Members Present: Rita Castro (Chair), Eric Todd, Tony Matcek, Robert Holtman, Janet Cates, Leatrice Bines

BVCOG Staff Present: Christopher Hamilton, Crystal Crowell

Guests: Heather Clark, School of Rural Public Health

The meeting came to order at 2:06 p.m.

Ms. Clark briefed the committee on the proposals to BVCOG and the final proposal, 300 surveys to be conducted, including a snowball sample to survey people out of care. She noted that the data that was gathered by the Austin Title I council will be used in the analysis.

A question was raised if the survey was being mailed out. Ms. Clark indicated that the survey was not going to be mailed out, but an informational letter would be mailed. Another question was raised about privacy issues and that of consent. It was noted that clients agreeing to receive mail or phone calls have given their consent for their agency and BVCOG, but it does not extend to the School of Rural Public Health (SRPH). One idea to preserve the confidentiality is for BVCOG to mail informational letters to clients. Ms. Cates stated that her clients may be less likely to open or participate in anything that is not coming from their provider. Ms. Castro also noted similar concerns. Ms. Clark said that it would be possible to have the letter sent by each client's provider, to address both the issues of confidentiality and the familiarity of the agency.

Ms. Clark then talked about the informational letter that will be sent out. It will contain three options for clients to participate, 1) clients can mail in the consent to participate indicating a specific date and time to be contacted to participate, 2) clients can call a toll free number during business hours and participate, or 3) clients can schedule a face to face interview. Ms. Clark also noted that there is a need to follow up with clients if they have not responded in order to increase the rate of participation.

Ms. Clark also described the snowball sample that would be conducted. The sample method relies on a word of mouth chain. Clients would be asked if they know of someone not receiving care. If the client does, they will be asked to refer that person to the surveyors for participation. If the out of care person completes the survey, the client that referred will receive an additional incentive. The client may refer up to five out of care people. A question was asked as to what constitutes out of care. Mr. Hamilton noted the HRSA definition which includes one of the following conditions 1) have not received a CD4 test in one year, 2) have not received a viral load test in one year, or 3) have not received ART or HAART medications in one year.

Ms. Clark said that the face to face interviews would take place in a location other than where clients receive services. She said that hotel conference rooms may be used or other similar locations. She also noted that the first thing she must do is submit the survey and proposal to the Institutional Review Board at Texas A&M, which must happen before any work may be started.

A question was asked as to how many surveys would be conducted based on the total number of 300. For the Austin HSDA, the focus will be on rural clients, to help augment the data already collected from that HSDA.
Austin HSDA: 12 surveys
Bryan - College Station HSDA: 77 surveys
Concho Plateau HSDA: 27 surveys
Temple - Killeen HSDA: 64 surveys
Waco HSDA: 90 surveys

Ms. Castro reiterated the idea that $10 incentives might be too low to really encourage participation in the survey and suggested that the committee and project director think about raising the amount.

Ms. Cates and Ms. Castro noted their concerns of preserving client confidentiality and the hesitancy of some clients to open mail or participate in something that does not have the name of the client's agency on it. They did agree to go forward with the assessment process.

Mr. Hamilton indicated that he will be sending the committee more information about the process as it becomes available.

The meeting was adjourned at 2:34 p.m.

Not part of official minutes,
Note to Committee Regarding Follow-Up on Issues Identified:
After the meeting, Ms. Crowell and Mr. Hamilton contacted the Austin Title I council and the Department of State Health Services (DSHS) to see how clients were recruited for the surveys but client confidentiality was preserved. The Title I Administrative Agent representative noted that a database of clients was not used, as is proposed here. They posted flyers and went to AIDS Service Organizations directly to recruit participants. The Planner from DSHS noted that in other areas similar to the central Texas area, the providers mailed out the informational letters, thus preserving confidentiality and clients receiving information from someone they know. Ms. Crowell and Mr. Hamilton then had a discussion with the Project Director from Texas A&M, Heather Clark, and decided to work through the providers to recruit client participation. Ms. Crowell and Mr. Hamilton also calculated that raising the incentive amount to $15 could be worked into the budget; it is within the funds available. A draft of the letter that will be sent to clients will go to providers first to receive feedback before actually being mailed to clients by their providers. Providers will not incur any costs associated with the project, all postage and supplies will be provided by BVCOG