Sexually Transmitted Diseases  >  Program Guidelines  >  Training and Professional Development

Program Operations Guidelines for STD Prevention
Training and Professional Development

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Appendix T-C

AREAS OF TRAINING IN STD PREVENTION

Some of the major areas of development related to STD prevention and associated knowledge and skills development are detailed here. Training and staff development efforts in these areas should be continuing and based on need. Also identified are areas of standard or basic training requirements for employees new to a given function (See appendix D for location and website address for PTCs).

1) Clinical Services

Personnel new to the performance of STD clinical care functions should be provided basic training in STD clinical services within one to three months after assignment of new duties. The training should emphasize skills development in diagnosis; management; counseling and treatment of STDs; medical records and protocols; clinic flow; performance standards for clinician-patient interactions; sexual history taking, and physical examinations; standard precautions; specimen collection; Clinical Laboratories Improvement Act of 1988 (CLIA) approved stat laboratory testing; clinical interpretation of laboratory results; clinical quality assurance; and disease intervention overview.

Experienced clinicians should continue to receive advanced training in clinical management as needs dictate. Non-clinicians, such as disease intervention specialists, who are involved in patient services but not required to perform clinical functions, should be provided in-service workshops or information seminars to gain general knowledge or an understanding of the basic clinical functions and tasks listed above.

STD prevention workers required to draw blood, within the limits permitted by state and local statutes, should be trained and certified in venipuncture. Such training should take place before workers independently perform venipuncture.

Programs should consider continuing training and development efforts to foster expertise in clinical design and evaluation of health services. This includes specific expertise to 1) assess health services needs in a community; 2) determine the organization, distribution, and cost structure of preventive health services within a community; 3) assess factors that determine the quality and accessibility of preventive services; and 4) identify opportunities for public or private collaboration in health services research and demonstration.

2) Laboratory Methods

Persons hired primarily to conduct basic laboratory services in support of STD clinical services should be provided the skills development training required by CLIA regulations, basic skills development training, as needed, in bright-field and dark-field microscopy procedures, endocervical and urethral specimen slide preparations, presumptive culture identification, rapid tests, maintaining laboratory records and protocols, and laboratory quality assurance.

Other STD prevention staff members, such as disease intervention specialists, who may serve in back-up roles to laboratory personnel must be provided the same basic skills training as stated above to meet CLIA requirements. STD prevention workers involved in patient services who may be required to answer specific laboratory-related questions should be provided in-service workshops or information seminars to provide an understanding or general knowledge of the basic laboratory methods listed above.

It is expected that while persons hired primarily to conduct laboratory procedures will be trained within the first two months of employment, persons serving in secondary or back-up roles should be trained to conduct most of the basic procedures within the first 6 months of employment, or as permitted by state or local statutes. All persons conducting basic laboratory procedures should be aware of and adhere to the guidelines governing the conduct of laboratory procedures as described in the Clinical and Laboratory Improvement Amendments of 1988 (CLIA). Experienced laboratorians should continue to receive advanced training in laboratory methods as skills needs dictate.

3) Community and Behavioral Change Interventions

STD prevention programs should provide basic training in individual, group, and community-level interventions to all persons who directly interact with STD clients. Skills should be developed so that staff members can provide effective prevention counseling to clients one-on-one, in groups, or to an entire community. This includes skills in interpersonal communications, in maintaining confidentiality and privacy, and in developing integrated prevention messages for STD, HIV, and unintended pregnancy. Training activities in these areas should also provide a basic understanding of the technical aspects of STDs including HIV and an orientation to human sexuality and a level of cultural competence or skills proficiency sufficient to allow staff members to recognize and effectively address cultural diversity issues and concerns.

a) Behavioral Counseling

Basic training in behavioral and prevention counseling for all workers interacting with STD/HIV clients should be provided within three months after assignment of intervention-related duties. The training should be designed to develop skills in providing counseling and health education interventions to persons who are at risk for STDs, including HIV. A major emphasis of this kind of training should be promoting and reinforcing safe behaviors, with sensitivity to the special needs of high-risk populations. The prevention counseling provided by the worker should be interactive, and should serve to assist the client in building the skills and abilities to implement behavior change. Information on adolescent cognitive and social development affecting behavior should be included.

The new STD worker should be introduced to HIV intervention during orientation, and formal training in HIV testing and counseling should take place before the worker is allowed to conduct HIV counseling and testing activities independently. Experienced counselors should continue to receive advanced training in this area as needs dictate.

b) Community Behavioral Intervention

Basic training in community behavioral intervention should be provided to STD workers involved with community-related intervention within six months after assignment of duties. In addition to the topics listed under community and behavioral change interventions, the training should address the dynamics of community and agency collaboration, street and community outreach, application of community-level intervention strategies, and application of STD prevention program planning and evaluation techniques.

Training and skills development for experienced workers should continue to address such areas as: 1) establishing effective liaison with community leaders and agencies; 2) identifying individuals and coordinating their cumulative strengths to achieve public health objectives; 3) organizing and developing alternative, innovative delivery systems for public health programs; and 4) developing effective community collaborations such as public- private partnerships and linkages with community-based organizations and other health and human services providers. Expertise in these areas requires application of ethical and legal principles and practices with respect to cultural, social, age based, and ethnic differences between public health workers and their clients.

Programs should also provide training and staff development support, as needed, to develop expertise in designing, implementing, and evaluating community-based or community-level behavioral interventions. This includes expertise in conducting targeted, science-based behavior change interventions at the community level.

4) Disease Intervention

a) Interviewing

STD prevention workers who are involved with interviewing or counseling clients should receive basic training in this activity within four to six weeks of their employment, before having independent responsibility for the function. Effective interviewing is critical to successful disease intervention. Skills development in interactive and client-centered communications, information elicitation, and behavioral risk reduction is necessary to ensure that patients diagnosed with an STD are treated and remain free of disease and that all sex partners of the patients receive prompt and appropriate medical attention.

b) Outreach and Field Investigation

Outreach activities such as field investigation and partner notification are important components of STD disease intervention. All STD prevention workers involved in these activities should be trained in these areas and should receive training within the first four to six weeks of assignment. Staff members performing intervention efforts should continue to receive advanced training in this area as skills needs dictate.

5) Supervision

All new supervisors should receive basic training in the principles of supervision, which includes two major areas of skills development. The first area is skill in interpersonal communications with subordinates as it relates to performance management and technical guidance. This includes skill in feedback and observation techniques. The second area is skill in applying basic human resource management methods related to employee relations, recruitment, performance management, position classification and pay compensation, and staff development. Basic supervisory training should be provided within six months after one is assigned supervisory responsibility.

Continuing training should be provided to experienced supervisors to address such supervisory skills as guiding and directing subordinates and others to accomplish performance objectives; planning, organizing, assigning, delegating, implementing, and evaluating day-to-day work activities; counseling and advising less experienced personnel (mentoring); managing and resolving conflicts, confrontations, and disagreements within the workforce; and managing and facilitating meetings

6) Leadership

Continuing training and staff development should be provided to members of the management staff to address leadership skills in such areas as applying interpersonal coaching and motivation techniques; managing a diverse workforce and effectively utilizing cultural diversity; motivating, mobilizing, and coordinating activities of individuals and groups to accomplish program goals; creating work teams and organizing their activities; managing group processes and facilitating team building; developing clear, agreed-upon goals; negotiation; and innovative thinking.

7) Surveillance and Data Management

STD managers should provide continuing training and development to STD prevention workers involved in the collection and use of epidemiological and surveillance data. Training should develop skills and expertise in applying statistical and epidemiological methods and techniques to efficiently collect, compile, organize, analyze, interpret, and disseminate data related to public health outcomes, risk factors, and health services. Expertise should also be developed in this area to aid in planning, implementing, guiding, or evaluating prevention program efforts.

Continuing training and development efforts should be provided to support development of specific expertise in developing, implementing, and evaluating information systems. This should include skills development in 1) determining organizational public health information needs; 2) developing public health information policy; 3) selecting appropriate technology for implementing an integrated system of data collection, storage, and access; 4) and ensuring integrity and validity of data for implementing trends analysis in morbidity prevalence and incidence, health behaviors, and access to care.

8) Public Health Management

STD prevention programs should provide continuing training and staff development efforts to support the development of expertise of management staff and appropriate external partners in such areas as these:

• Health Care Systems—Management staff should develop expertise and knowledge related to the practices, concepts, and integrated structures of various health care systems. These are needed in conjunction with skills in planning, implementing, guiding, or evaluating prevention program efforts.
• Public health program planning—Management personnel should develop expertise in determining priority health risks and problems by using and analyzing available disease and behavioral surveillance data; targeting and prioritizing primary versus secondary prevention strategies based on program performance information; and planning disease prevention and control programs.
• Public health program evaluation—Management personnel should develop skills and expertise including developing and implementing program evaluation strategies, identifying public health prevention program strengths, weaknesses, opportunities, and threats, and providing appropriate recommendations to enhance and improve prevention activities, and to improve resource management efficiency.
• Public health program management and administration—Management personnel should develop expertise such as managing organizational conflict and change; financing public health programs, with particular emphasis on responding to the effects and implications of competition, regulation, and rationing in health services delivery; managing grants and performing strategic planning; managing and developing human resources within the requirements of performance management, employee relations, position management, staff recruitment and training.
• Public health policy development—Management personnel should develop expertise such as developing, implementing, and evaluating effective local public health policy, legislation, and regulation that is consistent with local needs, Federal standards, and national public health goals, and objectives.

9) Health Communications

CDC defines health communications as the study and use of communications strategies to inform and influence individual and community decisions that enhance health status. It is a process that has become an accepted tool for promoting public health. Health communications principles are often used for various disease prevention and control strategies, including advocacy for health issues, marketing health plans and products, informing patients about medical care or treatment choices, and informing consumers about health care quality issues. Together with other program efforts, health communications can cause sustained behavior change and can overcome barriers to and systemic problems with public health services. These efforts can lead to increased patient satisfaction, increased compliance with medical regimens, and other positive health outcomes, including longer life, earlier detection and treatment of disease, and increased quality of life.

Programs should develop specific expertise in the area of health communications that incorporates aspects of health education, health promotion, and marketing. Expertise in health communications should include skills in communication planning, media relations, media advocacy, writing in journalistic style, crisis and risk communication, formative research and evaluation, message design, audience segmentation, and social marketing.

10) Computer Training

All STD prevention personnel who use automated systems should get basic training in the general use of the computer and standard system software such as data base, spreadsheet, and word processing software; and administrative management software such as E-Mail, which are needed in performance of day-to-day work activities. In addition, training on confidentiality of records and information should be routine. This training must be ongoing to address the changing computer environment and enhance skills for needed specific job responsibilities.

11) Training

STD prevention personnel should develop the necessary skills required to teach the various aspects of public health practice.

12) General

In coordination with specific skills development in the functional areas listed above, project areas should also provide continued training and development opportunities to support development of related skills in such areas as written and oral communications, problem analysis and solving, negotiation, and diverse cultural interaction.

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