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Table 3 IDEAS implementation E-resource manual for internal facilitator

From: Protocol for evaluating external facilitation as a strategy to nationally implement a novel stigma reduction training tool for healthcare providers

Important contact information

Principal investigator

Available by text, phone call, or email:

Project manager

2. Available by email:

3. Intervention fidelity checklist for implementing OT

Prior to:

â–ª Decide on IDEAS implementation date and provide to project manager

â–ª Provide stakeholder names and contact information (1 manager, 1 OT trainee)

▪ Provide mailing address and confirm receipt of shared assumptions and agreements (received via mail—hardcopy, electronic back-up)

â–ª Provide e-flyer: pre/post-test links, site code, and shared assumptions and agreements to OTs

â–ª Provide call-in details for research team member and panelists; ensure appropriate equipment

â–ª Confirm scheduled panelists with project manager

During:

â–ª Take attendance and inquire about/document reasons for absences

â–ª Remind people of pre-test/post-test

▪ Provide transparent introduction regarding role as the facilitator and capacity for that role Discuss limitations, special skills, and boundaries of the role. Below is an example of what I might personally say when discussing my skills, limitations, and boundaries. You will need to think through what to say regarding your own skills and limitations. You can read the ‘Role’ verbatim or adjust the wording as you see fit while keeping with the general tenets described below.

Skills: I have a background in African American studies and have been doing participatory research in the community focusing on addiction and mental health recovery for the past 10 years. I have been researching arts-based initiatives to enhance meaningful participation and reduce implicit provider bias, stigma, and the harmful impacts of anti-black racism for the past 5 years. I have training as an OT and in facilitating supportive educational and/or therapeutic groups.

Limitations: While I have had many opportunities to participate in and lead this work, my experience is also inseparable from my experiences of privilege in the world as a cis-gender, white woman. I recognize it is critical for me to continuously seek opportunities for increased growth and understanding on ways to help combat the harms that have resulted from centuries of oppression directly related to this country’s history.

Role: My role today is both supported and limited by my own personal experiences—I am here as a facilitator, to hold a space for us to engage in this reflective work of self-discovery, and to encourage continued work as well as the everyday use of what is learned today. My role is to walk us through today’s training, and to ensure that we recognize and uphold a set of shared agreements to promote a safe and supportive space.

â–ª Verbally review shared assumptions and shared agreements; ask group to raise hand in agreement to uphold these throughout

▪ Explain what IDEAS is and isn’t

o IDEAS is an opportunity to attune to/witness others’ stories in order to improve clinical encounters through increased empathy and understanding, and enhanced awareness of personal biases. Watching IDEAS performances allows us to observe our own reactions and grapple with them on our own time so that we have more flexibility with how we respond in the moment with clients.

o IDEAS is NOT a training tool that teaches particular skills or approaches for working with client populations, although performances may contain preferred terminology for addressing certain populations and informational/educational content about the impacts of stigma and institutional racism.

o IDEAS is an adapted, theatre-based intervention (we are not film-makers!) IDEAS performances consist of actors performing the verbatim words pulled from narrative interviews.

â–ª Acknowledge differences in the room and provide trigger warning

o Trigger warning: It is important to note there is some content that may be distressing or triggering for some people in the room—this performance may contain content related to drug use, systemic violence, microaggressions, trauma, and loss.

â–ª Play full film

▪ Zoom in 2–3 panelists and moderate panel discussion

o First, have the panelists introduce themselves

o Optional starter questions:

â–ª What stood out the most in the film?

â–ª What surprised you?

▪ What questions do you have about the film’s content?

â–ª Uphold assumptions/agreements

After

â–ª Email number of attendees and any known reasons for absences to program director

â–ª Ensure receipt of e-gift-cards and distribute to all attendees

â–ª Encourage post-test completion

IDEAS performances

THIS AUTHENTIC PERSON: Stories from transgender and gender diverse people

STORIES OF INEQUITY: Black women’s experiences of discrimination in healthcare

I’M DOING THIS FOR THE REST OF MY LIFE: Stories from people with substance use disorders and other addictive behaviors