Table of contents
Introduction
Training guide
Adapting the training manual
Using the Manual
Trainer Preparation
Trainers’ pre-training checklist
Preparing for the workshop
Venue
Workshop logistics
Participants
Facilitators
Learning Styles
Handouts
Module completion certificate
Running the workshop
Before the workshop starts
Starting the workshop
Inititating the first module
Practicalities and 'house-keeping'
Group rules, workshop ethos and practicalities
Confidentiality
Workshop expectations
Facilitating workshop tasks, individual and group contributions
Ensure everyone is contributing
Keep the discussion on track
Clarify contributions
Facilitating Group Discussion
Lecture/Didactic Presentation
Small Group Work/Exercises
Brainstorming
Ending modules/the workshop
Evaluating the training
Workshop Introduction
Introduction goal
Materials and resources required
Introduction time: Approximately 30 minutes
Slide 0.1: Introduction goal
Slide 0.2: Training overview
Module 1: The liver and hepatitis viruses
Introduction
Module goal
Learning objectives
Topics covered
Materials and resources required
Module time: approximately 90 minutes
Slide 1.1: Module 1
Anatomy
Slide 1.2: Location of the liver
Slide 1.3: Location of the liver
Physiology and function of the liver
Slide 1.4: Group work
Slide 1.5: Main functions of the liver
Slide 1.6: Importance of healthy liver function
Structure, types of viruses and reproduction
Slide 1.7: What is a virus?
Slide 1.8: Virus reproduction
Hepatitis and hepatitis viruses
Slide 1.9: Group work
Slide 1.10: Hepatitis and viral spread
Slide 1.11: Hepatitis, liver disease and damage
Liver Good Life – animated film showing liver function
Slide 1.12: Video
Summary
Slide 1.13: Summary learning points
Module 2: HCV transmission and risk prevention
Introduction
Module Goal
Learning objectives
Topics covered
Materials and resources required
Slide 2.1: Module 2
HCV transmission and risk factors
Slide 2.2: Group work
Slide 2.3: HCV transmission
Slide 2.4: Group work
How small is the hepatitis C virus? – an animated film
Slide 2.5: video
HIV and HCV survival in syringes – film on hepatitis C survival research
Slide 2.6: Video
HCV prevention interventions
Slide 2.7: HCV prevention strategy limitations
Slide 2.8: Group work
Slide 2.9: Group work
Does cleaning syringes work?
Slide 2.10: Video
Practice and service delivery improvements
Slide 2.11: Group work
Summary
Slide 2.12: Summary learning points
Module 3: HCV prevalence and course of HCV infection
Introduction
Module goal
Learning objectives
Topics covered
Materials and resources required
Before the training
Module time: approximately 90 minutes
Slide 3.1: HCV prevalence and course of HCV infection
HCV prevalence and public health implications
Slide 3.2: Global prevalence of hepatitis C infections
Slide 3.3: European prevalence of hepatitis C infection
Slide 3.4: The silent epidemic
Slide 3.5: Hepatitis C and public health burden
HCV transmission and injecting drug using populations
Slide 3.6: HCV and injecting drug use in Central and Eastern Europe
Slide 3.7: HCV and prisoners across Central and Eastern Europe
Slide 3.8: The silent epidemic
Liver damage and course of HCV infection
Slide 3.9: Group work
Slide 3.10: HCV and liver damage over time
Slide 3.11: Group work
Slide 3.12: Natural history of HCV progression
Slide 3.13: Acute infection
Slide 3.14: Chronic infection
Slide 3.15: Late stage chronic infection
Slide 3.16: Factors affecting disease progression
Contributory factors to clearing hepatitis C during the acute phase
HCV treatment is most effective during acute infection
Chronic stage
Compensated cirrhosis
Decompensated cirrhosis
Summary
Slide 3.17: Summary learning points
Module 4: Testing and monitoring
Introduction
Module goal
Learning objectives
Topics convered
Materials and resources required
Before the training
Module time: approximately 90 minutes
Slide 4.1
Getting tested: pros and cons
Slide 4.2: Group Work
Slide 4.3: Reasons for and against testing
Who needs access to testing
Slide 4.4: Persons for whom HCV testing is recommended
The main types of test relevant to the diagnosis and management of HCV
Slide 4.5: Group work
Slide 4.6: What tests are relevant to HCV
Slide 4.7: What does European guidance say about testing and treatment for PWID?
Antibody testing
Slide 4.8: Antibody testing - serologic assays
HCV RNA testing
Slide 4.9: HCV RNA testing
Slide 4.10: HCV RNA tests
IL-28B Genotype
Liver function Test (LFTs)
Slide 4.11: Liver Funtion tests
Slide 4.12: HCV tests and what the results mean
Liver biopsy and alternatives
Slide 4.13: Liver biopsy and alternatives
Slide 4.14: Biopsy results
Improving access to testing
Slide 4.15: Group Work
Slide 4.16: Possible HCV testing settings
Slide 4.17: Group work
Summary
Slide 4.18: Summary learning points
Module 5: Testing skills development
Introduction
Module goal
Learning objectives
Topics covered
Materials and resources required
Module time: approximately 90 minutes
Slide 5.1: Testing skill development
Pre-test discussion and giving results
Slide 5.2: Group work
Slide 5.3: Counselling skills
Slide 5.4: Pre-test discussion 1 – risk exposure
Slide 5.5: Pre-test discussion – Preparing for the result
Slide 5.6: Giving negative results
Slide 5.7: Giving positive results
Pre and post-test discussion - Role play
Slide 5.8: Group work
Summary
Slide 5.9: Summary learning points
Module 6: Treatment options
Introduction
Module goal
Learning objectives
Topics covered
Materials and resources required
Module time: approximately 90 minutes
Slide 6.1: Treatment options
Treatment goals
Slide 6.2: Group work
Slide 6.3: Goals of treatment
Choosing treatment – determining individual priorities
Slide 6.4: Considering treatment
Slide 6.5: Individualised treatment
Receiving treatment – personal stories 1
Slide 6.6: Video
Slide 6.7: Group work
Receiving treatment – personal stories 2
Slide 6.8: Video
Overview of conventional treatment
Optimal treatment
Slide 6.9: Optimal treatment of chronic HCV infection
Genotyping for optimal treatment response
Slide 6.10: Recommendations for HCV genotyping
Slide 6.11: HCV Genotypes
Slide 6.12: Distribution of hepatitis C genotypes
Combination therapy
Slide 6.13: Group work
Slide 6.14: Interferons
Slide 6.15: Pegylated interferon
Slide 6.16: Ribavirins
Treatment regimes
Slide 6.17: Treatment regimens
Treatment effectiveness
Slide 6.18: Effectiveness of combination therapy for HCV1
Slide 6.19: Effectiveness of combination therapy graph
Treating cirrhosis
Slide 6.20: Treating cirrhosis
Contraindications to treatment and re-treatment
Slide 6.21: Group work
Slide 6.22: Contraindications to interferon and ribavirin
Slide 6.23: Treatment failure and retreatment
Potential new treatments
Slide 6.24: Potential new treatments
Summary
Slide 6.25: Summary learning points
Module 7: Managing side effects and optimising treatment strategies
Introduction
Module goal
Learning objectives
Topics covered
Materials and resources required
Module time: approximately 90 minutes
Slide 7.1: Managing side effects and optimising treatment strategies
Side effects and implications for treatment
Slide 7.2: Side effects and treatment disruption
Slide 7.3: Group work
Slide 7.4: Minor side effects
Slide 7.5: Major side effects
Treatment management strategies
Slide 7.6: Treatment management strategies
Slide 7.7: Group work
Complementary and alternative interventions
Slide 7.8: Group work
Slide 7.9: Defining complementary and alternative therapies - CAM
Slide 7.10: Herbal supplements for hepatitis C
Slide 7.11: CAM: Key points
Summary
Slide 7.12: Summary learning points
Module 8: Lifestyle and living with HCV
Introduction
Module goal
Learning objectives
Topics covered
Before the training
Materials and resources required
Module time: Approximately 90 minutes
Slide 8.1: Lifestyle and living with HCV
Alcohol and other drugs
Slide 8.2: Group work
Slide 8.3: Impact of alcohol on hepatitis C
Slide 8.4: Alcohol, hepatitis C and treatment
Slide 8.5: Impact of other drugs on hepatitis C
Alcohol
Tobacco
Cannabis
Heroin
Cocaine/amphetamines
Enhancing well-being
Slide 8.6: Group work
Living with HCV
Slide 8.7: Group work
Slide 8.8: Living with HCV
Information, advice and support
Summary
Slide 8.9: Summary learning points
Module 9: Co-infection with HIV
Introduction
Module goal
Learning objectives
Topics covered
Before the training
Materials and resources required
Module time: approximately 90 minutes
Slide 9.1: Co-infection with HIV
HIV/HCV Co-infection
Slide 9.2: HIV/HCV Co-infection
Slide 9.3: Group work
HIV/HCV Co-infection prevalence in PWID
Slide 9.4: Hepatitis C Among Injecting Drug Users in the New EU Member States and Neighbouring Countries
Slide 9.5: WHO European Region HIV/HCV co-infection prevalence
Slide 9.6: Regional challenges to HIV/HCV co-infection
Treatment of HIV/HCV Co-infection
Slide 9.7: HIV/HCV co-infection and treatment implications
Slide 9.8: Impact of HCV infections on HIV disease progression
Slide 9.9: Group work
Slide 9.10: Treatment options people co-infected with HCV/HIV (1)
Slide 9.11: Treatment options people co-infected with HCV/HIV (2)
Summary
Slide 9.12: Summary learning points
Module 10: Treatment quality, stigma and discrimination
Introduction
Module goal
Learning objectives
Topics covered
Before the training
Materials and resources required
Module time: approximately 90 minutes
Slide 10.1: Treatment quality, stigma and discrimination
Hepatitis C and stigma
Slide 10.2: Hepatitis C: status and blame
Hepatitis C: experiences of stigma and discrimination
Slide 10.3: Hepatitis C: experiences of stigma and discrimination
Different populations
Slide 10.4: Cross-cutting factors
Obstacles to the provision of HCV treatment and care
Slide 10.5: (Obstacles to the provision of testing and treatment 1
Slide 10.6: Obstacles to the provision of testing and treatment 2
Slide 10.7: Obstacles to the provision of testing and treatment 3
Good practice in integrated services
Slide 10.8: Good practice example
Obstacles to the uptake of testing and treatment
Slide 10.9: Obstacles to the uptake of testing and treatment
Guidelines on integrated HCV treatment for drug users
Slide 10.10: Current guidance on HCV treatment for IDUs
Slide 10.11: Current guidance on HCV treatment for PWID (1)
Slide 10.12: Current guidance on HCV treatment for PWID (2)
Slide 10.13: Current guidance on HCV treatment for PWID (3)
Summary
Slide 10.14: Summary learning points
Module 11: Advocacy: Next steps and action planning
Introduction
Module goal
Learning objectives
Topics covered
Materials and resources required
Module time: approximately 90 minutes
Slide 11.1: Advocacy: next steps and action planning
The purpose of advocacy
Slide 11.2: What is advocacy?
Slide 11.3: Advocacy
Slide 11.4: Purpose of advocacy
Slide 11.5: Advocacy and enabling
Slide 11.6: Advocacy and empowerment
Slide 11.7 Main models of independent advocacy
Slide 11.8: Group work
Advocacy in practice: action planning
Slide 11.9: Group work
Slide 11.10: Action planning
Slide 11.11: Action planning example
Module 12: Evaluation
Constructivist Evaluation – an exercise
Slide 12.1: Evaluation
The set-up
The process
An alternative process
An introduction to constructivist evaluation
Bibliography
Abbreviations
Downloads
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