ race and ethnicity should be in compliance with OMB requirements, which gives clients the opportunity to identify themselves with more than one race. Therefore, the “More Than One Race” category should be used to aggregate data on clients who report that they are members of more than one race. When race and ethnicity data are not known for clients, use the “Unknown” rows.

Sex: For clients whose sex was not recorded or is otherwise not known, enter the number in the “U” (unknown) columns.

Transgender (also referred to as transsexual) refers to those individuals who have undergone or who are undergoing a physical and psychological sex change. This category should be used when interventions target the Transgender population or when people known to identify as transgender are part of the population served. Typically, this designation is used when it is reported by the client. In some cases, a clients’ transgender status will not be known, and they will identify as the sex to which they have changed.

Item #8 Number of full-time equivalent staff providing the interventions in the jurisdiction whose salaries are funded by CDC:

A full-time equivalent is calculated by summing the percentage of time that each staff member works on a particular type of intervention. For example,

Item #8 (continued) Number of volunteers providing the interventions in the jurisdiction:

Interventions developed by local providers are often the result of multiple sources of information. Their professional and community experience is a critical source of important, practical information about “what works.” In addition to practical experience, it is important that interventions have a basis in evidence or theory. This item calls for grantee staff to make a determination about the sufficiency of the evidence used in the development of each intervention. That is, someone must decide whether activities based on scientific evidence have been adequately integrated into the proposed intervention. The resulting determination is a simple designation of “Evidence Provided” or “Evidence Not Provided.”

This figure should reflect the total amount of CDC funds expended in the jurisdiction for each type of intervention serving a given risk population. These include both HIV prevention cooperative agreement funds (i.e., CDC funds provided to a state, territorial, or city health department for HIV prevention) as well as other CDC funds, such as those coming to the grantee health department (e.g., demonstration project cooperative agreements, supplemental funds, etc.).

This item will describe the number of clients receiving these three types of interventions in various settings. The following are definitions to help standardize the categorization of services or organizations in which the interventions might be implemented:

The number of sessions of an ILI, a GLI, or PCM is one measure of the intensity of the intervention. For PCM, the number of sessions is broken down by serostatus.

Outreach

Item #11 Enter the number of materials that were distributed in the jurisdiction during outreach activities

This item lists the number of materials by type that were distributed during interventions.

Health Communications/Public Information

Item #12 In the table to the right, enter the number of HC/PI interventions for this risk population provided by the following types of agencies. The sum should equal the total interventions this form describes.

This item is similar to the Interventions by Type of Agency data element present for the other types of interventions. The difference for HC/PI is that there are spaces for the four different types of HC/PI interventions (electronic and print media, hotlines, and clearinghouses). Thus, this item will describe the array of service providers who offered those four types of HC/PI interventions for a risk population during the previous year.

Item #13 Electronic Media: Broadcast
If intervention uses broadcast medium, enter the total number of times the pieces were aired.
Enter the estimated number of people exposed to the message(s).

Enter the number of times that a health department-funded HIV prevention message was aired over television or radio. Also enter the total estimated viewership or exposure to the message(s). Formats can include public service announcements, news broadcasts, or paid advertisements.

For example, if a public service announcement was aired 20 times on the radio and a television news station was recruited to do 4 stories on HIV prevention, “24” would be entered on this line. If the estimated listening audience of the radio station is 25,000 and the estimated viewership of the news program is 100,000, the total estimated exposure to be entered on the appropriate line would be “900,000.”

Do not include e-mail, Internet, or other technologies in this number.

Item #14 Print Media
If intervention uses a print medium, enter the number of distinct print materials that were used to disseminate HIV prevention messages to a large-scale audience.
Enter the estimated number of people exposed to the print material(s).

Enter the number of distinct print materials that were used to disseminate HIV prevention messages to a large-scale audience and the estimated exposure to these materials. These materials may include press releases, articles, print advertisements, direct mailings, billboards, or transportation signage. This item captures the number of distinct print materials created for the risk population, not the number of times the material was printed.

For example, if two different HIV prevention ads (Ad-A and Ad-B) are created targeting MSM and are printed in three different publications (Mag-X and Mag-Y and News-Z), the jurisdiction would enter “2” for number of print materials and would sum the estimated readership of the three publications (50,000 each) to get an estimated exposure total of “150,000.” Similarly, if four different billboards are designed to target heterosexual youth and they are placed in a neighborhood of 5,000, the jurisdiction would enter “4” for number of print materials and “20,000” for estimated exposure. If these two examples were actually from the same jurisdiction, the numbers would be “6” for print materials and “155,000” for estimated exposure.

Item #15 Hotlines
If intervention is a hotline, enter the total number of hotline calls

Clearinghouses
If intervention is a clearinghouse, enter the total number of requests for information

Enter the number of calls received by the hotline(s). Enter the number of requests for information received by the clearinghouse(s) or hits/downloads if an internet website or FTP site.

Item #16 Presentations/Lectures
If intervention is a presentation or lecture, enter the total number provided

Enter the total number of presentations and lectures provided to groups.

Partner Counseling and Referral Services

Item #18

• # HIV-infected clients interviewed
• # sex or needle-sharing partners identified for provider referral
• # sex or needle-sharing partners located by provider referral
• Known Provider Referred - Spousal Partners
  • # Spousal partners identified
  • # Counseled
  • # Tested
  • # Known to be previously infected
  • # Found to be newly infected
• Known Provider Referred - Non-Spousal, Sex or Needle-Sharing Partners
  • # Counseled
  • # Tested
  • # Known to be previously infected
  • # Found to be newly infected
• Intended Client-Referred Partners***
  • # Spousal partners
  • # Other partners: sex or needle-sharing

These items address the critical outcomes in the partner notification, counseling, and testing process; they correspond to the flow of client contacts that comprise partner counseling and referral services. The number of HIV-infected clients interviewed, the number of sex or needle-sharing partners identified for provider referral, and the number of sex or needle-sharing partners located by provider referral should be distinguished by whether the HIV-infected client and partners originally came to the program’s attention through a public or private source.

Known Provider Referred - Spousal Partners. These figures refer to the number of spousal partners (i.e. the husbands or wives of the HIV-infected clients) who were referred to counseling by a provider, rather than by the HIV-infected client.

Known Provider Referred - Non-Spousal, Sex or Needle-Sharing Partners. These figures refer to the number of non-spousal partners who were referred to counseling by a provider, rather than by the HIV-infected client.

Intended Client-Referred Partners. These data are drawn from self-reports by the HIV-infected client regarding the partners the client chooses to refer (rather than having the provider contact them for referral). The report should distinguish the clients’ spouses from non-spousal sex or needle-sharing partners.

Other Interventions

Item #19 Mark the one category that best describes the other intervention that was implemented.

This item should be used to characterize the type of other interventions that were funded in the jurisdiction that cannot be described by using the intervention categories found on example forms A - F. Please note that because this category does not describe one discrete type of intervention, a separate data set (or the optional example form) should be completed for each type of intervention characterized as an “Other Intervention.”

If the intervention cannot be characterized by one of the five common types shown on the example form, check Additional Intervention and use the following line to briefly describe this intervention. If additional space is necessary when using the example form, please attach additional sheets. A narrative description should be provided here to help CDC clarify the additional kinds of interventions that are being implemented across the nation that cannot be captured by one of the major categories of intervention types.

Item #20 Describe the major concrete accomplishments for this particular type of Other Intervention (e.g., enhanced accessibility to HIV prevention services, creation of consortiums, community or policy changes, etc.):

This field offers the opportunity to provide a description of the processes, outputs, and outcomes that have been accomplished by this particular type of Other Intervention. In the other, more discrete types of interventions, particular process variables were able to be determined. However, because the “Other Intervention” category is inclusive of a variety of other interventions, the jurisdiction is free to use this space to identify for itself what specific successes or accomplishments it wishes to highlight.

Narrative description will help CDC clarify the kinds of objectives and accomplishments that can be expected from various interventions in order to refine technical assistance and future evaluation activities.

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Evaluating Linkages between the Comprehensive HIV Prevention Plan, CDC Funding Application, and Resource Allocation