6. Training Community Leaders - IV
Training evaluation
Since this was the first time this training course was offered, and because it formed an integral part of the demonstration project, we wanted to know how successful it had been. We had many questions, such as: How much did the skills and knowledge of students increase? Were students satisfied with their level of participation? Was the investment in resources and supports justified? How well did the strategies to incorporate bilingualism into the course work? Did the low student to teacher ratio enhance learning? Were the original goals and expectations of instructors and of participants were met? How could the training be improved?
We used a variety of methods to evaluate the training, including collecting and comparing base-line and post-training data on student knowledge; anonymous questionnaires for students; audio-taped open-ended evaluation discussions, with and without the instructors present; and a group interview with the instructors.
LHP Graduation
All students successfully completed the course requirements, and 'graduated' in December 2001. They received two-half course credits at the second year level from the Carleton School of Social Work and a certificate in "Lay Health Promotion" from Algonquin College. To celebrate this achievement, a community reception and formal graduation ceremony was held. The graduation ceremony was very well attended by more than one hundred people and marked an important point in Mujer Sana-Comunidad Sana's visibility in the Ottawa Hispanic community.
The accomplishments of the students, and of the families and friends who supported them during the long and hard hours of the training course, were recognized during the ceremony. The activity increased the visibility of these 'natural helpers' in the community and validated their new skills. The event also marked the transition from training to programming: eleven 'natural helpers' were now ready to begin their work as health educators and participatory researchers. They were formally introduced to the community as newly-trained Lay Health Promoters/Participatory Researchers with Mujer Sana-Comunidad Sana.
Ongoing training
Training of Lay Health Promoters did not end when the training course was finished. In addition to practical on-the-job skills development, a series of additional training sessions were held in the first months of 2002. These included orientation to the requirements of working at a community health centre; health and safety; and various hands-on refreshers in relation to health education topics, interview techniques, and outreach strategies.
A nurse from the Breast Cancer Action - Extending the Caring Community Program met with the LHP/PRs twice for further training on breast cancer. A nurse practitioner and the recently hired Spanish-speaking physician from Centretown Community Health Centre (CCHC) each met with the them once to discuss more complicated questions that were coming up in their work with women, especially related to pap tests and cervical cancer . A Spanish-speaking social worker, member of the Advisory Committee, also led a session on co-facilitation skills, in response to issues that had been identified in the delivery of workshops.
Training in fact has been incorporated throughout the entire programming cycle of the Mujer Sana project. During the first twelve months of programming activities immediately following the training, participatory action research skills were reviewed, practiced, and strengthened at weekly evening meetings with LAZO 'madrinas' involved in the project. The content of these meetings subsequently shifted to include other areas where support was needed. As areas where skills needed to be developed were identified, the project members responded, and supported skills development in many ways. For example: the project co-ordinator provided many hours of individual training to LHPs who were not familiar with the documentation needs of an institution such as a community health centre. As another example, LHPs were trained by the project co-investigators to use software for computer-assisted qualitative and quantitative analysis, thus actively participating in coding, analyzing, and presenting findings from the research. Workshop facilitation and presentation skills were reviewed and refreshed by the co-investigator and a CCHC health promoter who worked closely with the group. English writing skills were reinforced when the co-investigator in charge of developing the web-site provided guidelines and individual feedback to LHPs who wrote stories about their experiences.
This ongoing training has been multi-directional: For example, LHPs have helped CCHC staff understand more about the Hispanic community, learn about organizing successful community fairs, practice diverse communication styles, and discover the strengths and challenges of working with a horizontally-structured organization such as LAZO. Co-investigators have learned from LHPs a range of innovative ways to approach the community. All of us have helped each other to learn how to work better in partnership, how to listen to diverse points of view, how to negotiate and compromise, how to improve the efficiency of meetings, how to communicate in a bilingual environment, and how to sing "Happy Birthday" in several languages!
