IPS Staffing and Supervision

IPS training and support

In order to achieve the desired outcomes and success with IPS, it is extremely important to ensure all IPS staff are adequately trained and supported. It is necessary to train IPS DIS and supervisors on a regular basis, as the world of technology changes rapidly and staff should have the skills to use all the tools and techniques necessary for success.

Historically, there are multiple ways in which IPS programs have been staffed:

• All DIS are trained to conduct PS, including use of online venues and mobile apps.
• A limited number of select DIS are trained and assigned to conduct technology-based PS. These DIS are sometimes assigned to specific regions of a program area (e.g. certain counties).
• A specific DIS (and a backup) is designated to act as the point person for all IPS activities to ensure consistency of services.
• The program contracts with a university or CBO to conduct some or all IPS (this varies by local rules and policies).

No staffing model has proven to be more effective than another. Rather, each model has been successful in different jurisdictions. One published study has compared IPS staffing models.²⁷ The North Carolina Department of Health found that, compared to all DIS conducting IPS, the centralization of IPS activities resulted in increased notifications as well as a higher yield of new HIV and syphilis diagnoses. If a program uses a centralized IPS model, a backup IPS DIS should be trained and designated.

Anecdotally, regardless of the model used, programs have found that when interviewing patients, those DIS who are familiar with popular websites, mobile apps, and other online meeting venues are able to gather more information about a patient's sex partners and sex-seeking activities.

7.1 IPS Supervision

As with all PS activities, effective supervision can reduce the likelihood of error, demonstrate the program's commitment to quality assurance and improvement, reduce the risk of misusing the internet and other technologies for non-work-related activities, and build the skills and competencies of staff conducting the intervention. The use of audits (e.g., of interview and field records), observations (e.g., of interviews, field visits, online PS activities), role plays, and team case reviews (chalk talks) are quality assurance tools for effective supervision.

Supervisors typically maintain a list of all IPS-related passwords and screen or profile names used or referred to by the patients. Supervisors also have access to all exchanges made between DIS and patients, including interview records, field records, IPS logs, and any other electronic or written documentation, in order to evaluate staff activities, provide feedback, and assess quality assurance.

7.2 Training

For IPS to be successful in meeting its program goals, STD/HIV programs will need to provide supervisors and staff with training specific to the use of technology for PS. See Appendix M for a list of suggested trainings. Ongoing support and training for IPS staff are important, as technology is constantly changing. Depending on the training topic, it is often helpful to conduct a pre-training assessment to determine staff's knowledge, attitude, skills, and beliefs about IPS. New IPS staff may also find it useful to "shadow" experienced DIS, particularly when exploring websites frequented by target populations. This helps new DIS gain familiarity with how these sites work and understand the sites from a public health perspective.

As with other PS elements, other key program staff are encouraged to attend trainings on IPS, as needed. For example, it may be beneficial for administrative staff, such as receptionists at STD clinics, to be aware that some patients may use their profile names when coming to a clinic or may only be known to the DIS by a profile name. Ideally, IPS training would include appropriate training for supervisors related to new technologies, the internet, and social networking apps. Staff who supervise DIS doing IPS may find it useful to conduct IPS themselves on a routine basis to evaluate internal systems, processes, and challenges. Staff supervising IPS DIS should have the requisite knowledge at a level equal to or exceeding that of the DIS doing the work.

For Technical Assistance with technology-based partner services, see Appendix N.