CHW Institute - Viviendo Valiente

2022 Community Health Worker Institute

Viviendo Valiente Training Course
The Community Health Worker (CHW) Institute will offer a two-day training using the Viviendo Valiente course – a Special Project of National Significance (SPNS) product developed by Prism Health North Texas. Viviendo Valiente is a health education program which focuses on HIV within the Latino community. The course provides education and skills-building to promote awareness, de-stigmatization, and conversations related to HIV/prevention within the CHW/CHW-I networks.

The two-day training is approved by the following accrediting entities:

New Mexico: Office of Community Health Workers in the state of New Mexico for 14 hours of continuing education units for Certified Community Health Workers (CHW's)

Texas: Texas Department of State Health Services (DSHS) for 14 hours of DSHS certified continuing education units for Certified CHW and CHW-I.

Participation in the full two-day in-person training is required as units cannot be divided. Both the training and curriculum will be in English and only certified CHW and CHW Instructors will be permitted to participate in the training.

Please note that this training will be in-person in Albuquerque, New Mexico in the ECHO Building (1650 Univeristy Blvd NE, Albuquerque, NM 87102 - Conference Room 5900 on the 5th floor). Once this form has been filled out, the conference coordinator will reach out to you to confirm your participation and provide you with additional details on the institute. If the trainings reach maximum capacity, you will be placed on the waiting list.
Read and Understand the aforementioned Institute description: *

Yes, I have
Name *

First Name Last Name
Email *
example@example.com
Are you a CHW or CHW Instructor? *
CHW # *
CHW Instructor # *
I want to attend the training on: *

March 16-17, 2022 March 18-19, 2022
Your Primary Profession/Discipline (Select one) *

Dentist Other Dental Professional Nurse Practitioner/Nurse Professional (prescriber) Nurse Professional (non-prescriber) Midwife Pharmacist Physician Physician Assistant Dietitian or Nutritionist Mental/Behavioral Health Professional Substance Abuse Professional Social Worker or Case Manager Community Health Worker (includes peer educator or navigator) Clergy or Faith-based professional Practice administrator or leader (i.e. chief executive officer, nurse admnistrator) Other allied health professional (specify, i.e. medical assistant, podiatrist, physical therapist) Other Public Health Professional Other non-clinical professional (i.e. front desk staff, grant writer)
Your Primary Functional Role (Select one) *

Administrator Agency Board Member Care Provider/Clinician - can or does prescribe HIV treatment Care Provider/Clinician - cannot or does not prescribe HIV treatment Case Manager HIV tester Client/Patient Educator (includes navigator) Clinical/Medical Assistant Health care organization non-clinical staff (i.e. front desk) Intern/Resident Researcher/Evaluator Student/Graduate Student Teacher/Faculty
Are you of Hispanic or Latino/a origin? *

Yes No
What is your racial background? Select all that apply. *

American Indian / Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White
What is your gender? Select one. *

Female Male Transgender, male to female Transgender, female to male
Which of the following characteristics best describe your principal employment setting? (Select one) *

Academic Health Center Correctional Facility Emergency department Federally qualified Health Center Family Planning Clinic HIV or Infectious Diseases Clinic HMO/Managed Care Organization Hospital-Based Clinic Indian Health Services/Tribal Clinic Long-term nursing facility Maternal/Child health clinic Mental health clinic STD clinic Substance abuse treatment center Student health clinic Other community-based organization Pharmacy Military or veterans' health facility Other federal health facility Private practice State or local health department Other primary care setting My principal employment setting does not involve the provision care or services to patients/clients I am not working (Stop here and click submit.)
List the ZIP codes (up to three) where you provide care and services to patients/clients:
Do you provide HIV prevention counseling and testing services to clients/patients?

Yes No
Do you prescribe HIV pre-exposure prophylaxis (PrEP) to clients/patients?

Yes No
Do you prescribe antiretroviral therapy (ART) to clients/patients?

Yes No
Does your principal employment setting receive Ryan White HIV/AIDS Program funding?

Yes No Not sure
Is HIV care and treatment provided by your principal employment setting?

Yes No
Do you have direct interaction with clients/patients?

Yes No
Do you provide services directly to clients/patients living with HIV?

Yes No
How many YEARS have you been providing services directly to clients/patients living with HIV? Round up to the nearest whole year. If less than a year, write "01"
Estimated the NUMBER of clients/patients living with HIV to whom you provided direct services in the past YEAR:
Which of the following best describes the way you provide services to clients/patients living with HIV:

Provide behavioral or support services, but no HIV treatment (i.e. case management, counseling, cognitive behavioral therapy, transportation, legal) Provide clinical services to people living with HIV, but no HIv treatment (i.e. nutrition, physical therapy, psychiatry, general primary care) Provide basic HIV care and treatment (novice) Provide intermediate HIV care and treatment Provide advanced HIV care and treatment Provide expert HIV care and treatment, which includes training others and /or clinical consultation
Estimate the PERCENTAGE of your clients/patients living with HIV in the past YEAR who are racial/ethnic minorities.

None 1-24% 25-49% 50-74% ≥75%
Estimate the PERCENTAGE of your clients/patients living with HIV in the past YEAR with hepatitis B or hepatitis C.

None 1-24% 25-49% 50-74% ≥75%
Estimate the PERCENTAGE of your clients/patients living with HIV in the past YEAR who are receiving antiretroviral therapy.

None 1-24% 25-49% 50-74% ≥75%
Should be Empty:

2022 Community Health Worker Institute