FINALFacetoFaceAdjusted304
Download
Report
Transcript FINALFacetoFaceAdjusted304
Promoting Rational Drug Use
in the Community
Face to Face Education
Session objectives
1) Understanding of:
What is good F2F education
Advantages and disadvantages of F2F
Why F2F is important/what it can achieve
How people change behavior with F2F
How and when to use F2F
How to plan a F2F education project
2) Develop skills to understand problems and
encourage the person to try a new practice
Face to face
Promoting Rational Drug Use in the Community
WHO
2
Face to Face in HIV/AIDS education
What characterizes good F2F?
Observations from field work?
Face to face
Promoting Rational Drug Use in the Community
WHO
3
Good face to face education
Relevant to personal and cultural needs
Shows respect for people’s ideas and
practices
Builds a bridge between old and new ideas
and practices
Skills and credibility of educator
Accessibility of key information
Room for discussion and negotiation
Includes check for understanding
Others ???
Face to face
Promoting Rational Drug Use in the Community
WHO
4
How and where to use F2F education?
To discuss
drugs with
customers
Face to face
Promoting Rational Drug Use in the Community
WHO
5
How and where to use F2F education?
In training
courses
In supportive
supervision
Use + other
methods and
materials
One-to-one
and small
groups
Face to face
Promoting Rational Drug Use in the Community
WHO
6
How and where to use F2F education?
In
groups
Face to face
Promoting Rational Drug Use in the Community
WHO
7
How and where to use F2F education?
Convince
managers of
need for
programme
To change
practices
Face to face
Promoting Rational Drug Use in the Community
WHO
8
The reality: >50% of youth have sex
Face to face
Promoting Rational Drug Use in the Community
WHO
9
Behavior change examples: Participants
What did
you change?
What or
who inspired
you to
change?
How long
time did it
take?
Face to face
Promoting Rational Drug Use in the Community
Children sent to buy drugs in
Kilifi: Reduced after training
WHO
10
Behavior change in the community
What will make
her change?
Can you
change others?
Face to face
Promoting Rational Drug Use in the Community
WHO
11
Behavior change basics
You can only change yourself
To change behavior, you need a good reason
No one has ”a wrong idea”
Help people see need for change by expanding their view
Never push someone to change
To change, you require time and energy to think and
reflect
When people are in a stressed situation, they will not
consider change
We often judge people as being stubborn or ignorant if
they don’t want to change
Information only does not make people change
Create an enabling environment to help people change
Face to face
Promoting Rational Drug Use in the Community
WHO
12
Emotions and Behavior Change
Emotions:
Trigger BC
Stop BC
”Fog” your view
Common problem UNCERTAINTY:
Not sure of anything
Stomach feeling,
Antennae down
Hear what you want to
hear
Face to face
Promoting Rational Drug Use in the Community
WHO
13
Can you read reactions correctly?
Face to face
Promoting Rational Drug Use in the Community
WHO
14
From Awareness to Change
Observations:
Role in group?
Any behavior or
practice you want to
change?
Ask group members to
support you to achieve
what you want
Face to face
Promoting Rational Drug Use in the Community
WHO
15
What makes an educator credible?
Status or “right to talk and be listened to”
Experience with HIV/AIDS
Knowledge
– of the problem and the treatment (biomedical)
– of the community: Perceptions, practices and
reasons for these
Attitude:
– Respects people and reasons why it might feel
impossible to follow advice to change
Communication skills (see next slide)
Face to face
Promoting Rational Drug Use in the Community
WHO
16
Educator: Essential communication skills
Face to face
Promoting Rational Drug Use in the Community
WHO
17
Educator: Essential communication skills
Empathy
Approachable, and makes people welcome and at ease
Respectful of others
Curious - willing to learn
Good communicator - good listener: Active listening
Inspires dialogue and views
Can identify problems/constructive solutions
Knowledgeable about the subject
Can say “I don’t know - I’ll find out”
Can accept criticism
Non-judgemental
Face to face
Promoting Rational Drug Use in the Community
WHO
18
Educating patient to use ARV
Demonstration role-play:
Lethiwe and Robert
Observe: What skills is she using?
What is she doing well?
What could be improved?
Face to face
Promoting Rational Drug Use in the Community
WHO
19
Six skills for effective education
The first set of 3 skills:
Understanding the problem by:
observing the mood of the
client/customer and responding
appropriately
asking open questions
listening carefully and trying to
understand
Face to face
Promoting Rational Drug Use in the Community
WHO
20
Six skills for effective education
The second set of 3 skills:
Responding to the problem/needs by:
giving accurate and clear advice and
explaining why
discussion to reach agreement
checking for understanding
Face to face
Promoting Rational Drug Use in the Community
WHO
21
How to
give
advice
effectively?
Face to face
Promoting Rational Drug Use in the Community
WHO
22
How to
give
advice
effectively?
Face to face
Promoting Rational Drug Use in the Community
WHO
23
How to give advice effectively
Make it clear and simple.
– how the drug works, how often to take it,
for how long.
Explain WHY this treatment
Explain importance of finishing the
treatment and what can happen if you don’t
Be confident, friendly and non-judgemental
Be practical - if possible demonstrate how
to measure and administer dose
Face to face
Promoting Rational Drug Use in the Community
WHO
24
Communication barriers (1): Client
Face to face
Promoting Rational Drug Use in the Community
WHO
25
Communication barriers (1): Client
The client or customer
feels uncomfortable
does not trust the educator
does not have money to follow advice
feels worried/judged/patronised
does not dare to ask questions
gets too much - or too complicated
information
does not have the time
Face to face
Promoting Rational Drug Use in the Community
WHO
26
Communication Barriers (2): Educator
Face to face
Promoting Rational Drug Use in the Community
WHO
27
Communication Barriers (2)
The educator
Unfriendly, judgemental or patronising
lacking respect for patient’s perceptions,
practices and concerns
Does not listen - interrupts - argues
Uses technical language
Lacks the appropriate knowledge and expertise
Does not follow-up
Face to face
Promoting Rational Drug Use in the Community
WHO
28
Communication barriers (3)
The environment
too noisy
not safe
not private
not comfortable
Face to face
Promoting Rational Drug Use in the Community
WHO
29
Using F2F in projects
Aim: What do you want to communicate? To
whom? Through which channels? Is F2F needed
for some of it? Why - to achieve what, with
whom?
What personnel is needed to do F2F? Do you
have this personnel? Do they need further
training?
What support materials do you need for the
trainers to use in their education?
What is your budget?
How are you going to monitor and evaluate the
effect?
Face to face
Promoting Rational Drug Use in the Community
WHO
30
Support F-to-F with other methods
Continuing community education - use
simple materials and health workers or
informal providers as resource people
Training for community leaders - encourage
them to take a lead role
Encourage activities in schools
Give information through community
meeting, local radio, community drama, etc
NB good supporting educational materials will
improve the impact of F to F interventions
Face to face
Promoting Rational Drug Use in the Community
WHO
31
Summary F-to-F
effective method to change practices
useful in a mix of methods
best supported by educational materials
content should be based on (participatory)
research
educator must understand and respect
community views and practices
educator must be respected and skilled in
participatory methods
supportive supervision essential
Face to face
Promoting Rational Drug Use in the Community
WHO
32
Additional slides and handouts for F to F
Slides … to … can be used to teach
content of session notes
Slides used in session today are new, and
introduces material (behavior change)
which is not included in session notes
Additional handouts provided gives this
background
Face to face
Promoting Rational Drug Use in the Community
WHO
33
Requirements for success
Analyse the problem - early research needed
Assess perceptions and practices and reasons
for these, and perception of need for change
Respect people and develop solutions with
them
Build bridges between old practices and new
Focus on sustainability
Use credible and skilled communicators
Involve and inform opinion leaders
Be available over time
Support with a variety of educational methods
Face to face
Promoting Rational Drug Use in the Community
WHO
34
Pros and cons of F-to-F education
Improves rational use and compliance
Reduces morbidity and mortality
Empowers people
Encourages good communication
Changes behaviour
Allows immediate feedback
Can include practical demonstration
Promotes general awareness
Encourages neighbours to discuss with each other
Expensive (financial and human resources)
Requires skilled and motivated educators
Face to face
Promoting Rational Drug Use in the Community
WHO
35
Evidence to support use of F-to-F
Review of 37 studies investigating
compliance/adherence concluded:
Teaching patients resulted in improved
compliance
Poor communication with health workers
most common cause of non-compliance
Lack of continuity in patient-physician
interaction contributed to non adherence
In Kenya ORS sales increased 30% and in
Indonesia 21% after pharmacy workers
received F to F training
Face to face
Promoting Rational Drug Use in the Community
WHO
36
Lessons from ORS study in Nepal
Gain the confidence of opinion leaders and
traditional healers - explain problem and plan invite their ideas and participation
Keep them involved and informed throughout
Use successes and positive experiences to
motivate others
Create (or use existing) forum for exchange of
experiences
Successful use of new practice by neighbours
inspires imitation
importance of using educators with local
knowledge and language as facilitators
Face to face
Promoting Rational Drug Use in the Community
WHO
37
Team building: Characteristics of team
There must be
Awareness of unity
Interpersonal relationship
Members must have the ability to
Act together toward a common goal
Face to face
Promoting Rational Drug Use in the Community
WHO
38
10 Characteristics of well-functioning
teams
Purpose: Share why team exist
Priorities: What needs to be done, by whom, when
Roles: Must know own roles, and when to ask others
Decision: Authority and decision-making lines clearly
understood
Conflict: Dealt with openly. Considered important to
decision-making and personal growth
Personal traits: Members feel appreciated and utilized
Norms: Group norms are set. Seen as standard for
everyone
Effectiveness: Members find team meetings efficient.
Look forward to this time together
Success: Know when team is successful, share it equally
and proudly
Training: Opportunities for feedback and updating skills
given, and used
Face to face
Promoting Rational Drug Use in the Community
WHO
39
Guidelines: effective team membership
Contribute ideas and solutions
Recognize and respect differences in others
Value the idea and contributions of others
Listen and share information
Ask questions and get clarification
Participate fully and keep your commitments
Be flexible and respect the partnership created
by the team - strive for the “win – win”
Have fun and care about the team and the
outcomes
Face to face
Promoting Rational Drug Use in the Community
WHO
40