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PROJECT NARRATIVE

Applicants must submit a Project Narrative with the application forms. Applicants must name this file “Project Narrative”

a. Background:

b. Approach

i. Problem Statement: The health care delivery system are predicted to shift some vulnerable and at risk populations (traditionally covered by STD/HIV safety net services) to an expanded network of primary care providers and patient-centered medical homes. Additionally, with declining public infrastructure at the state and local level, the siloed disease approach is no longer feasible and DIS / PS staff will need to be cross trained to meet local needs. Current DIS/ PS provider training courses will need to be updated and new trainings will need to be developed to prepare DIS/ PS provider staff to meet these challenges. Substantial changes in the health care delivery system require STD and HIV programs to adopt new strategies to maximize the many opportunities created by the expansion of insured individuals and coverage of many STD screenings and HIV testing without cost sharing.

Some of these new strategies will impact the activities of DIS and other PS provider staff working in or with health department STD and HIV programs whose roles will expand. The DIS and other PS provider staff possess a unique set of PH knowledge and skills which include, but are not limited to, partner or contact investigative interviews; field investigations; outbreak response; patient, provider and community PH education and health promotion, risk reduction counseling, patient follow-up (i.e., PH case management) and systematic collection and analysis of PH investigative and surveillance data. These unique PH skills must be maintained for STD/HIV prevention and control activities and for other infectious diseases surge capacity such as tuberculosis (TB) and viral hepatitis (VH). With declining public infrastructure at the state and local level, the siloed disease approach is no longer feasible and DIS /other PS provider staff will need to be cross trained to meet local needs. Thus, expanded activities might include, but are not limited to: involvement in PH detailing with primary care providers, patient navigation and linkage to health insurance and care, and collection of surveillance and other assessment data including community health assessments and assessment of safety net service gaps.

Current DIS/other PS provider staff training courses will need to be updated and new trainings will need to be developed to prepare DIS/other PS provider staff for these expanded responsibilities. In addition, rates of HIV testing and linkage to care are increasing but warrant continued effort. Increasing the percentages of HIV-infected persons who remain in care, are offered antiretroviral therapy, remain adherent, achieve viral suppression, and receive prevention counseling. The latest estimates suggest about 50,000 people become infected with HIV each year, 1 and that 1.2 million people in this country are now living with HIV. 2 Of those 1.2 million, an estimated 20.1% are unaware of their infections.3 It is important for DIS to be well trained and capable of interpreting surveillance data and applying these results to their disease intervention activities.

As the approach to HIV prevention evolves, consistent engagement in care, including medication adherence, will likely become an important part of the DIS/other PS provider staff responsibilities with greater expansion of treatment as prevention initiatives.” As front line PH workers and through field investigation, social media interventions and other strategies, DIS often find individuals at-risk for STD/HIV in the community who have not sought STD/HIV testing and PH treatment or if HIV infected, have not been linked to care or have fallen out of care. They will need to learn the necessary skills to communicate with patients to ensure a greater proportion of HIV positive individuals whom they contact are linked and retained in care, take their medications and reduce their risk of infection with other STIs to ultimately achieving viral suppression including genital viral suppression.

To effectively perform the above mentioned activities, DIS/other PS provider staff must have thorough knowledge of HIV, syphilis, gonorrhea, chlamydia, human papillomavirus (HPV), herpes simplex virus (HSV), TB, and VH. They must also understand the methods of case analysis and case management, investigation techniques, outbreak response, community assessment, basic surveillance, PH foundations, and partnering with private-sector providers. They must also possess the skills including: effective interviewing; verbal, non-verbal and written communication; cultural competence, problem solving; negotiation; investigation; and time management among others. This unique combination of knowledge and skills requires specially designed trainings, mentoring, decision tools and resources developed and facilitated by training professionals with expertise in the objectives and activities of PH department communicable diseases programs including HIV and STD and of every aspect of disease intervention services.

ii. Purpose: Applicants must describe in 2-3 sentences specifically how their application will address the problem as described in the CDC Project Description. (work on a very detailed distinctive couple of sentences hitting all major details of grant, benefits, and outcome)

iii. Outcomes: Research and Educate the Miami Dade county residents on STD/HIV awareness. (state a specific region, the statistics state and be very clear on who and how this project will benefit the general population include the different organizations in the Miami Dade area that we can partner with for collaborations (include community outreach programs/ teen advocates/ support services, referral programs for patients living w/ illness Check w/ local health dept. in area to get list of possible collaborations) the Logic Model by the end of the project period:  Increased access to relevant, quality training activities, decision tools, and resources for DIS and other PS provider staff performing PH disease intervention services;  Increased DIS and other PS provider staff knowledge, skills and capacity to perform efficient and effective STD/HIV disease intervention services;  Increased use of surveillance data to identify individuals for disease intervention services including PS and linkage to and retention in care;  Increased DIS/ Increased DIS/Increased DIS/Increased DIS/Increased DIS/Increased DIS/ Increased DIS/Increased DIS/Increased DIS/Increased DIS/ Increased DIS/other PS provider staff workforce leveraging of resources; Increased efficiency and effectiveness disease intervention services including PS, linkages to and retention in care and outbreak responsiveness;