Programming Connection

Around the Kitchen Table 

Chee Mamuk Aboriginal Program, BC Centre for Disease Control
British Columbia
2010

How Does the Program Work?

Location

ATKT training and workshops can be conducted anywhere that is suitably private, comfortable, well lit and quiet enough to facilitate confidential participation in discussion and activities. ATKT events are most frequently held in meeting rooms at local community centres.

Recruitment and engagement

Templates for many of the documents referred to in this section are available in the Program Materials section.

ATKT Facilitators and Local Organizations

To implement ATKT in a community, one local health or social service organization and at least two of its staff members must sign on to the project. A local organization is needed to provide institutional support, a work space, access to a photocopier and fax machine, and two staff people who have some background in providing health services.

The ATKT Project Coordinator begins recruitment by sending a letter of invitation and information package to all of the First Nations communities in the province. Packages are sent out to key community workers, leaders and role models through several networks, including First Nations and Inuit Health, Community Health Associates, Friendship Centres and Aboriginal Organizations.

The letter of invitation introduces the recipients to the ATKT project and Chee Mamuk, explaining that this innovative yet traditional project can help service providers further their training, build skills and learn from other women. The letter also outlines the application process for participation, indicating that interested groups can contact the Project Coordinator for support.

In filling out the application, interested communities must provide a letter of support from a Health Director or Director of a community-based organization (CBO) who is dedicated to the project and able to allocate staff to support its implementation. In addition, each community must identify at least four women to be trained as facilitators— two women employed in health or social services (such as a community health representative or a drug and alcohol counselor) and two volunteer community representatives (such as an elder and a youth worker) who are willing to commit to participate in the four-day facilitator training. It is also preferable that communities provide additional funding to the project, as this helps with the sustainability of the project in the community over time.

The application also asks if sufficient resources (staff time, meeting space, community support, people to lead cultural activities, etc.) are available to facilitate the sessions that will take place in the community.

The application process itself is designed to indicate the community’s capacity to undertake the project. By completing the application within the deadline, a community demonstrates team work and local support for the project. Communities that demonstrate limited capacity may be supported by Chee Mamuk to implement the project. Communities that are not selected will be referred to other Aboriginal AIDS service organizations that can provide community education and help build readiness for a project like ATKT.

The Project Coordinator and the ATKT working group review the applications and send letters of acceptance to those selected, following up to arrange a time to speak with community representatives by telephone. During these conversations, each woman is asked to think about and discuss strengths and challenges in their communities, especially as they relate to readiness to discuss HIV, STIs and hepatitis. The ATKT working group is comprised of Chee Mamuk staff, the Evaluator, a representative from the funding organization from First Nations Inuit Health, and a street nurse from Chee Mamuk’s partner program. The working group helps guide major decisions of the project, such as selecting communities, reviewing evaluation results and making recommendations for future ATKT projects.

During a follow-up planning call any specific issues that the community representatives decide need to be addressed during the training are identified.

Training

The four-day facilitator training prepares community representatives to become leaders who will organize and implement the ATKT program within their communities. Participants from different communities are trained together in one central location, allowing the women to be away from their communities during training to more fully immerse themselves in the ATKT training. This also offers the opportunity to meet women from other communities with whom they can share ideas and begin networking.

Training is focused around modeling the ATKT program that the women will implement in their home communities. The future facilitators first act as participants in the same type of sessions they will lead in their own communities. The trainers then explain how to facilitate these sessions through traditional teaching techniques, providing tips for facilitating a successful workshop.

Topics covered include: the context for HIV and Aboriginal communities; healthy self-esteem; the basics of HIV, STIs and hepatitis; how people can stay safer with drug and alcohol use; and healthy sexuality. 

Trainees are provided with project planning tools, session guides, instructional aids and a free-standing table chart. The table chart is used instead of a PowerPoint presentation to give a more intimate, informal feeling to the visual instruction component of each workshop they will be leading. For more information on these materials, please contact Chee Mamuk.

Facilitators in training are also given six different lesson plans (see “Community Implementation,” below, for titles of sessions), which are helpful to the women when it comes to delivering ATKT sessions in their communities. Each lesson plan clearly outlines a session’s objectives, assessment of the group’s familiarity with the topic, activities, timeline and materials needed. The lesson plan also provides instructions to the facilitator about when to refer to the table chart to help illustrate a portion of the material being discussed.

Finally, the facilitators are given steps and guidance for creating, implementing and facilitating an ATKT program tailored to the needs of their own community. They are supported as they begin creating their community implementation plan, which includes dates for the sessions, location(s), which ATKT facilitator will be the lead on the team, and who will be responsible for various tasks (arranging food, communicating with the Project Coordinator). The training concludes with a traditional ceremony to celebrate the women’s completion of the training and honours their strength to bring these challenging teachings back to their home communities.

Community implementation

Though ATKT follows a specific organizational structure, sessions can easily be tailored to the needs of each specific community as determined by the participants and local facilitators.

Facilitators begin by deciding when it will be best to hold their sessions—in the afternoon or evening, on weekdays or weekends—to attract the most participants. Anywhere from 10 to 35 women may attend each session; the optimal number of participants has varied by community. Based on previous experiences with implementing ATKT in a community, Chee Mamuk recommends holding the ATKT sessions once every two weeks, as one session per month proved too infrequent to develop group cohesion and one per week may be challenging to prepare for.

Recruitment of community participants

Participants are recruited primarily by word of mouth, especially in smaller, more remote communities. Facilitators are encouraged to tell their family and friends, advertise in newsletters and newspapers, provide personal invitations and/or make announcements at community gatherings and meetings.

Recruitment is typically far more successful when communities promote ATKT as a “women’s wellness group” involving traditional culture and health topics such as healthy self-esteem, drugs and alcohol, healthy sexuality and HIV. One community initially promoted the program as an “HIV women’s group” and no one signed up. When this community advertised as a women’s wellness group with HIV as one of the many topics, they were able to recruit a good-sized group.

Groups have ranged in size from 11 to 35 participants. In communities that identified the need for more focused programming, recruitment was limited to a specific population, such as younger women or women who were at a particularly high risk for contracting HIV, STIs and/or hepatitis.

Sessions

The project is generally organized into six sessions of approximately three hours in length. A typical ATKT session consists of women gathering together to share a meal, followed by an hour of facilitated learning activities on the scheduled topic using the table chart and other visual aids. Then, the group participates in the cultural activity while continuing to casually discuss the topic of the evening. Each session covers a different topic:

Session 1: Intro to ATKT and discussion of the strengths and challenges of Aboriginal peoples

By the end of this session, participants will be able to:

  • Identify Aboriginal peoples’ challenges and strengths
  • Describe how challenges can lead a person to be at risk for HIV, hepatitis or STIs
  • Explain how individuals and communities can use strengths to prevent infections and support people living with an infection

Session 2: Healthy self-esteem

By the end of this session, participants will be able to:

  • Describe healthy self-esteem
  • Identify sources of self-esteem
  • Identify ways in which self-esteem impacts people’s lives
  • Identify positive messages about self-esteem

Session 3: Myths and truths about HIV and hepatitis

By the end of this session, participants will be able to:

  • Describe the ways people can and can’t get HIV and hepatitis
  • Provide informal supports to people with HIV

Session 4: Healthy sexuality

By the end of this session, participants will be able to:

  • Describe healthy sexuality
  • Describe testing, treatment and prevention of STIs
  • Identify positive messages about sexuality

Session 5: Drugs and alcohol

By the end of this session, participants will be able to:

  • Describe drug and alcohol use in their community
  • Discuss how alcohol and drug use increase the possibility for the transmission of HIV, hepatitis B and C and STIs
  • Describe ways that people can reduce or stop using drugs or alcohol
  • Identify support resources

Session 6: Closing ceremony

While communities are encouraged to facilitate each of these six topic areas, they can work with the Project Coordinator to choose alternative topics that are best suited to their community. For each topic covered, groups choose an accompanying traditional activity. Some groups may choose to do a different cultural activity at each session while others may choose to work on one activity involving several steps (e.g., drum making) throughout the entire six sessions.

Possible cultural activities include moccasin making, canning, weaving, fishing, drum making, basket weaving, paddle making, carving, and collecting traditional medicines.

The ATKT session guides, presented to facilitators during their training, outline which pieces of information to highlight at each session and provide tips for engaging participants in discussion.

To illustrate different topics and the connections between them, Chee Mamuk utlilizes a number of “icebreaker” and “energizer” games to stimulate participation and discussion. One example is the “Sword and Shield” game, in which participants sit in a circle. Each participant selects two people from the circle: one is the sword, one is the shield. At the start, everyone moves around the room in an attempt to keep her shield between herself and her sword. Other games are included in the facilitator training manual and are meant to keep the energy levels up and to give participants the opportunity to interact with each other.

Facilitators may also invite guests, such as elders, nurses and cultural leaders, to guide participants through any of the topics. Sessions conclude with reminders of the next session, date, time and topic.

Providing ongoing community support

During the community implementation phases of ATKT, the Project Coordinator supports ongoing engagement via regular email and phone contact with each facilitator. While facilitators noted that they appreciated the ongoing support, Chee Mamuk will not provide teleconferences with all facilitators together in the future as facilitators greatly preferred the one-on-one support.

The Project Coordinator also visited each community in person to check in with facilitators, support planning and implementation of ATKT sessions, help solve problems and fill out ATKT paperwork if needed. The site visits proved to be an excellent opportunity to build an even better relationship between the facilitators and Chee Mamuk.