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HIV/AIDS EDUCATION
FOR
WORK PLACE AND PERSONAL CHANGE

by
Christine James
B. A., Eastern Washington University, 1987

THESIS SUBMITTED IN PARTIAL FULFILMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
MASTER OF EDUCATION
in
CURRICULUM AND INSTRUCTION

© Christine James, 2001
THE UNIVERSITY OF NORTHERN BRITISH COLUMBIA

April, 2001

All rights reserved. This work may be
reproduced in whole or in part, by photocopy or
other means, without the permission o f the author.

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0-612-62538-9

CanadS

APPROVAL

Name:

Christine James

Degree:

Master of Education

Thesis Title:

HIV/AIDS EDUCATION FOR WORK PLACE AND
PERSONAL CHANGE

Examining Committee:

Chair: Dr. MaxBlouw
Professor, Vice-President (Research)
UNBC

Supervisor: Dr. Paul Madak
Professor and Chair, Education Program
UNBC

Committee Member: Dr. Peter MacMillan
Assistant Professor, Education Program
UNBC

Committee M e n ^ r : Lela Zimmer, BSN, PhD (c)
Assistant Professor, Nursing Program
UNBC

External Examiner: Dr. Theresa Healy
Adjunct Professor, Women’s Studies Program
UNBC

Date Approved:

p ^ X

Il

ABSTRACT

Education for adults, or andragogy, can improve the knowledge and skill base o f employees.
Adults bring a huge variety in personal backgrounds, family experience, religion, education and
expertise to their work place. A disease like HIV/AIDS stigmatizes those it affects, and barriers
can arise in health and service delivery consciously or unconsciously. Work place education or
"training" can address such issues.

This research investigated the effects o f participation in the "Reducing Barriers by Building
Partnerships" HIV/AIDS education program through a descriptive, quantitative research process.
A survey was distributed through health and social service agencies whose staff or volunteers
had taken one to five o f the modules during the past five years. The return rate was 45.2% and
resulted in feedback from 16.4% o f the population o f past participants.

The survey respondents were primarily women, ranging in age from 21-61. Most attended
voluntarily and most were paid for their attendance time. The highest degree o f changes occurred
in the area o f gain in knowledge. In the attitude and behavior questions, the majority responded
that they remained "about the same" and a minority reported positive change. The textual
responses indicated that positive change did occur exemplified by "Ran across homophobic
people and tried to change their opinions" and "I speak with knowledge and therefore pass on
what I learned to stop stigma o f stereotyping". Education did result in positive rather than
negative transfers in knowledge, attitude and behaviors. The learning environment was strongly
praised, indicating an andragogical approach and the successful implementation o f a
transformative learning experience.

Ill

The implications for practice and the recommendations include the necessity o f a strong
theoretical base in the implementation o f adult learning opportimities, the recognition that work
place training situations can include transformational learning experiences to not only improve
service delivery but to strive for a socially responsible society, the need to encourage attendees
o f multi-module training to complete their involvement, and the need to disseminate the research
information. The "Reducing Barriers by Building Partnerships" HIV/ADDS program exemplified
a successful adult training initiative.

TABLE OF CONTENTS

ABSTRACT................................................................................................................................... n
TABLE OF CONTENTS..............................................................................................................v/
LIST OF TABLES......................................................................................................................... vt
ACKNOWLEDGEMENT............................................................................................................ viii
DEDICATION............................................................................................................................... Lx
I.

INTRODUCTION.............................................................................................................. 1

IL

PROBLEM
Statement o f the problem.................................................................................... 4
Significance o f the problem.................................................................................9
Definition o f terms................................................................................................ 11
Summary............................................................................................................... 13

III.

LITERATURE REVIEW
HIV/AIDS education........................................................................................... 14
Adult education and transformational learning................................................ 21
Attitudinal and behavioral change......................................................................29
Contribution o f this research...............................................................................33
Summary............................................................................................................... 35

IV.

METHODOLOGY
Methodology.........................................................................................................36
Target population................................................................................................. 37
Instrumentation.....................................................................................................38
Pilot project...........................................................................................................39
Distribution....................................................................................................
40
Summary............................................................................................................... 41

V.

RESULTS
Data Collection.....................................................................................................43
Demographic Data................................................................................................ 47
Data on BCnowIedge Change................................................................................ 50
Data on Attitudinal Change................................................................................. 51
Data on Behavioral Change................................................................................. 55
Data firom Concluding Comments..................................................................... 62
Representativeness and Validity........................................................................ 69
Volunteer Bias.........................................................................................69
Representativenes................................................................................... 70
Validity.....................................................................................................71
Summary............................................................................................................... 72

iv

VI.

CONCLUSIONS
Conclusions...........................................................................................................74
Has participation resulted in change?....................................................75
Knowledge...................................................................................75
Knowledge and understanding..................................... 75
Previous knowledge.......................................................77
Attitudes.......................................................................................77
Attitudes and confidence levels....................................78
Behaviors..................................................................................... 79
Empathy.......................................................................... 80
Communication..............................................................81
Service provision............................................................82
Advocacy........................................................................ 83
Work place changes.......................................................84
Summary.....................................................................................86
Was the change positive, neutral or negative?..................................... 87
What is the impact o f participation?......................................................89
Analysis o f the learning environment..................................... 89
Was this andragogy?......................................................90
Was this transformative learning?............................... 92
Determinants o f health..............................................................93
Original goals.............................................................................94
Social learning theory............................................................... 96
Impacts beyond past participants.............................................97
Implications for practice.....................................................................................98
Was change necessary?......................................................................... 98
Andragogy...............................................................................................101
Transformational learning..................................................................... 102
Module attendance................................................................................. 102
Delimitations and Limitations........................................................................... 105
Deliminations......................................................................................... 106
Limitations.............................................................................................. 109
Suggestions for further research....................................................................... 111
Recommendations...............................................................................................I l l
Summary..............................................................................................................114

BIBLIOGRAPHY....................................................................................................................... 117
APPENDICES

Appendices A - Q............................................................................ 119-145

VJ

LIST OF TABLES

Table 1:

Persons Testing Newly Positive for HIV by Health Region and Year............6

Table 2:

AIDS Case Reports by Health Region and Year o f Diagnosis.........................7

Table 3:

A Comparison of Assumptions and Designs o f Pedagogy and Andragogy.. 22

Table 4:

Survey Distribution Statistics............................................................................... 44

Table 5:

Modules Attended..................................................................................................47

Table 6:

Year Last Attended................................................................................................ 48

Table 7:

Age.......................................................................................................................... 49

Table 8:

Knowledge Learned...............................................................................................50

Table 9:

Change in Understanding o f Client Situation.....................................................5 1

Table 10:

Changes in Attitude Regarding Situation o f (Client) Groups...........................52

Table 11 :

Thoughts at Work: Textual Responses................................................................ 53

Table 12:

Thoughts Outside o f Work: Textual Responses.................................................54

Table 13 :

Changes in Confidence Level............................................................................... 55

Table 14:

Changes in Empathy Demonstrated at Work...................................................... 56

Table 15 :

Changes Regarding Discussion o f (Client) Groups at Work: Textual
Responses................................................................................................. 57

Table 16:

Changes in Service Provision at Work: Textual Responses............................. 58

Table 17:

Changes in Advocacy at Work: Textual Responses...........................................59

Table 18:

Changes in Work Place due to Staff Participation: Textual Responses...........60

Table 19:

Changes Outside o f Work Place Regarding Discussions o f (Client)
Groups: Textual Responses.................................................................... 60

Table 20:

Changes Outside o f Work Place in Personal Advocacy: Textual
Responses................................................................................................. 61

Table 21 :

Most Liked Aspects o f Woricshops: Textual Responses....................................63

vu

Table 22:

Least Liked Aspects o f Workshops: Textual Responses.................................. 64

Table 23:

Usefulness o f Workshops in Work Place: Textual Responses.........................65

Table 24:

Usefulness o f Workshops in Personal Life: Textual Responses......................66

Table 25:

Other Comments Regarding the Workshops: Textual Responses................... 67

Table 26:

Category Totals for All Textual Responses........................................................68

Table 27:

Grouping o f Textual Comments: Summary....................................................... 68

Vllt

ACKNOWLEDGEMENTS

I would like to gratefully acknowledge the many individuals who have supported and assisted me
in the completion o f this thesis, and in the attainment o f my Master’s Degree.
First o f all, thank you to my committee for your sharing o f your expertise and knowledge. As my
advisor, Paul, you gently and specifically steered my progress. Peter - your statistical, software,
and specific research knowledge were very helpful. Lela - your commitment to the “Reducing
Barriers by Building Partnerships” program, both in its development and in this research has
been so positive. Thanks also to my external examiner, Theresa, for your insightful direction.
Many, many thanks to AIDS Prince George for encouraging this research to occur. Olive - your
role was a key. Your belief in my abilities and your commitment to investigation through
research helped greatly. Mary - your contribution to this AIDS Education program is reflected in
the positive comments from participants. Gail - your assistance was invaluable, many thanks for
your patience and your humor. Thanks to all !!
To Joyce o f Bellamy Road Day Care: your love for my children, and your flexibility in the
arrangement o f their care was also a key aspect in the completion o f this research and degree.
Thank you for your very special work.
The contribution o f my friends to the care o f my children during classes, meetings and
homework has left a deep impression with me. To Ann (and Dougie !), to Pat (miss you !!), and
especially to Sandra (miss you so much !!): thank you for the loving care and time you gave to
us. Thank you also for your ongoing support and friendship.
A heartfelt thanks to my co-workers at Rainbow Adult Day Centre and Parkside and Rainbow
Intermediate Care Homes, and to my “boss” Tim for your interest in, patience and flexibility
with, and support o f me during not only this research but throughout this Masters program.
Thanks especially to my job partner Carla, for your belief in and advocacy for our job share
position - 1 couldn’t have done this without you.
Thank you to Julie Anne in the Office o f Social Research at the University o f Northern British
Columbia for your assistance with the data entry, and your patience with all my questions and
requests.
Many thanks to my husband Lome for his ongoing support, time, (finances!!) and everything
during these past five years.
And thank you to my parents for bringing me up in an environment that modeled and encouraged
both lifelong learning and reaching for one’s dreams.

LX

DEDICATION

In an environment o f lifelong learning,
and
In the spirit o f working towards positive change in our world,
I dedicate this work to my children.

CHAPTER I: INTRODUCTION

Epidemics have far-reaching social consequences. Public
knowledge that an invisible microbe is causing illness and
death can bring irrational fears and widespread panic... The
social sanctions suffered by victims o f disease fît well under
the broader rubric o f social stigmatization... The social
construction o f HIV/AIDS ... has made it among the most
stigmatizing medical conditions in modem history.
(Kalichman, 1995, p.191-192)
The acronmyms HIV and AIDS evoke an emotional response. We respond internally to the fear
associated with the disease process and with fear in our varied understanding o f the transmission
process. We respond to the stigma associated with this disease, and we consider the potential
sources o f infection in each individual. Sometimes we respond externally through our behavior,
ranging from changes in our communication style to responses as severe as ridicule, assault and
abuse. As a society, we have difficulty in coping with this medical condition.

For an individual with HIV or AIDS, societal response can result in many challenges. Tross and
Hirsch’s (1985) study (as cited in Kalichman, 1995, p. I l l ) found that “A positive HIV antibody
test result can lead to loss o f employment, the threat o f eviction, denial o f health and life
insurance, refusal o f professional services, and denial o f health and dental care”. Although this
quote is fifteen years old, these challenges still remain. The challenges exist not only for the
individual, but also for his/her family, fiiends and significant others. Stigma exists, and can have
a disturbing and negative impact on many aspects o f their lives.

In the central interior region o f British Columbia, the number o f individuals who have tested
positive for the HIV virus continues to grow. As a region, we have a commitment to supporting

individuals in remaining within their community. Individuals with HIV/AIDS need access to a
wide variety o f services to address the changing aspects o f their medical condition. This may
involve the services o f a number o f health and social service agencies, and may involve dealing
with many professionals and front-line staff throughout the course o f their disease process.

Health and social service agency employees are members o f the broader community, and as such
they are often a reflection o f their community. As adults, they bring to their workplace a great
variety in background experiences, education, family upbringing, religious viewpoints, and
communication skills. This range results in a broad spectrum o f professional behaviors in
working with clients who have or are impacted by HIV/AIDS. Positive and unfortunately some
negative interactions can occur. These interactions can have an impact on an individual’s ability
to maintain themselves in our community. The interactions also can impact an individual’s
ability to live a life o f dignity.

In 1993, AIDS Prince George developed a proposal to encourage social change through
education. They received funding through the federal AIDS Community Action Program
(ACAP) to design, develop, implement and evaluate an educational program designed for
employees o f health and social service agencies. The program became the fifteen hour, five
module series entitled “Reducing Barriers by Building Partnerships”. The modules are a)
“HIV/AIDS lO l”, which introduces the disease and its transmission; b)”The impact o f
HIV/AIDS on those infected and affected”, which explores the needs o f victims as well as their
families and friends in preparing and dealing with the disease and death; c) “Homophobia,
heterosexism and HIV/AIDS ”, which explores the feelings, attitudes and stigmas associated with
the gay and lesbian portion o f our population; d) “HIV/AIDS and First Nations people”, which

provides historical and current information on the rising rates o f HIV/AIDS among this
population; and e) “HIV/ADDS in a diverse community”, which mentions other populations such
as intravenous drug users and encourages us to accept the diversity which exists within our
communities. The titles and objectives for each module are listed in Appendix A. The program is
unique in a number o f ways: it addresses not only the technical or medical aspects o f the disease
but also the social and emotional impacts, it provides information on marginalized groups in
society which have either been associated with HIV/AIDS or are currently at greater risk o f
transmission o f the disease, it encourages participants to examine their attitudes and values
towards this disease and towards marginalized groups, and it examines the role that the social
determinants o f health play in the constellation o f factors associated with HIV/AIDS. The
program has been offered only within the central interior region o f the province o f British
Columbia and during the last five years. The program has been hosted through health and social
service agencies to their staff and volunteers as a work place education initiative.

The education o f adults, or andragogy, is an intrinsic component o f most work places.
Workshops and inservices assist in not only the ongoing training o f adults to achieve the best
service possible, but also assist in ensuring that the social climate, philosophy o f operation, and
policies and procedures are shared by all employees and associated volunteers. Education can
also be a process for change. Transformational learning is the process o f educating for personal
change and for external change in relation to improving the society around us. In this case, the
core content o f the educational program is HIV/AIDS. However, the program moves far beyond
this topic in addressing emotional, social, cultural, and historical factors. This thesis research will
examine the impacts o f the work place educational program, "Reducing Barriers by Building
Partnerships".

CHAPTER 0: THE PROBLEM

Statement o f the Problem

There are a variety o f factors that influence the health o f a population.
These include income and social status, social support networks,
education, employment and working conditions, social environment,
physical environment, personal health practices and coping skills,
healthy child development, health services, gender and culture.
Health should therefore not be viewed exclusively in terms o f
illness and death but rather as a dynamic state that individuals and
communities strive to achieve and maintain. Information on the
major social and economic trends and variations in health status
and understanding o f health issues is important. This information
provides a better understanding o f health issues so the changing
needs o f services can be anticipated and new strategies developed
to improve health.
(Northern Interior Regional Health Board, 2000, p. 6)
"Information on

and understanding o f health issues is important" (NIRHB, 2000, p. 6). These

key words set the stage for this thesis research, "HIV/AIDS Education for Work Place and
Personal Change". Service providers need current, applicable, non-judgmental knowledge and
understanding o f health issues in order to provide the best service possible to their clientele.
Individuals with HIV or AIDS, families and friends o f individuals with HIV or AIDS, and
members o f marginalized groups in society deserve the best service possible in order to address
their health needs. As mentioned above, the social determinants o f health encompass a variety o f
factors. This section o f the thesis will examine a number o f the social determinants characteristic
o f the central area o f British Columbia, establish that HIV and AIDS continue to arise, explore
the historical process which led to the establishment o f the workshop series "Reducing Barriers
by Building Parmerships", describe the problem which led to the development o f this study, and
begin defining the research and its variables.

The Health Services Plan 2000-2003 for the Northern Interior Regional Health Board (NIRHB)
identifies this region as accounting for 3% o f the province’s population (p. 6 - 7). Thirty-one
percent o f this population is under the age o f 19, and 63% falls between the ages o f 20 and 64
years. The portion o f the elderly o f 65+ years (7%) is lower than the provincial average o f 13%.
In terms o f education, the report stated that “In 1996,4% o f the NIHR population had a trade
level education, 28% had a non-university level education, and 16% had a university level
education” (2000, p. 7). The last statistic for university level education is far less than the
provincial average o f 25%. The Northern Interior portion o f British Columbia is a resource based
area, with a population that is traditionally working class. The economy relies heavily on the
forestry sector, with mining, manufacturing and tourism being significant employment areas
(2000, p. 5). The aboriginal population totals 9% o f the regions’ population, and “Aboriginal
persons have a considerably stronger representation in the Northern Interior Health Region than
throughout British Columbia (British Columbia Aboriginal population, 4%)” (NIRHB, 2000, p.
7).

The British Columbia Center for Disease Control publishes statistics on HIV and AIDS. The past
participants o f the “Reducing Barriers by Building Partnerships” modules have come primarily
from the Northern Interior Health Region’s communities o f Prince George, Vanderhoof and
Bum ’s Lake. The workshop series was also offered once in the Cariboo Health Region’s
community o f Williams Lake and associated rural areas. As well. Prince George is recognized as
a regional referral center for health issues for the entire northern portion o f the province.
Therefore, the tables below contain information from both the Northern Interior and the Cariboo
Health Regions plus information from British Columbia as a whole. Table 1 identifies the
number o f persons who newly tested positive by health region from 1994 to 1999. However the

totals may be misleading. “An HTV positive test report is designated to the appropriate HEALTH
REGION according to the location o f the phvsician/clinic site where the person was tested”
(MacDougall, Rekart, Knowles, Spencer & Elliot, 1999, p. 37). Therefore, if an individual is
concerned about stigma, lack o f privacy, lack o f services, or any other real or perceived barrier,
they may travel to another region o f the province to be tested. Their test and their result will then
be tallied within the region where the test occurred. Regardless, the following table indicates that
positive tests for HIV continue to occur within the two local health regions.

In Table I, the “Rate” rows are the rate per 100,000 population. The “Tests" rows are the number
o f HIV tests performed at the provincial laboratory including positive and negative results. The
Total column is cumulative from 1989 - 1999, although amounts for 1989 - 1993 are not shown.

Table 1
Persons Testing Newlv Positive for HIV bv Health Region and Year
Health Region

HIV

1994

1995

1996

1997

1998

1999

TOTAL

Northern Interior

persons

8

5

2

4

2

4

52

rate

6.47

3.95

1.55

3.03

1.50

3.00

tests

3426

3989

4034

4099

3981

3700

persons

2

2

3

2

1

rate

2.90

2.82

4.09

2.64

1.3

tests

1,088

1627

1738

1979

1861

persons

840

690

714

561

482

427

rate

22.82

18.23

18.39

14.17

12.02

10.55

tests

104,118

130,338

138,250

140,278

137,701

135,284

Cariboo

British Columbia

33,027
18

12,729
7283

1,085,630

(MacDouga 1, Rekart, Knowles, Spencer & Elliot, 2000, p. 37)

Table 2 shows the AIDS case reports by year o f diagnosis. In this table, the report is “designated
to the appropriate HEALTH REGION according to the patient’s place o f residence at the time o f
his/her diagnosis o f AIDS (ie. first disease indicative o f AIDS)” ( MacDougall et al, 2000, p. 11).
This information is, then, more specific to the region the individual lives in. However, it does not
account for information should an individual chose to move upon diagnosis or at any point in the
disease process. Individuals may chose to return to their home community or to a community
with strong familial or friendship supports, or move for any other reason. The information below
therefore does not provide us with data on the number o f individuals with AIDS who are living
within a region at any given time. Table 2 is structured in approximately the same format as
Table 1, using the terminology o f cases instead o f persons, and eliminating the tests row.

Table 2
AIDS Case Reports bv HEALTH REGION and YEAR OF DIAGNOSIS
Health Region

HIV

Northern Interior

Cariboo

British Columbia

1994

1995

1996

1997

1998

1999

TOTAL

cases

I

2

5

3

2

19

rate

0.79

1.55

3.78

2.25

1.50

cases

1

I

rate

1.36

1.31

cases

292

252

154

138

133

103

rate

7.93

6.66

3.97

3.49

3.32

2.55

7

2880

(MacDougall et a ,2 0 0 0 , p . 11)
AIDS/HIV is a medical condition which carries with it associated stigma unprecedented in this
century (Kalichman, 1995, p. 192). For those living with or impacted by HIV/AIDS, this stigma
can add challenges to the already existing difficulties in living with the physical disease process.

All o f us in society have the right to live and die with dignity. For those with HIV/AIDS, this has
not always been easy.

The Prince George AIDS Society embarked on a series o f community and consumer
consultations in 1993 in order to determine the future direction o f the organization, and the
service needs o f consumers. In 1995, they applied for AIDS Community Action Program
(ACAP) federal funding to further assist with the development and evaluation o f a project
entitled “Reducing Barriers by Building Partnerships”. In their application, they stated that “We
have identified the many barriers to service for people living with HIV/AIDS as the need to be
addressed at this time” (AIDS PG, 1995, p. 3). This statement was clarified further on page 7, in
saying “We will address the barriers to equitable service for people living with HIV/AIDS such
as stigma, ignorance and fear by workers in the human services”, and on page 8 with “Local
people living with HIV/AIDS (PLWHIV/AIDS) are articulating their desire and need to remain
in their home community and to be able to access the support and services they need to ensure a
good quality o f life”.

The project initially aimed to assist in developing stronger communication channels between
service providers, and to strengthen the social community within the service agencies through the
education process. The goals were further refined in the statements “to provide knowledge and
foster insight in health care and social service agencies in order to ensure sensitive, adequate,
accessible service and care for those living with HIV/AIDS in Prince George” (Walmsley &
Keith, 1998, p. 4). The second goal was “to strengthen social environments in social and health
service agencies for persons living with HIV and AIDS” (Walmsley & Keith, 1998, p. 4). This
thesis research investigated the impacts o f participation in this educational program, and

explored the participants’ perception o f personal and work behavior change. Research to
investigate the results o f an educational intervention helps in understanding the benefits and
drawbacks o f the educational process.

The “HIV/AIDS Education for Work Place and Personal Change” research investigated the
effects o f participation by health and social service agency employees in the AIDS Prince
George’s “Reducing Barriers by Building Partnerships” educational program. As such, I looked
for specific information based on specific questions. As this was a descriptive study it sought to
answer research questions rather than to test an hypothesis.

This inquiry targeted past participants o f the workshop series in the investigation o f three
research questions, “Has participation in the 'Reducing Barriers by Building Partnerships'
program resulted in changes in your knowledge, attitudes, beliefs and/or actions on a personal
level and in your workplace?” The second question was “Has your participation resulted in a
positive, negative or neutral transfer or change?” This second question will be further clarified in
the literature review section o f this proposal. The final summarizing question was as follows
“What is the overall impact o f participation in the 'Reducing Barriers by Building Partnerships'
program?”

Significance o f the Problem

The “Reducing Barriers by Building Partnerships” educational program series pilot project ran
&om 1996-1998. The evaluation plan was designed in advance o f the implementation o f the
sessions. AIDS Prince George gathered quantitative data in a pre-test and post-test format as well

10

as qualitative data to evaluate the program. The pre-test and post-test questions asked
participants about changes in knowledge and attitudes regarding the technical content and the
population groups discussed in each module. Each module was analyzed statistically using the
software program "Statistical Package for the Social Sciences" (SPSS), with Module One
information at a nominal level and performing two-way chi-square tests, and Modules Two
through Five analyzed using the Mann Whitney U test for ranked or ordinal data for non-paired
results (Walmsley & Keith, 1998, p. 13). The qualitative evaluation component included
questions such as “The most important thing I learned today w as...”, “As a result o f this
workshop I w ill...” and “What would you change about this module...” (Walmsley & Keith,
1998, p. xvi-xvii). The evaluation was compiled in 1998 and included the summary statements as
follows: “It appears that in general, the learning objectives for each module were met. It was
evident that the program participants were extremely positive about the modules and there were
very few negative or critical comments” (Walmsley & Keith, 1998, p. 5). The report suggested
further evaluation o f the “Reducing Barriers by Building Partnerships” program using a
qualitative research design.

The “HIV/AIDS Education for Work place and Personal Change” thesis research addressed the
suggestion for follow-up inquiry into the program. It was determined that a quantitative and
descriptive research design would provide further information from a greater number o f past
participants than a qualitative research design. The initial evaluation had provided surface input
on whether the participants enjoyed the program and learned from the program. From this initial
information, several areas for further investigation arose. Did the workshop series make a
difference in the personal lives and work lives o f the program participants in the months and
years following the workshops? Did the educational program results in changes in attitudes

Il

and/or changes in behavior? How did this gain in knowledge translate into changes in the work
place? What aspects o f the learning environment contributed to the participants' enjoyment o f the
program? Further evaluation and inquiry would provide deeper insight into the effects o f this
educational program.

Nationally, the AIDS/HIV health community has recognized the need for more evaluation and
research in its programs. AIDS Prince George staff members are currently participating in both
provincial and national committees to assist in developing frameworks for research and
evaluation. This study is timely in that it contributes to the knowledge base at a time when the
importance o f such inquiry is recognized among the HIV/AIDS health community. The
information in this research will be disseminated not only locally but also provincially and
nationally through a variety o f academic means.

Definition o f terms

The “HIV/AIDS Education for Work Place and Personal Change” thesis research involved the
use o f a survey (see Appendix B) to gather input from past participants o f a workshop series.
This section will define the basic concepts and terms in relation to the process o f the inquiry and
the content o f the survey instrument.

This inquiry examined the process o f change through education. The term education refers to
“the act or process o f acquiring knowledge” and “the knowledge or training acquired by this
process” (Collins, 1995, p. 409). Change is defined as “to make or become different; alter” and

12

“the act or fact o f changing or being changed” (Collins, 1995, p. 221). As the participants o f this
program were adults, the framework o f this educational opportunity falls within the field o f adult
education, or andragogy.

The goals o f the “Reducing Barriers by Building Partnerships” program were to strengthen social
environments, and to provide knowledge and foster insight within health and social service
agencies. The challenge was to operationalize these goals into identifiable and measurable
variables. To do so, this research focused on some work place and personal experiences which
respondents could self-measure. The concept o f change can be defined as any movement,
whether positive or negative, as reported by the programs’ past participants. The survey opened
with a section on demographics, in order to gather generic information. The survey’s three
central sections consist o f sections entitled knowledge, attitudes, and behaviors or actions.
Broadly speaking, these are the three variable areas. The dictionary defines knowledge as “the
facts or experiences known by a person or a group o f people” (Collins, 1995, p. 724). The word
attitude is defined as “the way a person views something or tends to behave towards it, often in
an evaluative way” (Collins, 1995, p. 78). The term behave is listed as “to act or function in a
specified or usual way” (Collins, 1995, p. 114) while behavior is defined in psychological terms
as “the response o f an organism to a stimulus” (Collins, 1995, p. 114). These variable areas were
further considered in terms o f knowledge, understanding, confidence level, empathy, discussion
o f clients and client groups, advocacy, service provision, and work place changes. Additional
categories o f usefulness, helpfulness, and situational reflection provided data relating to the
impact o f participation in the workshop series. This study requested that respondents measure
their own changes in the above areas, through a process o f self-reflection. Respondents were
asked to decide themselves what the impact o f their own participation was. This research did not

13

set standards or use external measurement processes. The methodology section will further
clarify the research procedures.

Summary

Living with dignity, access to services and the ability to remain in one’s own community are
issues which face individuals infected with and impacted by HIV/AIDS in the central interior o f
British Columbia (AIDS PG, 1995, p. 3 ,7 ,8 ). The non-profit organization AIDS Prince George
developed and implemented an education program directed towards health and social service
agency employees and volunteers in order to provide knowledge and foster insight into
HIV/AIDS. The program has been in existence for five years. The “HIV/AIDS Education for
Work Place and Personal Change” research investigated the impacts o f participation in the
“Reducing Barriers by Building Partnerships” education program. The research explored the
knowledge, attitudinal and behavioral changes in relation to personal and work place change.
The inquiry requested infomiation based on the perceptions and self-reflection o f the workshop
series' past participants. The provision o f such education and the implementation o f this research
are vital components in the process o f education for social change

14

CHAPTER ni: LITERATURE REVIEW

The process o f personal and professional change through education is the primary concept
explored in this thesis. However, the topic area is multi-disciplinary in nature due to a number o f
factors. The provision o f opportunities for learning places the primary focus in andragogy, or
adult education. The provision o f services to individuals with or associated with HIV/AIDS
places the setting in both health care and social services. The examination o f stigmas and
attitudes or beliefs touches upon sociology, the process o f attitudinal and behavioral change falls
within psychology, and the implementation o f work place training is most often encountered in
business literature. In order to examine the basis or need for both the provision o f the educational
program and for the research itself, this section will first explore education in health care
settings, beginning with HIV/AIDS education.

HIV/AIDS education

Professional, non-judgmental and timely service provision will affect not only the client's health
and social situation, but will also assist in reducing real or perceived barriers to the access o f
service. However, service providers are also individual adults with a variety o f historical
influences including education, religion, family upbringing, culture, and other factors which
impact their actions consciously or unconsciously. Staff who work with HIV/AIDS clients and
families can themselves have complex emotional reactions.

15

Nurses, for example, may experience conflicts between their personal
mores about sexuality, homosexuality, and drug use, which are based
on religious beliefs and upbringing, and their professional responsibilities.
Phobias about becoming infected with HIV, combined with fear o f
death and dying, cause considerable stress on the job, adding a
dimension that must be addressed by educators.... An organization
focused educational program approach can go beyond changing
individual professional attitudes and utilize peer influence to create
positive group norms.
(Dworkin, 1992, p. 673)
Literature in HIV/AIDS education speaks to the need for the ongoing education o f service
providers. In AIDS Education for Health Care Professionals in an Organizational or Svstems
Context. Joan Dworkin (1992) explained that:
...health care for persons with acquired immunodeficiency syndrome
(AIDS), and members o f their families, mainly is delivered within health
and human services organizations
Addressing organizational,
community and health care delivery system issues as part o f an
education program provides a forum for defining problems and a basis
for uniting professionals and developing solutions, (p. 668)
Dworkin points out that administrators and front line staff are actually gatekeepers in terms o f
service provision, and that one o f the goals o f education is to “change or improve attitudes and
behavior toward affected persons” (Dworkin, 1992, p. 670). There is a need to “prepare health
professionals to care for persons affected by HIV” (Dworkin, 1992, p. 670). She also reminds us
that HIV/AIDS affects not only the identified patient but also the entire family.

Dworkin further explored this topic in relation to the larger community in which health and
social service agency personnel work and live.
Many o f the organizations in which they work are microcosms
o f their communities, reflecting the diversity o f attitudes,
beliefs, fears, and misinformation found in the general
population. Some professionals share the views o f their
community; others do not and attempt to change those
around them; others must work in a hostile environment (p. 674).

16

Dworkin concluded by encouraging the sharing o f knowledge, and the development o f a multi­
disciplinary approach in the provision o f services to individuals infected with and affected by
HIV/AIDS. This article was by far the most comprehensive and the most relevant to this research
as it speaks to the need for education o f health care professionals on preparation for caregiving.
As well, the article addresses societal and personal attitudes and emotions as does the “Reducing
Barriers by Building Partnerships” program.

The right to refuse to provide services to clients is an issue that one does not expect will arise in
health or medical services. However, the nature o f HIV/AIDS and its associated stigmas have
resulted in documented situations o f this attitude and behavior. Randall, Bryce, Bertler, Pope
and Lawrenchuk (1993) investigated “knowledge and attitudes related to human
immunodeficiency virus (H IV )... among 807 state and 2797 local public health personnel in
Michigan” (p. 127). One o f their findings was that “32.4 percent believed that they should have
the right to refuse treatment, and 9.4 percent reported that they would not be willing to provide
routine public health services to an HIV-infected client”(Randall et al, 1993, p. 127). They
concluded that “... public health personnel are in need o f HIV education that focuses on... the
development o f appropriate attitudes toward persons infected with HIV” (Randall et al, 1993, p.
127). The results o f this study are quite shocking, and greatly reinforce the need for health and
social service personnel oriented education programs such as the “Reducing Barriers by Building
Partnerships” program.

The above resource items described HIV/AIDS education directed towards the same target
population as this research, which was service providers in health care with the purpose o f
education for social or work place change. The field o f HIV/AIDS education often focuses on the

17

area o f prevention. Education for prevention teaches individuals about the disease itself, the
means o f transmission, strategies for reducing this transmission and the associated behavior
changes which are needed. For this review o f the literature, I perused thirteen resource items
including journal articles, a conference proceeding, and a 300 entry bibliography. The vast
majority o f these (twelve out o f fourteen resources) explored education for prevention among
various members o f the public. However, many o f the resources addressing education for
prevention did discuss attitudinal change, behavioral change and research characteristics that are
relevant to this thesis research. The literature overwhelmingly speaks to the positive results of
education in affecting knowledge levels about the topic o f AIDS/HIV, as shown in Dworkin
(1992), Randall et al (1993) and Strauss et al (1992).

Strauss, Corless, Luckey, van der Horst & Dennis, 1992 explored the impacts o f education on
future community and professional leaders in an HIV/AIDS prevention education program for
students at the University o f North Carolina. The authors stated “AIDS was dealt with in this
course not only as a disease, but also as a case study o f how societies deal with contagion,
stigma, disability, death, social stratification, and access to scarce resources” (Strauss et al, 1992,
p. 569). The research used pre-test and post-test methods to examine attitudinal and cognitive
changes over the period o f the course. They state “the literature on the impact o f AIDS education
suggests that knowledge and attitude changes do occur over the course o f educational programs”
(Strauss et al, 1992, p. 570). Again, the right to refuse to provide care arose.
Attitudes toward the rights o f health workers to refuse to
care for persons infected with HIV changed over the course
period. There was a significant reduction in the percentage
o f those who indicated that physicians (-13.7%) and nurses
(-13.5%) had such a right. Attitude changes were found,
demonstrating by the course end increased understanding and
tolerance for persons who are HIV positive” (p. 571).

18

Does the process o f education always result in positive changes? One o f the literature resources
used an electrifying title to draw attention to its content. In AIDS Education may Breed
Intolerance Yam (1991) quoted organizational behavior researchers at the Georgia Institute o f
Technology who state that “a little education may be worse than no education at all” (Yam,
1991, p. 30). The author suggests that programs which are less than 45 minutes in length can
result in workers being less tolerant o f individuals with or impacted by HIV/AIDS. He goes on to
state that “In contrast, longer programs, those lasting more than two hours, improved the
attitudes o f employees” (Yam, 1991, p. 30). This article did not specify the occupations o f the
employees, nor the research setting, methodology or reference information. However, this was
also a very short article o f six paragraphs only. The distinction in the length o f presentations
needed does provide some positive reinforcement for the “Reducing Barriers by Building
Partnerships” program, as it consists o f five modules which are each three hours in length.

The next two literature resources focus on education for prevention (Kirby, Short, Collins, Rugg,
Kolbe, Howard, Miller, Sonenstein and Zabin, 1994) and (WHO, 1990). These articles refer to
changes in various public groups regarding transmission, whereas this research deals with staff
members and volunteers who work with individuals infected by or affected by the disease.
However, the articles do contain several relevant points. In School-Based Programs to Reduce
Sexual Risk Behaviors: A Review o f Effectiveness, authors Kirby, Short, Collins, Rugg, Kolbe,
Howard, Miller, Sonenstein and Zabin (1994) reviewed 23 studies o f school-based programs in
order to investigate the distinguishing characteristics o f the programs they deemed effective in
reducing sexually risky behavior. The researchers identified six characteristics, the majority o f
which deal with specifics on sex education which are not applicable here as this research focuses
on changes in knowledge, attitudes and behaviors in the work place and in personal life.

19

However, the second characteristic is relevant, and is as follows: “In general, the effective
programs were based upon theoretical approaches that have been demonstrated to be effective in
influencing other health-risk behaviors: for example, social cognitive theory, social influence
theory, social inoculation theory and cognitive behavioral theory” (Kirby et al, 1994, p. 353).

The marked need for education o f health care professionals regarding HIV/AIDS, and the
ongoing need for appropriate evaluation o f HIV/AIDS programs are the most important issues
for this research. The proceedings document from the World Health Organization 1990
Consultation on the Monitoring and Evaluation o f AIDS Education/Health Promotion Programs
contains the following item:
Attitudes toward people with AIDS reflect mixed sentiments.
While most people have expressed feelings o f compassion,
many would not work with a person with AIDS. There is some
evidence to suggest that accurate knowledge is associated
with less stigmatizing attitudes and fewer unnecessary personal
anxieties.
(p. 5)
This again speaks to the not only the stigmatization that occurs with HIV/AIDS, but also to the
outcomes o f an educational process in terms o f attitudes and emotions. The report encourages
A continued investment in national educational programmes for
the general public....in order to maintain high levels o f awareness about
HIV/AIDS....correct widely prevalent misinformation and myths, and
counteract discrimination and stigmatization. .. And improve the quality
and depth o f people’s knowledge... (p. 6)
The World Health Organization's 1990 consultation included thirteen representatives from
eleven countries, whose purpose was to “examine the practical relationship between monitoring
and evaluation studies and decisions concerning the development and implementation o f health
education and health promotion programs for AIDS prevention” (WHO, 1990, p. 1). The
consultation team discussed the conclusions and lessons learned from existing programs,
examined and listed the technical challenges inherent in the evaluation and monitoring processes,

20

considered a number o f means of addressing organizational barriers to monitoring and
evaluation, and developed 10 recommendations for national and regional WHO programs. The
report also stated that:
The evidence o f behavioral change in the general population is
weak. Educational programmes for the general public can be
made more effective if messages and materials are pretested on
representative members o f the target audience
and supported
by the provision o f adequate and accessible services... (p. 5)
This report reinforces the need for research examining the effects o f an HIV/AIDS educational
program, in order to further develop the knowledge base on attitudinal and behavioral change.
This also speaks to the need for educational opportunities which are well planned and
implemented. This inquiry will investigate the learning environment o f the "Reducing Barriers
by Building Partnerships" workshop series, in order to learn about the successful and the
unsuccessful factors in the implementation o f the program.

Although this report is speaking to national and regional AIDS/HIV programs, the above quotes
again reinforce the goals o f our local workshop series by reinforcing the role o f education in
changing attitudes and in increasing accessibility to services for individuals with and impacted
by HIV/AIDS. The report continues in stating that:
Monitoring and evaluation can help those concerned to track
progress, assess effectiveness, measure impact, calculate cost
efficiency and improve the planning o f programmes. They also
disseminate information about the experience gained, (p. 6)
The report therefore provides support for the need for research such as this thesis: research that
examines the effects o f education. The first research question "Has participation in the 'Reducing
Barriers by Building Partnerships' program resulted in changes in knowledge, attitudes,
behaviors and/or actions on a personal level and in the work place" speaks directly to the

21

problem areas identified in working with individuals infected or affected by this disease and with
associated and other marginalized groups in society.

Adult education and transformational learning.

The field o f adult education recognizes that adults are different from children in their learning
needs, situations and processes. This section o f the thesis will introduce the concept o f adult
education, define and describe this field o f education, introduce the category o f transformational
learning, and explore several frameworks for positive and productive adult learning
environments.

Throughout history, the word education has been viewed more in terms o f children than in terms
o f adults. The theory o f education was known as pedagogy. "The label 'andragogy'... is based on
the Greek word aner... meaning 'man not boy' or adult (Knowles, 1980, p. 42) was developed in
Europe. Researcher Malcolm Knowles first introduced this term into North America in 1968.
The comparisons between pedagogy and andragogy are shown in Table 3 on the following page.

22

Table 3
A Comparison o f Assumptions and Designs o f Pedagogy and Andraeoev

ASSUMPTIONS
Self-concept
Experience
Readiness
Time perspective
Orientation to learning
DESIGN ELEMENT
Climate

Pedagogy

Andragogy

Dependency
O f little worth

Increasing self-directedness
Learners are a rich resource for
learning
Developmental tasks o f social roles

Biological development, social
pressure
Postponed application
Subject-centred
Authority-oriented
Formal
Competitive

Planning
Diagnosis o f need
Formulation of ob jectives
Design

By teacher
By teacher
By teacher
Logic of the subject matter

Activities
Evaluation

Transmittal techniques
By teacher

Immediacy of application
Problem-centred
Mutuality
Respecthil
Collaborative
Informal
Mechanism for mutual planning
Mutual self-diagnosis
Mutual self-negotiation
Sequenced in terms of readiness
Problem units
Experiential techniques (inquiry)
Mutual re-diagnosis o f needs
Mutual measurement o f program

(Reprinted with permission from Knowles, M. (1984). The Adult Learner: A Neglected Species
ed.), Houston: Gulf, p. 116, and as cited in Spencer, 1998, p. 17)

The field o f adult education itself is still a relatively new and undefined field within education.
In what is considered the starting point o f many modem
developments in adult education, the 1919 Report to the
British Ministry o f Reconstruction by its Committee on
Adult Education defined adult education as... all the
deliberated efforts by which men and women attempt to
satisfy their thirst for knowledge, to equip themselves for
their responsibilities as citizens and members o f society or to
find opportunities for self-expression.
(Selman & Dampier, 1991, p. 3)
Currently, the definition o f adult education most frequently cited is that which was contained in
the Recommendations on the Development o f Adult Education prepared for UNESCO and
approved formally in 1976. Adult education is:

23

. . .the entire body o f organized educational processes, whatever
the content, level or method, whether formal or otherwise, whether
they prolong or replace initial education in schools, colleges and
universities as well as in apprenticeship, whereby persons regarded
as adult by the society to which they belong develop their abilities,
enrich their knowledge, improve their technical or professional
qualifications or turn them in a new direction and bring about
changes in their attitudes or behavior in the twofold perspective
o f full personal development and participation in balanced and
independent social, economic and cultural development....
(cited in Selman & Dampier, 1991, p. 3-4)
The diversity suggested above remains one o f the challenges in attaining a clear and concise
definition. “The field o f adult education and training remains broad, fractured and amorphous,
differently understood, labeled and defined in different countries and by different interests”
(Tight, 1996, p. 3). The first research question will provide direct and relevant feedback
regarding the effectiveness o f this adult learning opportunity to the various stakeholders o f this
process, including the health and social service agencies, the past participants, the host agency
AIDS Prince George, and the academic community.

Earlier in this thesis a question was posed: "Does the process o f education always result in
positive changes?" The reference Developing and Training Human Resources in Organizations
by Wexley and Latham (1991) addresses this question. In Chapter Four, the authors discuss the
retention and transfer o f learning, and provide interesting information applicable to this study.
Transfer refers to the extent to which what was learned during training
is used on the job. Three transfer possibilities exist:
Positive transfer: Learning in the training situation results in
better performance on the job.
Negative transfer: Learning in the training situation results in
poorer performances on the job.
Zero transfer: Learning in the training situation has no
effect on job performance.
(Wexley & Latham, 1991, p. 96)
This description o f possibilities relates to this study’s second research question, “Are these
changes o f a positive, negative or neutral nature?” The “Reducing Barriers by Building

24

Partnerships” program was designed as a work place training initiative, with an end goal that was
to improve environments and access to service for individuals with or impacted by HIV/AK)S. It
would be helpful to know if participation in the educational program has resulted in a positive,
negative or neutral transfer situation.

The third research question, "What is the overall impact o f participation in the 'Reducing Barriers
by Building Partnerships' program?" leads to an examination o f the learning environment in
relation to the goals o f this educational program. These goals involve the strengthening o f social
environments by providing knowledge and fostering insight. The specific educational term for
this is transformational learning.
Adult education is primarily interested in people, the changing
o f people to become better citizens, better workers, better
contributors to society. .. Education for transformation,
however, is intentionally towards a vision o f society that is
socially responsible, for those work situations that promote
humanization and freedom for creativity. (Scott, 1998, p. 186)
Scott (1998) explained that within adult education, there are two primary kinds o f
transformation, social and personal and a third type known as change in knowledge. Specifically,
The aim o f the change is to catalyze a fundamental shift
in people’s beliefs and values and must include a social
vision about the future based on a value system that
includes the struggle for freedom, democracy or equity,
and authenticity.
(Scott, 1998, p. 178)

In order to assess if a change is transformative, Scott provides four criteria:
1. there must be structural change,
2. the aim or intention must be grounded in a future vision that
includes freedom, democracy and authenticity,
3. there must be a shift in what counts as knowledge, and
4. the change must be based on conflict theory
(Scott, 1998, p. 179)

25

One o f the primary theorists in transformative learning is Mezirow. Cranton (1998) explores
Mezirow’s ideas in the article Transformative Learning: Individual Growth and Development
Through Critical Reflection. Mezirow’s theories are summarized as follows:
Transformative learning theory draws on research and
ideas from philosophy, psychology, sociology and
education.... Meaning schemes are our expectations
o f what will happen, based on what has happened.
Meaning perspectives are the broader views we hold
about the world around us. We have meaning schemes
and perspectives about knowledge, culture and ourselves,
...Often our perspectives have gone unquestioned. We do
not know where they came from and have never examined
their validity. When we are led to question our assumptions,
critical reflection, the central process in transformative
learning takes place.
(Cranton, 1998, p. 198)
Transformative learning is a process which encourages social change. Social change has also
been suggested in the "Reducing Barriers by Building Partnerships" goals through the process o f
strengthening the work environment.

Although the field o f adult education is fractured and differently understood, there exists a
considerable body o f research which speaks to positive and productive learning environments for
and with adult participants. In Adult education: Helping adults begin the process o f learning.
Campbell (1999) explores the role o f nurses as educators in their work places. She defines adult
education as “a cognitive process influenced by a variety o f elements such as prior learner
knowledge, learner attitudes, and beliefs toward the source, content, topic, and mode o f
presentation, and state o f the learner”. Campell further states “As a noun, learning refers to the
phenomenon o f internal mental change characterized by a flash o f insight or rearrangement o f
neural paths. It can be seen externally in the form o f permanent behavioral change” (p. 31).
Campbell translates her theory into twelve instructional methods adapted from Galbraith’s
(1990) book Adult Learning Methods: A Guide for Effective Instruction. The methods are

26

learning contracts, lecture, discussion, mentorships, computer assisted, distance learning, case
study, demonstration, simulation, forum, panel and symposium.

Galbraith uses the terminology "adult learning transactional process" (1991, p. 1) to describe the
learning situations discussed here. He states that the following six principles should be present:
1. An appropriate philosophical orientation must guide the
educational encounter.
2. The diversity o f adult learners must be recognized and understood.
3. A conducive psychosocial climate for learning must be created.
4. Challenging teaching and learning interactions must occur.
5. Critical reflection and praxis must be fostered.
6. Independence must be encouraged.
(Galbraith, 1991, p. 16)
Galbraith further defines the most common elements as being "collaboration, support, respect,
freedom, equality, critical reflection, critical analysis, challenge and praxis" (1991, p. 3). He is
insightful in recognizing that theory and reality do not always match, in stating that
When the vast array o f settings in which adult learning occurs
and the reasons for the learning, whether it be for personal,
social, professional, recreational, or political, are considered, it
is rather naive to think that all elements o f the transactional process
that will be incorporated. However, it does not eliminate our
responsibility in the teaching and learning encounter to put
forth the effort.
(Galbraith, 1991, p. 3)

Galbraith continues by suggesting "seven adult learning methods that seem most appropriate for
the transactional process: discussion, simulation, learning contracts, inquiry teams, case method,
critical incident and mentoring" (1991, p. 103). Galbraith's theoretical framework is therefore
applied through specific learning method suggestions, which provide a good basis for planners
and presenters o f adult learning situations.

Work place educational opportunities such as the "Reducing Barriers by Building Partnerships"
program can be described as health and social service education or inservicing, according to the

27

fields o f employment o f the participants. The program can also be described as training, which is
the generic term for employee learning opportunities. Tight (1996) defines training as “preparing
someone for performing a task or role, typically, but not necessarily, in a work setting” (p. 18).
As such, literature on training is usually located in the field o f business. Such inconsistencies are
common within the field o f education, and are just one example o f not only the complexity o f the
field but the incongruities within the terminology. Regardless o f the positioning o f the field, this
educational opportunity was designed as a work place education program.

Tight provides an historical framework to the specific Reid o f training and development in the
following information:
It is quite common to recognize four waves o f change in training
and development practice since the Second World War. The first
wave focussed on job skills training; the second, from the 1970’s
onwards, on management and supervisory training; and the third, in
the 1980's on organizational development and performance
technology. We are now, supposedly, dealing with the fourth wave,
the focus o f which is on information, knowledge, and wisdom. (1996, p.20)

Training can be further defined as "the systematic acquisition o f skills, rules, concepts or
attitudes that result in improved performance in the work situation" (Goldstein and Gessner,
1998, p. 43 as cited in Tight, 1996, p. 19). This information is particularly relevant to this
research as it mentions concepts, attitudes and performance and mirrors our discussion o f
knowledge, attitudes and behaviors. Tight provides a further quotation in saying "As a result o f
training we are able to respond adequately and appropriately to some expected and typical
situation" (Deardon, 1984, p. 59 as cited in Tight, 1996, p. 19-20). This reflects the underlying
reason for offering educational programs in the work place, the development and reinforcement
o f the abilities o f the employees to deal with the challenging situations arising firom HIV/AIDS
and in working with the marginalized groups identified in the modules.

28

In the late 1980's, the concept o f the "learning organization" arose as an international concept.
"The learning organization concept may provide the catalyst which is needed to push forward, in
an holistic way, the many strands, ideas and values with which organizations must now concern
themselves" (Jones and Hendry, 1992, pp. 58-59 as cited in Tight, 1996, p. 45). It is interesting
that the aspect o f ideas and values is mentioned here as a function o f an organization. The
concept o f the learning organization specifies that learning is more than just individual or group
learning, but rather that systematic learning is needed as well. This reflects back to Dworkin's
suggestions that learning must be addressed at the organizational level. Tight suggests that "it
represents an interaction between the organization's component parts, and the outside
environment, to the benefit o f the organization as a whole" (1996, p. 40).
A learning organization is one that has a climate that accelerates
individual and group learning. Learning organizations teach their
employees critical thinking process for understanding what it does
and why it does it. These individuals help the organization itself
learn from mistakes as well as successes. As a result, they recognize
changes in their environment and adapt effectively. Learning
organizations can be seen as a group o f empowered employees
who generate new knowledge, products and services; network
in an innovative community inside and outside the organization;
and work towards a higher purpose o f service and enlightenment
to the larger world.
(Marquardt and Reynolds, 1994, p. 22 as cited in Tight, 1996, p. 43)
Tight does mention that the concept o f a learning organization has been criticized, with
suggestions that it may be "diaphanous and unrealizable" (p. 44), there are "substantial variations
in practice and experience" (p. 44), and there is a lack o f research establishing links between the
concept and the success o f the organization. However, the concept is now a part o f the
international community o f business and adult education. There are elements o f this concept
which are laudable, and which can have a positive impact on not only the work place but the
provision o f services as follows:

29

Benefits for customers include... making available products and
services that meet their evolving requirements....the rate o f iimovation,
not just in products and services, but in process adaptability and
responsiveness... Benefits for employees include. .. the ability to
enhance both internal and external employability.... the opportunity
for better job security.... a sense o f self-respect...the availability of
the right people with the right skills in the right place at the r i ^ t time.
(Mayo and Lank, 1994, pp. 9-13 as cited in Tight, 1996, p. 44)

The thesis survey provided respondents with an opportunity for input on the organization and
presentation o f the workshop. The final research question, "What is the impact o f participation in
the 'Reducing Barriers by Building Partnerships' educational program" will provide insights into
both the learning environment and the applicability and usefulness o f the content and
presentation o f this workshop series.

Attitudinal and behavioral change

The concepts o f attitudinal and behavioral change are also a key component o f this thesis
inquiry. This portion o f the Literature Review will provide brief information on these extensive
and complex fields. The goals o f the “Reducing Barriers by Building Partnerships” workshops
include the strengthening o f social environments within health and social service agencies, and
the fostering o f knowledge and insight within such agency employees. The ACAP funding
application identified the need to address barriers to service such as stigmas and attitudes o f
health employees. This literature review assists in understanding what attitudes are, how they are
formed, how they are interrelated with behavior, and how they are related to adult learning.

30

Attitude is defined as “an evaluative disposition toward some object... an evaluation o f
something or someone along a continuum o f like - to - dislike or favorable - to - unfavorable.”
(Zimbardo & Leippe, 1991, p. 31). The authors point out that attitudes are learned, and are
influenced by society and its behaviors and rules. Similarly, “An attitude is a relatively stable
opinion containing a cognitive element (your perceptions and beliefs about the topic) and an
emotional element (your feelings about a topic, which may range from negative and hostile to
positive and loving)” (Wade & Tavris, 1998, p. 667). The basis for attitudes is varied, including
“thinking, conformity, habit, rationalization, economic self-interest, and many subtle and
environmental influences” (Wade & Tavris, 1998, p. 668).

One o f the initial North American researchers in the measurement o f attitudes was Thurstone
(1928). “His work, based on the methods and theories o f the psychophysicists, provided the
foundation for the modem techniques o f attitude measurement” (Eiser, 1994, p. 3). Eiser (1994)
summarizes Thurstone's work as follows:
The principal question which Thurstone himself addressed was that
o f how favorable or unfavorable an individual or group could be said
to be towards a given issue. He was not especially concemed with a
person’s reason for holding a given position, but simply locating that
position on an ‘attitude continuum’ ranging from extreme unfavorability
(anti) to extreme favorability (pro). The assumption o f continuity
here is very important. It leads us to thinking in terms o f degrees
o f favorability rather than looking for dividing points between
different ‘sides’.
(Eiser, 1994, p. 4)
Eiser continues by saying “Not all attitude measurement restricts itself to Thurstone’s single
continuum o f opposition/support” (1994, p. 4). However, this research is designed to be
descriptive in examining the level o f change in variables such as attitude, and will not investigate
the reasons for or factors affecting these changes in an individual.

31

The impact o f feelings or the emotional element, as identified in Wade and Tavris above, is a
primary factor in learning. The motivational theories o f Wlodkowski (1985) in terms o f the
interaction o f learning and feelings are summarized here:
Affect or the emotional feelings, concerns, and passions o f the adult
are a major motivational factor while learning is taking place. Most
psychologists accept the idea that thinking and feeling interact or
influence one another as well as to lead to changes in behavior. It is
important to note the degree or intensity o f feeling may be most
influential on immediate behavior. Harmony between thinking and
positive feelings sustain motivation, involvement, and interest in
the subject.
(Campbell, 1999, p. 34)

Learning is impacted by feelings, feelings are a component o f attitude. Attitudes affect behaviors
and behaviors affect attitude. The interrelationship o f these facets o f human beings is extremely
complex, and provides insight into the variety and the uniqueness o f the adult learning situation.

As human beings, many o f our behaviors are not consciously considered acts. We react based on
our internal beliefs, attitudes, histories and experiences. As mentioned earlier, the term “behave”
is defined as “to act or function in a specified or usual way” (Collins, 1995, p. 114). In terms of
stigmatizing situations, we may behave in manners which are not morally appropriate but which
are at the same time socially appropriate. The “Reducing Barriers by Building Partnerships”
program recognizes that social behavior changes according to society’s mores, and provides a
learning experience with the purpose o f changing the experiences o f individuals with and
associated with HIV or AIDS in terms o f health and social service agency interactions.
“Ultimately, the goal o f an influence agent is to change the target’s behavior” (Zimbardo &
Leippe, 1991, p. 30). The workshop series also attempts to sensitize service providers to more
morally appropriate behavior. Zimbardo and Leippe provide an interesting distinction through
asking “has an influence attempt totally failed if the target’s behavior does not change? Not by a

32

long shot. The influence eflbrt may have succeeded in changing the target’s beliefs or attitudes”
(p. 31). The “Reducing Barriers by Building Partnerships” program was designed to educate
employees in the hopes that their behaviors and/or their attitudes may be influenced by increased
knowledge and understanding o f the issues and challenges faced by individuals with and
associated with HIV or AIDS.

The relationship between attitudes and behaviors is not always clear cut. Wade and Tavris (1998)
point out that
Although it is commonly believed that the way to change behavior
is first to change attitudes, it also works the other way around:
Changing behavior can lead to a change in attitude because the
new behavior alters our knowledge or experience,
(p. 668)
This thesis inquiry requested that the workshops' past participants reflect on changes in attitudes
and changes in behaviors within separate sections in the survey, inviting both numerical and
textual responses. This research does not attempt to impose a direction upon the change, or even
necessarily to link the attitudinal and behavioral changes. It is valid to acknowledge that change
does occur in both directions. This would especially be applicable in work place settings, as the
impacts o f an individuals' attitude and/or behavior can be reflected back to that individual based
on interactions with clients and co-workers.

Psychologist Albert Bandura has been a primary researcher and developer o f Social Learning
Theory.
Social Learning Theory stresses the interrelationship between
people, their behavior, and their environment in a process called
reciprocal determinism. While the environment may determine or
cause certain behaviors, a person may act in ways to change the
environment. The theory states that behavior depends on a person’s
self-confldence and outcome expectations.
(Campbell, 1999, p. 34)

33

More specifically,“...This approach focuses on how people learn behavior patterns both fi'om
being directly reinforced and from observing the consequences that follow the actions o f other
people” (Zimbardo & Leippe, 1991, p. 44). In social learning theory, “...the person, the behavior,
and the environment all interact to change one another” (Zimbardo & Leippe, 1991, p. 44). The
Building Partnerships program hoped that by training a number o f individuals from a workplace,
changes would occur both initially following the training and on an ongoing basis through
personal and workplace readjustments in attitudes and behaviors. This research questioned past
participants about changes in self-confidence, which Campbell states is a factor in the potential
for change in behavior. This research inquired into the effects o f participation on service
provision, and asked about changes in the work place due to staff participation in the workshops.
As discussed in the AIDS Education portion o f this Literature Review, Dworkin (1992) refers to
the need to address the organization and organizational issues in the education process. The
name o f the workshop series itself, “Reducing Barriers by Building Partnerships” reflects this
approach, as the name can refer to building and strengthening systems both internally within an
organization and externally between organizations.

Contribution o f this Research

The literature review, particularly in the area o f education for HIV/AIDS, highlighted a number
o f gaps. These gaps are the lack o f research on education for social change rather than education
for prevention, the lack o f research with Canadian content, the lack o f research addressing
interdisciplinary populations in health care service providers and the lack o f research oriented

34

towards social service agency staff. This thesis research, “HIV/AIDS Education for Work Place
and Personal Change”, will be a start in addressing some o f these areas.

Most HIV/AIDS education in the literature is oriented towards prevention o f the transmission of
the disease. This literature review did discuss two articles that addressed education for change in
health and social service staff (Dworkin, 1992) and (Randall et al, 1993), and one which was
oriented towards post-secondary students (Strauss et al, 1992). The reference lists in the three
resources, as well as the text Understanding AIDS: A Guide for Mental Health Professionals do
give further sources on education for work place change. However, most o f these research
studies were targeted to one field o f health care only, for example to nurses or to physicians. This
inquiry is the only one involving a multi-disciplinary population, that o f staff and volunteers in a
number o f health and social service agencies in the community.

The literature reviewed also highlighted a lack o f reference material with Canadian content. All
o f the items reviewed here were American. This study adds a Canadian component to the
literature, one that is uniquely northern in its perspective, and representing Prince George and
several surrounding communities specifically.

This thesis inquiry will contribute to the body o f knowledge involved in the fields o f adult
education, and the associated fields o f psychology, sociology, business and health care because it
is investigating the relationship between education and attitudinal and behavioral change in the
work place and in personal life. The information will provide insight into the effects o f an
educational process.

35

Summary

Living with HIV/AIDS requires the accessing o f health and social service systems to address
physical, financial, social, emotional and other personal needs. The literature indicates that
personnel in health and social service agencies are a reflection o f their communities. As
HIV/AIDS is one o f the most stigmatizing disease processes o f this century, individuals
impacted by this disease will understandably encounter a broad range o f attitudes and behaviors
within health and social service agency staff.

Research in HIV/AIDS education has primarily focused on education for prevention. A number
o f sources discuss education for transformative learning, the process o f developing a more
socially responsible society through individual learning. Changes in attitude and behavior can be
a component o f this learning process.

This chapter explored the literature in relation to this study's three research questions: the need
for HIV/AIDS education for health and social service agency personnel will be addressed in the
first question, “Has participation in the 'Reducing Barriers by Building Partnerships' program
resulted in changes in knowledge, attitudes and behaviors or actions on a personal level and in
the workplace?” The theory o f attitudinal and behavioral change also applies to this research
question. The field o f adult education or andragogy provided information on the educational
setting, resulting in the second question “Has participation resulted in positive, negative or
neutral transfer or change?”. The sub-field o f transformative learning, and theory on the learning
environment are reflected in the third and summarizing research question, “What is the impact o f
participation in the 'Reducing Barriers by Building Partnerships' program?"

36

CHAPTER IV: METHODOLOGY

Methodology

The research project “HIV/AIDS Education for Work Place and Personal Change” explored the
effects o f participation in an educational program through a quantitative and descriptive research
process within a postpositivist framework. Specifically, a quantitative approach is "a research
method that emphasizes numerical precision; a detached, aloof stance o f the researcher's part;
...and, often, a hypothetico-deductive approach" (Palys, 1997, p. 423). The goal in descriptive
research is "to accurately portray the characteristics or a particular individual, situation, group,
sample or population" (Palys, 1997, p. 77). A postpositivist framework is:
A theoretical tradition that reflects classic positivism but
differs in two ways. First, it is less rigidly realist, acknowledging
that we may not be able to know things with certainty;
knowledge may end up being probabilistic rather than
certain. Second, postpositivists show considerably less
hostility toward metaphysical concepts like attitudes and
beliefs, and now believe that verbal reports can include
valid and reliable data.
(Palys, 1997, p. 423)
The decisions made in the planning o f this research methodology are reflected in the above
definitions. In positioning this research within the postpositivist approach, a balance is
maintained between the use o f an aloof approach involving a survey and the compilation o f
numerical information, and the acknowledgement that my interest in this research was stimulated
by my own past participation in these modules. However, this participation predates the
development o f this research project. I am therefore familiar with the module content and
presentation style, but chose to use a questionnaire to maintain an appropriate distance from the
areas examined, and to gain information from the past participants to research this project.

37

The survey (Appendix B) and a covering letter (Appendix C) were distributed to past participants
of the "Reducing Barriers by Building Partnerships" workshops inviting them to provide scale
and textual feedback on the educational program. The survey, therefore, invites respondents to
describe their own insights into their own change process rather than observing them through an
external, positivist research process. The scale and textual information provide reliable and valid
input relating to the three research questions.

Target Population

AIDS Prince George received funding for the project that became the “Reducing Barriers by
Building Partnerships” workshop series in 1994. Staff members conducted focus groups,
literature reviews and associated research in the process o f developing the content for the
workshops. AIDS Prince George staff and volunteers began presenting the workshops in 1996 to
staff and volunteers o f health and social service agencies. By the year 2000,27 agencies from
four communities in the central interior o f British Columbia had participated in the workshops.
The agencies provide a variety o f services including counseling, parenting skills, public health
services, transition services, long-term care, acute care, palliative care, living expense funding,
home support, addictions services, needle-exchange and many other services. D ie clients o f
these agencies represent the full spectrum o f the population including babies, children, teenagers,
young parents, adults, and seniors. A brief review o f that attendance lists indicated
approximately 457 different individuals had participated in between one and five o f the modules.
The gender breakdown o f these participants was 368 women (84.5%), 67 men (15.4%) with 25

38

names being indecipherable or gender unknown. The first few workshops offered did not record
participant names, so it was not possible to determine an exact number o f individual participants.
This did not, however, affect this research as the particular agencies initially involved invited all
staff members who participated in a workshop to complete a survey. This research targeted the
entire population o f past participants o f the workshop series with the exception o f present and
past staff o f AIDS Prince George as well as student participants o f a local training agency.

Instrumentation

This research was conducted through the use o f a quantitative survey (Appendix B). The
research proposal and a draft o f the survey were reviewed by the Ethics Committee at the
University o f Northern British Columbia during the summer o f 2000. The survey was designed
to be completed anonymously and confidentially. Informed consent was implied through the
process o f including a covering letter, through the anonymity, and through the voluntary nature
o f the response process. The survey was organized in five sections which were as follows:
demographic information, knowledge, attitudes, behaviors and/or actions, and concluding
comments. The questions numbered twenty, although many questions had more than one part.
The survey resulted in 45 variables and a further 14 opportunities for textual input. Questions
included closed questions such as age and gender, tables with Likert type selections, yes/no
questions, comments, and open ended questions. The survey was preceded by an attached
covering letter which explained not only the background o f the research, but gave agency

39

specific information on due dates and drop o ft points for the completed questionnaires (see
Appendix C).

Pilot Project

The survey was pilot tested in advance o f its finalization. A draft o f the survey, along with a
covering letter, a feedback sheet, and a second copy o f the survey was distributed to six past
participants o f the “Reducing Barriers by Building Partnerships” workshops. All six individuals
were ftom differing agencies, and had participated in a range o f module amounts. Some o f the
individuals had participated recently, others in years past. The pilot project respondents were
asked to fill out the survey, to time themselves in doing so, and then to provide input via the
feedback sheet as well as to make any suggested changes to wording, content or format on the
second copy o f the survey.

Four o f the six pilot project participants provided feedback. The completion time varied from 1040 minutes. The respondents felt the wording and the content were fine, but suggested that the
length o f time since their participation atlected their ability to fill out the survey. There were
several comments requesting clarification o f wording, and questioning potential breaches o f
confidentiality. Based on their feedback, changes were made to the content o f the survey. In a
number o f the questions which invited comments, a statement was added requesting general
information and asking respondents not to include confidential client/staff information. The
headings were changed to be more specific in identifying the marginalized groups being

40

discussed in a module, to ensure individuals commented on their feedback regarding groups in
society such as the gay and lesbian population and the First Nations population.

I ran a second pilot project in distributing the revised survey to two individuals. Both felt that the
changes enhanced the clarity and reduced the intrusiveness o f the survey, and felt this final
version would provide the needed input based on the research’s purpose.

Distribution

AIDS Prince George provided a list o f the 27 participating agencies, their primary contact names
where available, addresses and phone numbers. As mentioned previously, one agency was
eliminated because its participants had been short term students who would no longer be
involved with the agency. I contacted each agency by telephone in advance to ask they distribute
the survey to their employees and volunteers who had participated in the education. Ten agencies
requested a list o f their past participants, and AIDS Prince George faxed these out as requested.
Approximately 75% o f the agency contacts were very helpful in reviewing the participant lists,
in providing me with an estimate o f the numbers o f surveys to provide to them, and in
distributing the surveys to their employees and volunteers. Some o f the agency contacts were
not reachable despite numerous phone calls. In those situations, we communicated via answering
machines. In three cases, communication was via electronic mail. Following these initial
contacts, an appropriate amount o f surveys were hand delivered to the specific contact person at
each organization. I mailed the surveys to the contact person in agencies located in towns other

41

than Prince George. Most o f the agencies then distributed the surveys to the specific individuals
on the participant lists. The agency contacts were predominantly female (21 out o f 26 or 80.8%).

The “Reducing Barriers by Building Partnerships” workshops have been offered since 1996. In
any workplace, there is a change o f employees and volunteers over time. All o f the workplaces
had names, on the lists o f participants, o f individuals who were no longer working or
volunteering with them. This resulted in a reduction in the number o f potential respondents. The
amount o f attrition varied from one hundred per cent in two o f the agencies, to only a few o f the
names in other agencies. In order to address this attrition, the research was publicized in the
Northern Interior Regional Health Board’s employee newsletter, in the Prince George Citizen
newspaper, in the University o f Northern British Columbia’s graduate newsletter, and through
Bruce Strachan’s talk show on the Prince George radio station CJCI. Two individuals came
forward as a result o f this public relations process. Following the collection o f the surveys, a
thank you card with preliminary information on response rates was sent to all o f the participating
agency contact persons.

Summary

The “AIDS/HIV Education for Work Place and Personal Change” research investigated the
effects o f participation in the educational program “Reducing Barriers by Building Partnerships”
through a quantitative, descriptive research process within a postpositivist f ir e w o r k . The target
population was all o f the past participants o f this workshop series with the exception o f myself.

42

the students from a local training agency, and present and past staff o f AŒ)S Prince George. The
research was approved through the University o f Northern British Columbia's Ethics Committee.
The study was conducted using a quantitative survey which was initially piloted to six
individuals, with four o f these providing input. The survey was distributed through 26 agencies
whose staff and volunteers had participated in the educational program. The agency contacts
were key in the distribution and collection o f the surveys.

43

CHAPTER V: RESULTS

Data collection

The thesis research “HIV/AIDS Education for Work Place and Personal Change” asked
respondents to analyze the impact o f their own participation in the “Reducing Barriers by
Building Partnerships” HIV/AIDS education program. The survey was distributed through 26
health and social service agencies in the central interior o f British Columbia. Each agency
received surveys with covering letters containing due dates and collection locations specific to
their agency. 1 hand collected the completed surveys as well as the remaining blank copies from
each local agency shortly after their due date, and left a note with each requesting the mailing o f
any further surveys directly to my home. The out o f town surveys were mailed directly to my
home, and I communicated via telephone or electronic mail with the contact persons. Table 4 (on
the next page) provides statistics on the distribution and collection process. O f the 325 surveys
initially handed out, 166 surveys were actually distributed to potential respondents. A total o f
161 blank surveys were either returned directly to me, destroyed at the agency (destroyed copies
are indicated with a D in Table 4) or in the case o f agency #9 the fate o f the surveys is unknown.
A Public Relations campaign through various local media was conducted to reach individuals
who may have changed employment or volunteer situations since participating in the workshops.
The media campaign resulted in two individuals coming forward, and are shown as line 28 (PR
for Public Relations) in Table 4 on the next page.

44

Table 4
Survey Distribution Statistics

Agency

1
2
3
4 (Elim)*
5
6
7
8
9 (Elim)***
10
11
12
13
14
15
16
17
18
19
20 (Elim)*
21 (Elim)**
22
23
24
25
26
27
28 (PR)
Totals

Participants

14+
11
11
8
7
24
16
59
28
22
20
14
20
8
72
20
4
6
3
3
13
6
14
3
8
9
34
N/A
457

Total surveys
distributed

Returned
undelivered

Net surveys
distributed

15
9
10
3
5
20
20
45
25
20
15
26
15
8
15
20
4
5
3
3
0
6
15
3
6
4
5
2
327

12
4
2
(3D)
0
16
13
5
(25?)
17
12
(160)
9
2
0
(50)
3
0
(20)
(30)
0
(30)
6
0
1
0
(20)
N/A
161

3
5
8
0
5
4
7
40
')

3
3
10
6
6
15
15
1
5
1
0
0
3
9
3
5
4
3
2
166

Surveys
turned
in/completed
2
4
2
0
2
1
3
8
0
0
3
6
3
5
11
6
1
1
1
0
0
2
4
3
3
1
1
2
75

In calculating distribution and response rates, several agencies were eliminated. Two agencies
reported 100% attrition in the staff which had participated in the AIDS Education workshops
(see Table 4, agencies numbered 4* and 20*). One agency had been previously eliminated as it
was a student training center (Table 4, agency number 21**). I eliminated one further agency,
(Table 4, number 9***), as 1 was not able to determine if their surveys were ever distributed. 1
did not receive a single completed survey from this agency, and was not able to reach the contact

45

person despite numerous attempts. With the exception o f this one agency, all o f the other 25
agencies were helpful in distributing and returning the surveys, or in providing information on
non-distributed surveys.

O f the 166 distributed surveys, a total o f 75 were completed or partially completed and returned
to me. This resulted in a 45.2% return rate (surveys divided by distributed surveys). The amount
o f surveys in relation to the total population o f past participants is 75 out o f 457 or 16.4%. The
surveys were given a code number as they were turned in, with a separate list recording the code
number and the agency from which the completed survey derived.

The returned surveys were screened before data entry. The participants had been asked to fill in
the sections o f the questions relating only to the modules they had attended. Not all respondents
followed these directions, however, the inappropriate data was screened out and not entered in to
the software program. Also, not all o f the respondents answered all o f the questions. Although
the survey returns numbered 75, the total for each question may not total 75. Some o f the tables
indicate the number o f missing responses, while others indicate only the data that is relevant to
the question. This is especially applicable in the textual responses (Appendices D through Q).
The appendices list the total number o f responses at the bottom o f each list o f comments.

The data was entered into the computer using the Excel software program. The textual comments
were entered directly into the software Work and as shown on the surveys, including any
grammatical or spelling errors but excluding any words or phrases that may have identified a
specific work place such as a Health Unit, or a specific learning institution such as the name o f a
university. Many o f these responses are quoted in the Results and Conclusions portions o f this

46

thesis, and all responses are listed in the appropriate appendix. The order o f entry o f the textual
comments was changed in each o f these appendices, to ensure that any one individual’s
responses could not be tracked throughout the appendices. The content o f each appendix was
categorized and included in tables throughout this chapter. Comments that did not provide
meaningful information (for example, “probably” in Appendix F) are not included in the
category counts. As the majority o f the textual responses were positive in nature, I have included
a count o f the negative responses within the textual tables mentioned above. The textual response
categories are summarized at the end o f this chapter.

The Office o f Social Research at the University o f Northern British Columbia assisted with the
entry o f the numerical variables. The research assistant analyzed numerical variables using Excel
for frequencies and percentages, and developed tables in the Word software program based on
my suggestions. The research assistant entered the numerical data on a single-entry basis, and I
randomly checked these entries to ensure accuracy.

This chapter presents the results obtained from the 75 completed and partially completed surveys
that were returned. The information is organized according to the major sections in the survey:
demographics, changes in knowledge, changes in attitude, changes in behavior, and the
concluding comments section. The numerical information will be presented in the form o f tables
and within the text throughout Chapter Five. Appendices D through Q contain the textual
comments, and relevant comments and categorical tables are included in this chapter. The results
will be summarized briefly.

47

Demographic Data

The first section o f the survey provided information on the modules the respondents attended,
their last year o f attendance, gender, age, and attendance arrangements. The respondents were
health and social service staff and volunteers fi’om 22 agencies (Table 4).

The “Reducing Barriers by Building Partnerships” educational program has five different
modules (Appendix A). Question A asked the participants to indicate which modules they
attended. The majority o f respondents (67 out o f 75 or 89.3 %) had attended Module 1:
HFV/AIDS 101 (Table 5). Participants were not required to attend the modules in order,
however they were encouraged to begin with Module One and progress through to Module Five.

Table 5
Modules Attended
Surxcys (N)
Yes
Module Attended
Module 1(Mod-1) HIV/AIDS 101
75
67 (89.3%)
56 (74.7%)
Module 2 (Mod-2) Impact o f HIV/AIDS on Those Infected & Affected
75
75
51 (68.0%)
Module 3 (Mod-3) Homophobia, Heterosexism, and HIV/AIDS
75
50 (66.7%)
Module 4 (Mod-4) HIV/AIDS & First Nations People
44 (58.7%)
Module 5 (Mod-5) HIV/AIDS in a Diverse Community
75

A definite trend is indicated as the attendance decreases throughout the series. The percentages
in Table 5 above are calculated as attendees over respondents as all responded to this question.

Question B asked participants to indicate the year they last attended a module. A significant
portion (17 out o f 75 or 22.7%) could not remember the year that they had last attended. The

48

remainder o f the respondents were spread out over the years 1996-2000, although there were
fewer respondents from the early years o f 1996 and 1997 (see Table 6).

Table 6
Year Last Attended

Year

Frequency

Percent

1996

1

1.3

1997

11

14.7

1998

18

24.0

1999
2000

15

20.0

13

17.3

dk

17
75

22.7

Total

100.0

Question C asked participants to indicate their gender. Health and social service agencies
traditionally are staffed primarily by women. The survey respondents were primarily female (64
out o f 74 or 86.5%). Ten o f the respondents (or 13.5%) indicated that they were male.

The next question in the demographic data section asked participants to write in their age. In
total, 68 o f the 75 respondents filled in this question. The ages have been summarized in 5 year
categories in Table 7. The mean o f the ages was 42.78, the mode o f the age ranges was 46-50
with 17 responses. Twenty-seven (39.7%) o f the respondents were between 21 and 40, while 41
(60.3%) o f the respondents were between 41 and 61 years o f age indicating that the distribution
o f the ages was skewed to the older age range. However, there were respondents across the broad
range o f 21 to 61 years o f age.

49

Table 7
Age o f Survey Respondents
Age

Frequency

2 1 -2 5

5

2 6 -3 0

6

3 1 -3 5

8

3 6 -4 0

8

4 1 -4 5

8

46 - 50

17

5 1 -5 5

9

5 6 -6 0

6

6 1- 6 5

1

Total

68

Missing

7

Mean

42.78

The final question in this section o f the survey asked participants about their attendance
situation. Almost two-thirds (46 out o f 66 or 69.7%) o f this question’s respondents indicated that
their attendance was voluntary with 20 individuals (30.3%) stating that their attendance was
mandatory.

The second portion o f the question E asked if participants were remunerated, with the options of
“paid”, “non-paid”, or “other with an explanation” requested. Most o f the respondents (46 out o f
66 or 69.7%) were paid for their attendance time, with 18 individuals (27.3%) indicating that
they were not paid for their attendance time. Two individuals chose the “other” category, and
provided explanations such as “Hospice training” or “both paid and unpaid” (Appendix D).

To summarize, the demographic information provides us with insight into the respondents. The
majority o f respondents (89%) attended Module One, with a decreasing amount attending each
o f the further modules. Some respondents (23%) had difficulty remembering their last year o f

50

attendance. Respondents were primarily female (86.5%), with mean age o f 42.78. Most
respondents (69.7%) attended the sessions on a voluntary basis, and most were paid for their
attendance (69.7%).

Data on Knowledge Change

The next section o f the survey asked respondents to explore the amount o f learning that occurred
by providing a rating o f (1) none, (2) very little, (3) little, (4) medium, and (5) lots. Question F
asked respondents to rate the amount o f knowledge learned in each o f the modules they had
taken (Table 8). The total number o f respondents for each module is listed in the “N” column.
Two columns have been combined into the “Med+Lots” column, showing a range between 68%
and 81.3% o f respondents indicating they had learned either a medium amount or lots during
these workshops.

Table 8
Knowledge Learned
iVbdule
Mod-1) AIDS/HIV 101
Mod-2) Impacts o f AIDS/HIV
Mod-3) Homophobia/Heterosex
Mod-4) First Nations
Mod-5) Diverse Comnunity

None
Very Little
0 (0.0%) 7 (11.3%)
1 (1.9%) 5 (9.3%)
2 (4.0%) 5 (10.0%)
1 (2.1%) 3 (63%)
1 (2.4%) 3 (73%)

(MedfLots)
Lots
Uttle
Medium
12 (19.4%) 21 (33.9%) 22 (35.5%)
69.40%
75.90%
7 (13.0%) 21 (38.9%) 20 (37.0%)
68.00%
9 (18.0%) 20 (40.0%) 14 (28.0%)
8130%
5 (10.4%) 19 (39.6%) 20 (41.7%)
78.00%
5 (12.2%) 14 (34.1%) 18 (43.9%)

N
62
54
50
48
41

The second knowledge area question asked respondents to rate the changes in the amount o f
understanding toward the situation o f client groups in the modules. Table 9 indicates that
respondents reported changes across the hill range o f possibilities. The percentage o f individuals

51

reporting “medium” or “lots” o f change ranges from a high o f 73.8% for Module 5 to a low o f
60.8% for Module 3.

Table 9
Change in Understanding o f Client Situation

Module
Mod-1) Individuals with HIV/AIDS
Mod-2) Fantities/fhends o f ......
Mod-3) Gay and lesbian people
Mod-4) First Nations people
Mod-5) Other marginalized/diverse
people

Lots
(MedfLot)
17 (27.9%)
72.20%
9 (16.7%)
68.80%
12 (23.5%)
60.80%
12 (24.5%)
69.40%
7 (16.7%) 23 (54.8%) 8 (19.0%)
73.80%

None
Very Little
Uttle
IVIedum
1 (1.6%) 6 (9.8%) 10 (16.4%) 27 (44.3%)
2 (3.7%) 5 (93%) 10 (18.5%) 28 (51.9%)
3 (5.9%) 4 (7.8%) 14 (25.5%) 19 (37.3%)
2 (2.1%) 4 ( 8.2%) 9 (18.4% 22 (44.9%)

N
61
54
51
49

1 (2.4%)

42

3 (7.1%)

Data on Attitudinal Change

The attitudinal change section o f the survey asked respondents to report any changes in attitudes
or beliefs that may have occurred as a result o f their participation in the “Reducing Barriers by
Building Partnerships” workshops. This section introduces a new rating scale. The scale relates
to the potential for positive, negative or neutral transfer due to an educational experience, as
described in the Literature Review. Each o f the remaining scale questions is based on a five point
system, with the ratings o f (I) lots more negative, (2) more negative (3) about the same, (4) more
positive and (5) lots more positive. The wording for each o f the scales changes according to the
question’s content, but the categories remain the same.

52

The first question in this section asked respondents if there have been changes in their attitudes
toward the situation o f any o f the client groups (Table 10). The majority o f respondents in each
module reported that their views remained the same (53.2% to 60.5%). However, the totals o f the
“more positive” and the “lots more positive” columns indicated a range o f 34.9% (for Module 5)
to 45.1% (for Module I) did indicate positive changes in their attitudes towards the situation o f
client groups. The largest change was found for “individuals with HIV/AIDS”, while the
smallest change was for the “other marginalized/diverse people” category.

Table 10
Changes in Attitude Regarding Situation o f (Client) Groups
Lois more
Module
negatiw
Mod-1) Individuals with HlV/AlDS 0 (0.0%)
Mod-2) Families/friends of.....
1 (1.8%)
Mod-3) Gay and lesbian people
1 (1.9%)
Mod-4) First Nations people
1 (1.9%)
Mod-5) Other marginalized/diverse 1 (2J%)
people

Lots more (More + lots
iVlore
About the
More
positive
more)
negative
same
positive
1 ( 1.6%) 33 (531%) 18 (29.0%) 10 (16.1%)
45.10%
1 (1.8%) 32 (57.1%) 14 (25.0%) 8 (14.3%)
3910%
1 (1.9%) 30 (56.6%) 13 (24.5%0 8 (15.1%)
39.60%
1 (1.9%) 29 (55.8%) 13 (25.5%) 8 (15.4%)
40.90%
1 (13%) 26 (60.5%) 8 (18.6%) 7 (161%)
34.90%

N
62
56
53
52
43

The following questions I and J asked for a “yes or no” response, followed by a request for
textual input if the initial response had been “yes”. The first question was “Have there been times
at work when something has happened which made you think about what you learned or talked
about during the Building Partnerships workshops?” The responses were fairly evenly split, with
34 (50.7%) indicating “yes” and 33 (49.3%) reporting “no”.

53

The respondents provided written examples o f situations at work in which they had thought o f
the workshop information (Appendix E). The textual responses to this question are categorized
in Table 11 below, with the first column indicating the frequency o f each category’s response
and the second column indicating the nominal ordering o f the response category. The comments
included 17 responses on knowledge learned such as “wearing gloves all the time”, “requests for
finances not previously understood”, “switching from mugs to disposable cups to cut back on
colds and flu germs”, as well as 7 comments on attitudes o f self and other staff such as “Not
specific story but it makes me stop and think about my values so 1 can provide a more nonjudgmental service”. Respondents also provided 6 comments on impacts on their organization
such as “we need more workshops and education”, and “being able to pass on the knowledge
gained ... to staff if questions arise”.

Table 11
Thoughts at Work: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
17
7
0
I
6
1
I
1
1
0

O rder
I
2
4
3
4
4
4
4

The next question asked the same content but in the context o f situations outside the work place.
33 (or 50.8%) indicated “yes” and 32 (or 49.2%) indicated “no” to this question.

A total o f 31 respondents provided textual information (Appendix F). The written comments
again included a high number o f examples o f information learned (11 responses), such as “ .. .ink

54

bottles used in tattoos should be changed between clients, needle change is not enough”, and “a
general discussion about contraceptives with friends” (Table 12). Attitudinal change responses
numbered 7, and included comments such as “Generally, I have become a more inclusive/openminded individual”. This time the responses included advocacy (7), with examples o f the ways in
which survey participants had responded to issues o f racism or discrimination. These are
exemplified in the comment “uniformed or rude comments, racial, sexist jokes etc - 1 leave or
speak up stating I don’t agree or appreciate or want to hear that”. These comments also address
one o f the original goals o f this educational program, that o f social change through education.

Table 12
Thoughts Outside o f Work: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
11
7
0
0
0
0
1
7
0
1

O rder
1
2

3
2
3

The final question in the section on attitudinal change asks respondents if there have been
changes in their confidence levels in working with individuals in the client groups (Table 13).
The majority indicated their confidence levels remained the same, as the results range firom
53.5% to 61.4%. However, the totals o f the “more confidence” plus the “lots more confidence’
columns range from 36.9% to 45.9% with the highest change for the “individuals with
HIV/AIDS” and the lowest change for “ families and fiiends o f HIV/AIDS”.

55

Table 13
Changes in Confidence Level
Lots less
Less
About the
More
Module
confidence confidence
same
confidence
Mod-1) Individuals with HIV/AIDS 0 (0.0%) 0 (0.0%) 33 (54.1%)! 22 (36.1%)
Mod-2) Fairaiies/friends of.....
1 (1.8%) 0 (0.0%) 35 (61.4%) 16 (28.1%)
Mod-3) Gay and lesbian people
1 (1.9%) 0 (0.0%) 28 (53.8%) 17 (32.7%)
Mod-4) First Nations people
I (1.9%) 0 (0.0%) 28 (53.8%) 17 (32.7%)
Mod-5) Other marginalized/diverse 1 (2J% ) 0 (0.0%) 23 (53.5%) 14 (32.6%)
people

Lots more (More +
confidence lots more)
6 (9.8%)
45.90%
5 (8.8%)
6 (11.5%)
6 (11.5%)
5 (11.6%)

36.90%
44.20%
44.20%
44.20%

N
61
57
52
52
43

Data on Behavioral Change

The behavioral change section o f the survey asks participants about any possible changes in their
behavior or actions both inside and outside of their work place. This section contained one scale
question, and six “yes or no” questions all o f which invited further textual comments.

Question L asked respondents to rate the amount o f change in the empathy they demonstrate
when working with any o f the client groups. Table 14 summarizes the responses according to the
modules. Once again, the majority o f the respondents (between 53.8% and 60.4%) responded
that their level o f empathy demonstrated at work has remained the same following participation
in the modules. However, the combination o f the “more” and the “lots more” columns reported a
range o f 35.8% to 44.1% indicating a positive change in the levels o f empathy they demonstrate
in the work place.

56

Table 14
Changes in Empathy Demonstrated at Work
Lots less
Module
empathy
Mod-1) Individuals with HIV/AIDS 1 I (1.7%)
Mod-2) Families/friends of.....
2 (3.5%)
Mod-3) Gay and lesbian people
| 2 (3.8%)
Mod-4) First Nations people
2 (3.8%)

Less
empulhy
0 (0.0%)
0 (0.0%)
0 (0.0%)
0 (0.0%)

Mod-5) Other marginalized/diverse
people

0 (0.0%)

2 (4.9%)

About the
same
32 (54.2%)
33 (57.9%)
32 (60.4%)
28 (53.8%)
23 (56.1%)

Lots more (More +
empathy lots more)

More
empathy
21 (35.6%)
16 (28.1%)
13 (24.5%)
17 (32.7%)

5 (8.5%)
6 (10.5%)
6 (113%)
5 (9.6%)

44.10%
38.60%
35.80%
42.30%

II (26.8%)

5 (12.2%)

39.00%

N
59
57
53
52
41

Questions M, N and 0 contained three options for answering; yes, no, and not applicable. These
questions asked if respondents had noticed changes in the way they carried out their work. The
purpose o f the “not applicable" answer was to screen out individuals who may not have been in a
position to appropriately answer a question. For example, participants may not be dealing with
any o f the client groups in their work places or they may no longer be working or volunteering in
a health or social service agency. The calculations for the percentages for these questions screen
out the not applicable answers.

The question “Have you noticed any changes in the way you discuss any o f the (client) groups
with co-workers” resulted in a total o f 15 out o f 41 respondents (29.4%) indicating they had
changed the way they discussed any o f the client groups with co-workers, and 16 "not applicable
responses. The majority (70.6%) reported that “no” change had occurred.

The 17 textual responses to this question are in Appendix G. Respondents commented on
knowledge learned (4 responses), attitudes (2 responses) and advocacy (3 responses) (Table 15).

57

This question resulted in the first responses in the area o f “knowledge learned and passed on”,
exemplified in “By being better informed I am able to discuss the situation and ask more
informative questions”, and “I think we all have a better understanding and therefore can now
speak with knowledge and not from assumptions”. However, most o f the comments (6 o f 17)
clarified their existing and previous frameworks, in “have always supported clients regardless o f
health issues”, and “ 1 have always been careful about confidentiality and shared information”

Table 15
Changes at Work Regarding Discussion o f (Client) Groups: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
4
2
0
3
0
0
0
3
0
6

Order
2
4
3

3
1

When asked if they have changed the way in which they provide services to the client groups, 19
out o f 51 individuals (37.3%) indicated that they had changed, with a further 16 indicating that
this question was not applicable to them. However, 32 (62.7%) indicated that they had not
changed. In reflecting upon changes at work regarding the provision o f service, 6 individuals
gave specific examples o f behaviors or actions including “I am more aware o f my body language
- how I ask questions etc - more sensitive to their experiences”. O f the six responses, four
individuals used the terminology “more empathetic” to describe their behaviors. Again,
individuals made comments (2) reflecting their past and present philosophy, such as “I consider
myself to be empathetic and work diligently in my care delivery”. This question engendered the

58

new response category o f “Resources - including networking” which speaks to the increased
knowledge regarding resources in the community and includes networking. Three individuals
commented on this, including one who addressed accessibility in the comment “More aware o f
making services more accessible”. Eighteen individuals provided textual responses to this
question (Appendix H and Table 16).

Table 16
Changes in Service Provision at Work: Textual Responses

Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
4
4
6
3
0
3
0
0
0
2

O rder
2
2
1
3
3

4

Respondents were asked if they had noticed any changes in the amount o f advocacy they do for
and with a client or group. Seventeen out o f 47 (36.2%) indicated that they had noticed changes,
18 indicated "not applicable, and 30 (63.8%) stated that they had not noticed changes. Seven
individuals again commented that advocacy had always been an important facet o f their jobs.
The remainder o f the respondents clarified their experiences increasing usage o f resources (2)
such as “more calls to community agencies”, “connecting people to other support systems”, and
changes in behaviors (2) such as “able to explain need better and necessity o f item required”
(Appendix I and Table 17).

59

Table 17
Changes in Advocacy at Work: Textual Responses
Category
knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
0
1
2
I
0
2
0
0
0
7

Order
3
2
3
2

I

Question N asked if participants had noticed any changes in their work place as a result o f staff
member participation in the workshops. The number o f “yes” responses remained about the same
as the above questions, as 24 out o f 62 individuals or 38.7% indicated that they had noticed
changes. Thirty-eight o f the respondents (71.3%) indicated that they had not notices any changes
in their work place. Appendix J lists the comments from the 28 textual responses to this
question. The greatest number o f responses fell in the category o f “Knowledge learned”, with 12
responses including “using universal precautions”, and “A better more accurate knowledge
base”. Attitudes were identified by 7 respondents with statements such as “Everyone seems more
open minded”, and “Greater understanding and knowledge, less prejudice”. Eight respondents
discussed behavioral changes including “A bit less o f off-color joking”. This question
engendered two negative responses regarding the content o f some o f the modules, such as “Many
co-workers resented the tone o f the First Nations component....ears were shut and important
information was not internalized”, and “most staff members not pleased with the training
content”.

60

Table 18
Changes in Work Place due to Staff Participation: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
12
7
8
0
2
0
0
0
2
0

Order
1
3
2
4

4

Question O addressed social change in asking participants if they had noticed any changes in
their personal lives, outside o f the workplace, in terms o f the way they discussed any o f the
marginalized groups. Twenty-four o f the 65 respondents (36.9%) reported that they had noticed
changes in this area, with 41 (63.1%) indicating no changes. The 20 comments (Appendix K)
included a high o f 11 responses regarding advocacy, such as “Over the last few years I find
myself trying to educate people I come in contact with, because I find most people very stuck on
old beliefs” . Two individuals commented on the learning and passing on o f knowledge, in “Share
HIV information with family/fnends” and “Let people in my life know what I learned” .

Table 19
Changes Outside o f Work Regarding Discussion o f fClientl Groups: Textual Responses
Category
Knowledge learned (including changes)
Anitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
2
1
3
2
0
0
0
II
0
0

Order
3
4
2
3

I

61

The final area o f information requested in this section asked for changes in the amount o f
advocacy (outside o f work) that participants are doing for marginalized groups. Only 9 out o f 56
respondents (13.8%) indicated there was a change in their advocacy, with the majority o f
respondents (56 or 86.2%) indicating that there was no change. The 10 textual responses
(Appendix L) include the comment “Knowing the history ie. Aboriginals, you can begin to
understand why they may be there, as well as how the systemic marginalization is embedded into
our society, and everyone deserves equality” which is indicative o f knowledge learned and
understanding gained. The single item in the “knowledge gained and passed on” contains a
recommendation, “People judge out o f ignorance, I just pass on what I learned. My suggestion to
all is to take modules”. O f the five individuals who indicated they continued their practices
according to prior experiences, two o f these related back to their work. An example o f this is the
statement “ Like I said before I have advocated for clients for a long time. That is part o f my job”.

Table 20
Changes Outside o f Work Place in Personal Advocacv: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)

Frequency
1
0
0
1
0
0
0
1
0
5

O rder
2

2

2
1

62

Data from the Concluding Comments Questions

The concluding comments section o f the survey was designed to allow general feedback on the
workshops, and to allow respondents to sununarize the impacts o f their participation. This
section also provides information on the presentation and organization o f the workshops.

The first two questions asked individuals for comments on what they liked most and what they
liked least about the workshops. These questions resulted in more comments than any other
questions as 58 individuals provided information on what they most liked (Appendix M) and 33
individuals commented on least liked aspects (Appendix N). Table 21 and the remaining tables
includes an expansion o f categories due to the content o f the comments.

Eighteen respondents reported that they most liked the workshop content. Comments included
general statements such as “Basic easy to understand info”, as well as statements mentioning
specific content areas such as “The First Nations workshop was a real ‘eye’ opener” and “How
issues o f racism and homophobia are brought forward”. The second highest category was the 13
responses regarding the workshop facilitators, including “The humanness and realness o f the
facilitators and the knowledge they shared”. Workshop participants listed the participatory
environment in 11 responses, including the statements “Information was given in fun with
demonstrations and interactive exercises” as well as “A lot o f good discussion was generated. I
liked the high interactive environment immensely” . They also commented on the learning
environment (8), with five individuals using the word “open”. This question also engendered 6
statements relating to the transformative learning process, with examples such as “I enjoyed the
knowledge from experts and the chance to examine my feelings”, and “The way it was presented

63

allowed me to see where I needed work because my values and beliefs play a part in how I
analyse and then work with my clients” (see Table 21).

Table 21
Most Liked Aspects o f Workshops: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)
Participation/Discussions
Facilitators
Environment: Opeimess, sharing
Transformative learning
Positive comments- no specific area
More anendance opportunities
Content

Frequency
1
I
0
0
4
4
0
0
0
0
11
13
8
6
0
0
IS

O rder
7
7

6
6

3
2
4
5

1

In terms o f the areas that participants liked least, 8 comments identified specific content areas.
Examples o f content areas that were not liked include "The fact that the workshop commenced
with an exercise that indicated/accused all participants as homophobic and racist”, “the approach
and tone o f the First Nations content”, “A large part appeared to be political indoctrination”, and
“A slightly condescending attitude towards certain groups (eg. Church) - there should be no
labeling o f other beliefs”. Three comments expressed concern that the participant was not able to
take more or all o f the workshops, resulting in the new and positive category o f “More
attendance opportunities”. Four individuals provided information that they did not have a least
liked area with comments such as “I appreciated it all”. There were no responses in the
categories o f facilitators, environment, and participation. Three individuals commented on the

64

length o f the workshops, including “Having 5 parts may mean people are unable to commit for
the entire series and so miss out on information” (see Appendix N and Table 22).

Table 22
Least Liked Aspects o f Workshops: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)
Participation/Discussions
Facilitators
Environment: Openness, sharing
Transformative learning
Positive comments- no specific area
More attendance opportunities
Content
Length

Frequency
0
5
0
1
0
0
2
0
0
0
0
0
0
0
4
3
8
3

O rder
2
6

5

3
4
1
4

Question R asked participants if they thought that the workshops were useful to them in their
work place. This question resulted in the highest positive response o f any o f the yes/no
questions, with 51 out o f 63 (79.7%) responding “yes” to this question and 13 individuals
(20.3%) responded “no”. This question also engendered a high rate o f comments with 48
individuals providing written information (Appendix 0 ). The strongest result came in the
category o f “knowledge learned”, with 31 responses. Again, there were general statements such
as “At the time they increased my knowledge” as well as specifics such as “Better understanding
o f how HIV/AIDS affects people”. The next highest category was that o f impacts upon the
organization or the work place, with 8 people providing responses exemplified by “Ensured we
all had a similar base o f info” and “Made us realize that we need separate policies regarding

65

HIV. Also brought forward how much work needs to be done on the ‘isms’ in our place”. The
one negative comment crossed a number o f categories such as content, facilitators and
environment with the statement “Partially - good and relevant info was negated in parts due to
‘accusatory’ tone”.

Table 23
Usefulness o f Workshops in Work Place: Textual responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)
Participation/Discussions
Facilitators
Environment: Openness, sharing
Transformative learning
Positive comments- no specific area
More attendance opportunities

Frequency
31
3
3
2
8
1
1

Order
1
3
3
4
2
5
5

I
I

5
5

1
I
0
0
0

5
5

Participants were next asked if the workshops were useful for situations outside o f work. Again,
the result was higher than many o f the previous yes/no questions, as 39 out o f 61 respondents (or
63.9%) indicated “yes” and 22 individuals (36.1%) responded “no”. The highest response
category was “knowledge learned and passed on” with 9 responses in total (Appendix P). Five o f
those individuals mentioned that the impact o f their participation was expanded to include their
families, as exemplified in “So I had educated information that I could pass on to family, friends
and others”. Advocacy was again a result o f participation, as four responses provided examples
such as “Provide me with more info for people who don’t know or understand (eg. Its NOT only
gay people who get HIV)”. Three individuals hinted at their previous knowledge base, such as “a

66

good review and update in some areas and learned new information in other areas”, and “It did
not expand my knowledge nor change how I viewed the issue”. This question resulted in two
negative responses, including the “I have discussed the teachings o f AIDS PG with friends and
family members and the slant that is portrayed by AIDS instructors and the filthy graphic
comments made by them”.

Table 24
Usefulness o f Workshops in Personal Life: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)
Participation/Discussions
Facilitators
Environment: Openness, sharing
Transformative learning
Positive comments- no specific area
More attendance opportunities

Frequency
5
0
0
9
0
0
0
4
2
3
0
0
0
0
0
0

O rder
2

1

3
5
4

The final question allowed for any fiirther input from respondents. Appendix Q contains the list
o f comments from 37 individuals, however some o f these comments originate in portions o f the
survey that did not request comments and have been typed in here. For example, the comment
beginning with (G*) was written in beside the scale Question G. The category o f “positive
comments” had 9 responses, with examples including “ ...these workshops should be mandatory
for all medical workers, helping profession, general public...”, and “excellent information given
in an open way” . The 10 comments on the passage o f time included “it has been so long it would
be nice to be refreshed to some degree on these”, and “the workshop was over three years ago -

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very difficult to remember specifics”. Six individuals commented on their past life experiences
or educational experiences, with “I am not trying to be negative, I spent 10 years in LA, lost
many fhends to AIDS - so my awareness and education were more advanced than most o f my
co-workers”, and “these workshops are valuable - they didn’t significantly impact my
knowledge and skill base only because I have previously done... training”. The one negative
response was “It was a disgusting experience for me and many others who left the modules or
never returned. Problem is they left with more negatives then when they started”.

Table 25
Other Comments Regarding the Workshops: Textual Responses
Category
Knowledge learned (including changes)
Attitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)
Participation/Discussions
Facilitators
Environment: Openness, sharing
Transformative learning
Positive comments- no specific area
More attendance opportimities

Frequency
3
3
I
0
0
0
10
0
1
6
0
I
I
0
9
3

O rder
4
4
5

1
5
3
5
5
2
4

The textual comments throughout the survey provided us with insight into the impacts o f
participation in the “Reducing Barriers by Building Partnerships” HIV/AIDS education program.
The categories o f the textual comments are summarized and totaled in Table 26 as follows

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Table 26
Category Totals for All Textual Responses
Category
Knowledge learned (including changes)
Altitudes (including changes)
Behaviors (including changes)
Knowledge learned & passed on
Organizational impacts
Resources (including networking)
Time since participation
Advocacy
Negative comments (Miscellaneous)
No changes (Prior knowledge etc)
Participation/Discussions
Facilitators
Environment: Openness, sharing
Transformative learning
Positive comments- no specific area
More attendance opportunities
Content
Length

Frequency
91
41
23
23
20
11
15
27
7
31
11
15
10

Order
1
2

6
6
7
10

s

6

4
12
3
10
8
11
13

13
3
18 + 8
3

14
5
14

9

The categories can be grouped to provide us with a summarization o f the comments according to
change and content areas, as shown in Table 27.

Table 27
Grouping o f textual comments: Summary
Content Grouping
Knowledge

Total frequency
97

Behaviors

84

Learning environment

65

Attitudes
Organizational impact
Attendance

41
20
18

Positive comments
Negative comments
No change
Total

13
7
31
376

Includes variables (frequency)
Knowledge learned (91)
Transformative learning (6)
Behaviors (23)
Knowledge learned/passed on (23)
Advocacy (27)
Resources (11)
Participation/discussions (11)
Facilitators (15)
Environment ( 10)
Length (3)
Content (18 + 8)
Attitudes (41)
Organizational impact (20)
Time since participation (15)
More attendance opportunities (3)
Positive comments (13)
Negative comments (7)
No change (31)

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Representativeness and validity

The purpose o f descriptive research is to adequately represent or describe a population. As this
research process involved the completion o f a survey in a voluntary nature, the issues o f bias and
representativeness need to be addressed to explore if there has been an impact on the results.
Secondly, this section will explore the validity o f the research, in determining if the content
asked what it meant to ask.

Volunteer bias
The issue o f volunteer bias arises when surveys are distributed through the mail or by being
dropped off to a potential participant or organization. In this case, the surveys were distributed
through a key individual within the health and social service agencies. However, their means of
distributing the surveys onwards to potential participants did vary. Some distributed the surveys
directly to specific individuals, others mentioned the surveys at staff meetings and encouraged
individuals to pick up a survey from a central location, and others communicated the information
via posters or other non-personal means. The completion o f the surveys was designed to be
voluntary and confidential. The surveys were not numbered or tracked or matched to individual's
names. This process was followed to ensure that there was no misuse o f the survey information
within the agency, and to ensure that respondents felt safe and anonymous in order to encourage
the most open and honest responses possible. However, as Palys (1997) indicates.
Volunteers are often different firom non-volunteers in ways that
may affect the results o f your research. A variety o f studies, for
example, have shown that people who participate in social science
research tend to be more highly educated, politically more liberal,
less authoritarian, more in need o f social approval, more intelligent,
and most interested in the issue being addressed than those who
don't, (p. 147)

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Palys suggests using return graphs to track the frequency o f returns, and compare the first wave
against a second wave o f returns. However, logistically this was not possible for a number o f
reasons. Firstly, the surveys were distributed through 26 different agencies. Secondly, the
surveys were collected in a central location in each agency after a staggered response period that
averaged 2-3 weeks. It was simply not logistically appropriate to try and encourage a second
wave and a second round o f responses for this varied group o f organizations. It is possible that
volunteer bias exists within these results, however the area o f representativeness does provide
reassurance as follows.

Representativeness
Representativeness is "a term used to describe how well a sample represents the population from
which it's drawn. A sample is considered representative when the distribution o f characteristics
in the sample mirrors the distribution o f those characteristics in the population" (Palys, 1997, p.
425). This research invited participation from staff and volunteers in 26 health and social service
agencies in four communities. Beyond the names o f the agencies, there is little information on
the characteristics o f the population o f past participants. However, the data does provide us with
some examples and insights in four areas.

O f the 26 agencies, surveys were completed by staff or volunteers in 22 o f the agencies (see
Table 4). Therefore, the vast majority o f the agencies (84.6%) were represented in the data
collection. The survey respondents were primarily female (86.5%), while the count o f the past
participants had shown that females constituted 84.6%, and the percentage o f agency contacts
which were females numbered 80.8%. Therefore, the responses were definitely representative
according to gender and host agency. On an observational basis, the gender results mirror the

71

make-up o f staffing in most health and social service agencies, as they are predominantly staffed
by females. The respondents ages reflected almost the complete range o f possibilities, as the ages
ranged from 21-61. The mean o f the respondents was 42.78, which is close to the midpoint o f the
range o f the ages. However, the majority o f respondents or 41 out o f 68 individuals, are over the
age o f 40. Again, by observation it can be noticed that our work force is aging.

The textual comments throughout the survey also provide us with information on the population.
Examples o f positive comments on the workshops such as “Enjoyed the workshops and feel they
were/are worthwhile for our community” as well as negative comments such as “It was a
disgusting experience for me and many others who left the modules and never returned” indicate
that the survey did reach a cross-section o f the population, both those who were interested in the
modules and the research, and those who were certainly not interested in the content o f the
modules.

Finally, the surveys which were partially or fully completed did number 75 returns. An aggregate
o f 75 responses helps in reducing individual propensities in self-reporting, and trends can be
identified across the returns. The above points and the amount o f returns provide the rationale
that the results are representative o f the population surveyed.

Validitv
Palys defines validity in "the most general sense, to whether research measures what the
researcher thinks is being measured". As the instrument was designed specifically for this
research project, relating to this educational program's content, it is not an instrument that has

72

been used or tested elsewhere. However, both the pilot project and the textual results indicate
validity exists in this research.

The instrument was piloted through four individuals, all o f whom were past participants o f the
workshop series. As reported in the Methodology section, all tested the survey, reviewed the
content and the structure, and gave suggestions for change. The survey was then re-distributed to
two o f pilot participants, who reported that the changes improved the survey and that the survey
would provide the information sought through the research questions.

The content o f the textual results provide an interesting insight that also shows validity does
exist. Table 26 provides a summary o f the categorization o f the textual responses. These
categories were inductively derived once the comments had been entered into the Appendices.
These comments derive from two types o f open-ended questions; broad questions such as "What
did you like most (or least) about the workshops?" and more specific questions such as "Have
you noticed any changes in the way.... you discuss any o f the (client) groups with co-workers?"
The comments derived from the open-ended questions mirrored either the questions themselves
or the Literature Review content areas. Categories such as knowledge learned, attitudes,
behaviors, organizational impacts, networking, time since participation, and advocacy reflected
the question areas. Categories such as participation/discussions, facilitators, environment,
transformative learning reflected the Literature areas. Because these inductively developed
categories do not contain any other content areas, the validity o f the survey is shown in the
responses to these open-ended questions. The survey measures what is was supposed to measure.

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Summary

The results o f the “AIDS/HIV Education for Work Place and Personal Change” research survey
provided information on the demographics o f the respondents, their self-reported changes in
knowledge, attitudes and behaviors, and their insights into the presentation o f and the usefulness
o f the “Reducing Barriers by Building Partnerships” workshops. Although each question
requested information on a specific variable, the textual responses contained information relating
to a number o f the variables. Therefore, the textual responses for each question were categorized
and counted, and the frequencies o f the categories were reported in table form. The category
totals were summarized at the end o f this chapter. The survey may have some volunteer bias,
although the returns are representative in terms o f gender, derive from most o f the host agencies,
mirror the age o f the general work force, and number 75 in total. Based on the pilot information
and the analysis o f the textual responses, content validity appears to be high.

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CHAPTER VI: CONCLUSION

The “HIV/AIDS Education for Work Place and Personal Change” thesis research has been based
upon three research questions;
Has participation in the “Reducing Barriers by Building Partnerships”
program resulted in changes in knowledge, attitudes, behaviors
and/or actions on a personal level and in the work place?
Has participation resulted in a positive, negative or neutral transfer
or change?
What is the impact o f participation in the “Reducing Barriers by
Building Partnerships” educational program?
Chapter Six will discuss the conclusions drawn from, and the implications o f this research. The
delimitations and the limitations o f this research will be examined, suggestions for further
research will be proposed, and recommendations arising from this research will be presented.
The chapter will conclude with a summary o f this research.

Conclusions

In this portion o f the chapter, conclusions will be drawn from the research in relation to each o f
the three research questions. This information is derived from the results relating to each content
area, regardless o f the source o f the information in the survey. For example, the discussion o f
changes in knowledge will draw numerical information from survey Questions F and G, but will
draw textual information from any o f the appendices which contain information on knowledge
learned.

75

Did participation result in changes?

The first research question was “Has participation in the ‘Reducing Barriers by Building
Partnerships’ program resulted in changes in knowledge, attitudes, behaviors and/or actions on a
personal level and in the work place?” The results have shown that the answer to this multi­
faceted question is “yes” in all areas, although the changes in knowledge were numerically much
stronger than the changes in attitude or the changes in behavior. The areas o f knowledge, attitude
and behavior will be addressed separately in the following sections.

Changes in Knowledge
Survey questions F and G requested information on changes in knowledge and changes in the
understanding o f client situations. These numerical variables are supplemented by 97 textual
comments, not including the 23 responses in the "knowledge learned and passed on" category.
Knowledge was the only item that was mentioned in all o f the textual response appendices.

Knowledge and Understanding
The results o f Question F indicated that most o f the respondents experienced an increase in their
knowledge base, with between 68% and 81.3% reporting medium to lots o f learning firom the
modules taken. This was essentially an introductory question, as the initial evaluation (Walmsley
& Keith, 1998) provided detailed information on the learning that occurred in each module.

The survey’s second question in the knowledge section began laying the groundwork for social
change. The question asked if respondents experienced a change in their understanding o f the
client groups discussed in the modules. The literature has shown that changes in knowledge

76

about and understanding o f an item or an idea can positively influence attitudes and behaviors
toward the item or idea being considered. The number o f participants who reported medium to
lots o f change in their understanding o f client situations ranged from 60.8% to 73.8% o f
respondents. This again is a positive result. Between these two results, it is evident that the
primary impact o f these workshops has been in the area o f knowledge gained.

The survey respondents indicated that they had increased their knowledge in technical or medical
areas such as details on the progression o f the disease, in personal health care practices such as
universal precautions, in historical contexts such as First Nations history, in their understanding
o f the social and emotional needs o f clients and their families, in their awareness o f community
resources, and in many, many other associated areas. This knowledge base forms a framework
for an understanding o f an issue in the broad perspective, and has moved the participants beyond
the narrow framework o f dealing only with the disease. This constitutes an holistic approach to
health and social service delivery, encompassing a model that is socially rather than medically
driven. The social model o f service delivery is critical in addressing the needs o f the whole
person, rather than only addressing the needs o f a component o f an individual's issues.

The Literature Review identifled knowledge as being a factor in an individual's attitudes. Wade
and Tavris (1998) described an attitude as having a cognitive and an emotional component. As
one survey respondent stated: “Knowledge and understanding equal less discrimination and
fear”. The development o f a solid knowledge base is then an important factor needed in
encouraging change in attitudes and behaviors. This is reinforced by the comment "Greater
understanding and knowledge. Less prejudice". It would be very difficult to encourage a shift in

77

attitudes and a shift in work place behaviors without first addressing the knowledge needs o f the
staff and volunteers.

The importance o f learning opportunities in the work place can not be overstated. Simply the act
o f providing or encouraging such opportunities sends a message to the staff and volunteers that
their professional development is encouraged; there is confidence in their ability to learn; their
personal learning needs are important; and, that there is a recognition that as the world changes,
so do the skill and knowledge areas needed to cope with these changes. The offering o f
educational opportunities by employers expresses a belief that the employees themselves are
very important in the delivery o f service. Tight spoke to the recent fourth wave in training and
development, focusing on "information, knowledge and wisdom" (1996, p. 19). The recent
concept o f the learning organization has at its core the development o f individual, group, and
systemic knowledge and skills to address the needs o f today's work place. The development o f
knowledge is a critical component in the functioning o f today's health and social service
organization. As one respondent indicated, "We need more education and workshops".

Previous knowledge.
Table 26 provided the total figure o f 31 comments relating to "No change (Prior knowledge
etc)". Respondents wanted to reassure us that their lack o f change was not due to the content or
presentation o f the workshops, but due to the fact that they were already knowledgeable about
these topic areas. Examples include ‘T o clarify - It’s not that the modules weren’t informative,
its just that I already knew a lot o f it” and “I don’t believe my understanding has changed. I have
always had an appreciation o f groups listed from a S. W. perspective”.

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Changes in attitude
The Literature Review section on attitudinal and behavioral change defined attitude as having an
evaluative component. Both Thurstone (1928) and Zimbardo and Liepe (1991) discussed the
continuum o f like - to - dislike or favorable - to - unfavorable which defines the continuum.
This research asked respondents if they experienced any changes in their attitudes or beliefs as a
result o f their participation in the “Reducing Barriers by Building Partnerships” workshops. This
section will discuss the two numerical variables, changes in attitude regarding the situation o f
(client) groups, and changes in confidence levels regarding working with the (client) groups as
well as examine the textual feedback regarding attitudinal change.

Attitudes and confidence levels.
The results for Question H, requesting a rating o f the changes in attitude and Question K,
requesting a rating o f the changes in confidence levels, are remarkably similar. The changes in
attitude question had a majority o f responses (53.2% to 60.5%) in the “about the same” category.
The combination o f the “more positive” and the “lots more positive” categories ranged from
34.9% to 45.1%. The changes in confidence level responses also had a majority o f responses
(53.5% to 61.4%) in the “about the same” category, with the two categories o f “more
confidence” and “lots more confidence” ranging from 36.9% to 45.9% o f responses. These
results are numerically substantially lower than the results firom the knowledge category
questions.

Appendices F and G contain 14 comments categorized as attitudes, with 8 o f these reporting
positive changes. Examples o f these include “It helped me be more open and aware o f the higher
risk activities and diverse people I come in contact with”, “Generally I have become a more

79

inclusive and open-minded person”, and “A close friend revealed his sexual preference and I
think I was more open-minded”. These examples speak to the original workshop goals o f
fostering insight and strengthening social environments, and show us that the workshops have
resulted in changes in attitudes among some o f the participants. As presented in the Literature
Review, the original definition o f change stated that change is any movement, whether positive
or negative, as reported by the program’s past participants. These responses indicate that change
has occurred. As expressed in the above example regarding sexual preference, the attitudinal
change o f being more open-minded will have been resulted in a less judgmental, more accepting
interaction. Such a change can be very meaningful, and is an expression o f a more accepting
relationship. Each small change such as this gives hope for the development o f a kinder, more
understanding community and society.

The textual responses discussing attitude numbered 41 in total. The category o f “Attitude” shows
comments in 11 out o f the 13 questions inviting textual input. Question N-b, inviting input on
changes in the work place due to staff participation also resulted in 7 responses on attitudes.
Examples o f comments included “Everyone seems more open-minded” and “less prejudice”.
Again, these are very important pieces o f information as one o f the original goals o f the
workshops was to strengthen social environments in health and social service agencies. Attitudes
underlie our actions, and if we can continually strive to become more open and accepting, then
our clients will have more o f a chance to receive equitable and accessible service. As adults, we
bring to our work places a variety o f background experiences and knowledge based on familial
upbringing, religious background, education and life experience. Any positive change in our
attitudes will affect the work we do.

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Changes in behavior
The area o f behavioral change was operationalized in the following five variable areas: changes
in levels o f empathy demonstrated at work, changes in discussions o f (client) groups both at
work and outside o f work, changes in service provision at work, changes in advocacy regarding
(client) groups both at work and outside o f work, and changes in the work place due to staff
participation in the workshops. Numerically, the data indicates that between 38.6% and 44.1% of
participants reported medium to lots o f change. O f the 110 comments in Appendices H through
M, 79 comments gave examples o f positive changes, 21 responses indicated that they had not
changed in the areas discussed, two o f the responses indicated a change to the negative, and
seven o f the responses did not provide us with useable information. Barriers to equitable service
such as ignorance, fear and stigma were identified earlier in this paper. This workshop series has
resulted in positive changes in all areas, as the discussion o f these five variable areas will show.

Empathv.
Question L used a scale to request information on changes in empathy demonstrated at work.
The responses to this question are similar to the attitudinal scale questions. Between 53.8% and
60.4% o f the respondents reported that their behaviors are about the same. The combinations of
“more empathy” and “lots more empathy” categories resulted in a range o f 35.8% to 44.1%
reporting changes. Therefore, the results are positive in that between one-third and one-half o f
the respondents are translating their participation into actual changes in the work place. The
expression o f or use o f an empathetic approach in dealing with clients is further described in
textual comments such as “I feel I gained more o f an understanding as to what the client faces, so
I would be able to work with the client in a more nonjudgmental way, to deal with what faces
them instead o f focusing on the horrible disease”, and “Being more empathetic, less critical o f

81

their choices - more supportive - more focused on the need to teach people - knowledge that
will help them increase their choices”. Stigmas are one o f the primary barriers to service, and the
judgmental approach o f a case worker can have an impact on service delivery. Education that
results in changes in the empathy demonstrated can potentially have a positive impact on the
lives o f individuals with or impacted by HIV/AIDS.

Communication.
Appendices H and L provide textual input on changes regarding discussion o f (client) groups in
the work place and in personal life. Five o f the comments can be categorized as “Knowledge
learned and passed on”. The following comment is interesting because it indicates the connection
between knowledge, attitudes and communication:
Being able to make others aware o f the issues that impact people’s
life and the choices they are able to make with the knowledge they
have - Being so aware o f people’s needs and share that with others
before judgements take place.
This quote as well as the comment “Let people in my life know what 1 have learned” speak to the
broader impact o f the workshops, indicating the content did not just remain with the participants.
This is a very positive statement as it indicates that the content has been accepted and
internalized, and that the participant feels strongly enough about the information that he/she
wants others to be aware o f it as well.

In Appendix H, the category o f “Knowledge learned and passed on” once again provides
interesting insights especially with the statements “Giving information in a fun way. Also using
the modules to give clients small pieces o f information over time for learning that meets their
learning needs” and “More focused on the need to teach people - Knowledge that will help them

82

increase their choices”. Marginalization o f groups in society can result in a decrease in choices in
a variety o f ways, including lack o f choices due to lack o f knowledge or education and lack o f
choices due to inherent program or service barriers. Empowerment is the concept o f enabling
others to make their own choices, rather than the process o f making a choice for someone. This
study indicates that the workshop series has significant potential to empower clients within our
communities.

Appendix J provides more information on changes in communication. The comments “More
awareness o f conversation and who might be around”, “One co-worker acknowledged his
inappropriate vocabulary around clients” and “A bit less o ff color joking” speak to the
strengthening o f social environments through increased care in communication. Our society’s
mores are often reflected in the language that we use, the assumptions we make, even in the
jokes we communicate. Stigmas are reinforced through our language usage. As one o f the
original funding applications listed a goal o f enabling individuals to remain in their home
community, the community in general needs to exhibit an open and accepting environment for
all peoples. Language usage is a key to this.

Service provision.
The third behavioral change variable area for discussion is that o f change in service provision at
work. Appendix H contains 18 responses to this request for information. Some o f the responses
identify content areas discussed previously, such as increases in knowledge and changes in
attitudes, but also changes in approach such as being more empathetic as well as teaching others
the module information. The issues o f resources and o f networking are addressed here for the
first time. It is very important for service providers to have knowledge o f and encourage use o f

83

the services that exist in a community, keeping in mind that each community has differences in
availability and structure o f services. This also reduces the need for any one provider to attempt
to address all needs, which is generally a difficult or impossible task. Service providers also have
differences in their points o f entry, and in their client definitions. Knowledge o f one's own
community can enhance the range o f service options for a client, and, as one respondent
indicated, "More aware o f making services more accessible".

Advocacv.
Numerically, the advocacy change frequencies numbered 36.2% for work place advocacy, and
13.8% for personal advocacy. Twenty-seven o f the comments from the survey identified the
learning o f strategies that could be termed as advocacy, although only one o f these was written
down as a response to the two questions concerning advocacy. The Collins Concise Dictionary
(1995) defines the term “advocate” as “ 1. to support or recommend publicly, 2. a person who
upholds or defends a cause, and 3. a person who intercedes on behalf o f another” (p. 17).
Examples o f advocacy from other appendices include “How to comment when negative
comments made regarding First Nations people, homosexuals were discussed” and “When topic
came up in conversation was more assertive about cutting o ff negative talk”, and “Ran across
homophobic people and tried to change their opinions” yet these are not identified by the
respondents as advocacy. I would conclude that the meaning o f the term “to advocate” is not
necessarily understood by many o f the participants in terms o f their personal roles.

The respondents indicate that there is some understanding o f their professional role as an
advocate for clients in their comments on advocacy at work. Examples include "I have always
tried to advocate for ALL o f my clients" and "We were strong advocates before the training" and

84

are included in the "No change" frequencies. The ability to advocate for and with one's clients is
an essential function in a health and social service agency, especially in terms o f working with
individuals who face stigmas due to health, race, sexual orientation, age or any other
marginalizing factor. It can be very challenging to be an advocate for a client with personal
aspects that one doesn't respect, or like, or agree with. The purpose o f this educational program
was to develop knowledge and foster insight among employees, as well as to strengthen social
environments within agencies to encourage and ensure that the needs o f a client are addressed in
the most professional maimer possible. Advocacy can play a strong role in service provision.

The following comment addresses not only the individual’s advocacy but also his/her approach
with “The biggest change in fact I almost never let a negative statement re: HIV/AIDS,
gays/lesbians/IDU’s etc go by without ‘gently’ commenting on a more generous point o f view’’.
The use of the word “gentle” is evocative o f positive yet persistent encouragement for social
change. Imagine what society would be like if each o f us did not allow negative comments to
continue about individuals or groups based on race, sexual orientation, health, economic factors
or any other discriminatory aspect! In summarizing this area o f change, it is very positive to see
the increase in understanding and action regarding marginalized groups.

Work place changes.
The final variable area in the broad category o f behavioral change is that o f changes in the work
place due to staff participation in the workshops. Appendix J provides the 28 textual responses to
this question. Eight o f these responses are categorized as “Behavior”.

85

The statement “Knowledge o f issues helps the work team work in consistent manner with our
clients” introduces the area o f operational procedures. Consistency is important for many
reasons: it ensures that clients are treated in the same manner in each interaction; it ensures that
service provision does not vary due to outside factors such as time, location or knowledge; and it
ensures staffing changes do not result in service changes. In order for this to occur, it is helpful if
the staff receive the same or similar training, and that procedures are formally or informally
communicated.

The specific category “Organizational impacts” includes two statements. The first expresses
positive results in saying “Brought us closer together as a result o f shared experience" which
addresses the need for teamwork and mutual support in a work environment. The second
comment identified an area o f concern in saying “Most o f staff still do not want to talk about
issues o f marginalization”, indicating some frustration with co-workers. However, the act of
participating in the module may have opened the door for enhanced communication on the issue.
The following comment touches on “Knowledge learned”, “Attitude” and “Behavior” in stating
“Increased knowledge and confidence among my co-workers. This created a more supportive
atmosphere for both clients and myself (when in need o f a second opinion or someone to ‘vent’
to)”. These responses speak to Dworkin’s (1992) statement that “An organization - focused
educational program can go beyond changing individual professional attitudes and utilize peer
influence to create positive group norms” (p. 673). As stated previously, an organization is often
a microcosm o f society. Therefore, it follows that not only the clients need a respectful service
area, but all workers need to be part o f a respectful working environment. The employees and
volunteers themselves will also reflect their environment, there may be individuals as described
in the modules’ client groups who are working within these health and social service agencies.

86

Positive changes in an environment will especially assist marginalized individuals to feel more
comfortable and potentially more effective if their working environment supports them as well.

Summarv
The research question “Has participation in the ‘Reducing Barriers by Building Partnerships”
program resulted in changes in knowledge, attitudes, behaviors and/or actions on a personal level
and in the work place” has been answered in this portion o f the chapter. This research was
designed to question the individual participant on their internal knowledge and attitudinal
changes, and their external behavioral changes, and not to externally observe or test these
changes. The research has given us a large number o f examples o f these changes: examples
internally in knowledge gained, examples internally in attitudes that have shifted, and examples
externally in behaviors and actions both in the work place and in their personal lives. The
process o f social change through education is ultimately displayed through external attitudes and
behaviors. Numerically, the change figures were not as strong as the textual examples sometimes
indicated. This reflects one o f the challenges o f adult learning situations: that participants come
to the situation with differences in backgrounds, experiences and knowledge. This research did
not presume a level playing field within the adult participants, hence the approach in requesting
the individual analyze himself regarding his/her perceived change levels rather than imposing an
external measure o f change. The numerical results also reflect the previous knowledge that the
population had come with, knowledge that may have been gained through college or university
experiences, through the popular media o f television, newspaper and radio, and through previous
workshops or seminars in content area the same or similar to this educational program. Such
knowledge becomes ingrained, and it is difficult to ascertain the original source o f the

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knowledge and o f the attitudes and resultant behaviors. The research does indicate that change
did occur in all o f the areas investigated.

Has participation resulted in positive, neutral or negative transfer or change?

The second research question, “Has participation resulted in positive, negative or neutral transfer
or change?” draws us back to Wexley and Latham (1991) in the Literature Review. It is easy to
presume that any learning situation will result in an increase in, for example, the knowledge base
o f an individual participant. Wexley and Latham, as well as Yam (1991) state this is not
necessarily so. There are a number o f reasons why a learning experience could result in a
negative transfer. If the content o f an education session is controversial, if the presentation or the
learning environment is less than optimum, if the participants are not motivated, if the
information is not applicable, or if the information provides too little content, then negative
transfers may occur. The “Reducing Barriers by Building Partnerships” workshops are based on
a medical topic that raises fears in the general population. The workshops challenged individuals
to examine their beliefs and value systems. The content included taboo topics such as gay and
lesbian li festyles and issues, and the historical marginalization o f First Nations people. The
workshops discussed stigmas, morality, disease, sex, addictions, racism, sexism and many
associated topics that some individuals are simply not comfortable with. There was a risk that the
workshops could have resulted in a negative change, with a resulting decrease in the openness
and increase in the stigmas expressed professionally and personally in our communities. A
negative transfer or change would be a disastrous result for any educational situation.

The possibility o f a zero or neutral transfer or change is also an area that we tend not to consider
when reviewing educational opportunities. A zero transfer would indicate that the workshop
content was not relevant to people’s needs, that the participants did not care about the
information presented, and that the educational opportunity did not challenge its participants in
any way. The zero transfer could occur if the participation did not result in any difference in the
lives o f the workshop attendees. This would have an impact on employee training, in that
employers are most certainly not willing to support a training opportunity which, in essence, is
not meaningful. A neutral or zero transfer or change would also be a disastrous result for an
educational situation.

The research results show that all o f the variables measuring change have scored in the range o f
positive change. The knowledge area resulted in the highest positive gains, while the attitudinal
and the behavioral change responses showed lower rates o f positive transfer and higher rates of
neutral or "no change". Negative transfers did exist, with frequencies o f 1-2 individuals in total.
The results indicate the “Reducing Barriers by Building Partnerships’’ workshops were definitely
a success in terms o f the transfer to the work and personal situations o f participants, especially in
the area of creating change in the knowledge base o f respondents.

A number o f the questions asked respondents to provide "yes", "no" or "not applicable" answers,
and to add comments following any "yes" answers. For example. Question M asked "Have you
noticed any changes in the ... way in which you discuss any o f the (client) groups with co­
workers". These open-ended questions did not specify if the responses should be positive or
negative changes, yet o f the 376 textual responses only 7 responses described negative situations.
A further 3 1 responses indicated "no changes", leaving a grand total o f 340 statements

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expressing positive feedback. These figures indicate a very strong case for the positive effects o f
the "Reducing Barriers by Building Partnerships" educational program.

What is the impact o f participation?

The third research question, "What is the impact o f participation in the "Reducing Barriers by
Building Partnerships' educational program" will be addressed by examining the participants'
analysis o f the learning environment, the strengthening o f the social determinants o f health
through the participation in these modules, evaluating the results in relation to the original goals
o f the workshop series, addressing the existence and impact o f Social Learning Theory, and
acknowledging the impacts to individuals beyond the past participants. This final research
question therefore pushes the boundaries beyond personal and work place change to look at the
broader change issues involved in education for social and community change.

Analvsis o f the learning environment
One o f the impacts o f participation in the workshops and in this research process has been the
analysis o f the learning environment by the respondents. The concluding section o f the survey
asked for input on most liked aspects o f the workshops, least liked aspects o f the workshops,
applicability o f the workshops to both work place and personal life situations, and any other
areas the respondent wished to comment on. The purpose o f these questions had been to provide
insight into the factors influencing the success o f these workshops. The primarily textual input
again provides positive results overall, and provides some very specific input important to adult
learning situations.

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Was this andraeoev?
The respondents provided the information that the learning environment was a key factor in the
success o f these workshops. The “Reducing Barriers by Building Partnerships” workshops
reflect the andragogical approach in that participants stated the workshops were participatory,
relaxed, worthwhile, provided opportunities to explore issues, provided a good and current
knowledge base, provided factual information, were interactive and intimate, and left participants
feeling good (see Appendix M and P). The participants are adults who experienced the
opportunity to learn about the content in an atmosphere o f mutuality, respect, inquiry, and
informality. The word “open” was used by five respondents in this section o f the comments.
Reflecting back to Knowles’ Comparison o f Assumptions and Designs in Table 1, the feedback
indicates that the workshops encouraged learners to share their knowledge, provided information
with immediate application, were problem and reality centered, allowed for mutual self­
negotiation in the time lines o f the modules, were respectful, collaborative and informal in their
presentation style, and encouraged self-diagnosis. The workshops also used six o f the twelve
strategies suggested in Campbell (1999): lecture, discussion, case study, demonstration, forum
and panel. The variety o f presentation methods, the resources o f the guest speakers, the
participation o f the group members, the collaboration between teachers and learners, and the
challenge and critical reflection that was encouraged resulted in the wide variety o f positive
comments from the survey respondents.

The “Reducing Barriers by Building Paitnerships” program incorporated many o f Galbraith's
(1991) characteristics in its five modules by providing lecture material, reading material,
discussion, demonstration, guest speakers, collaborative group work, questioning, selfexamination, learning objectives, case examples and many other techniques in its presentations.

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The aim o f the learning opportunity was to encourage individuals to learn, enjoy, reflect,
consider and perhaps change through their participation in this program. The content and
presentation structure therefore addressed all six o f the guiding principles for the transactional
learning experience as identifled in Galbraith's theories.

Throughout the survey, the respondents commented on the provision o f workbooks for each o f
the modules. Comments such as “Being able to pass on the knowledge gained (using the resource
material) to staff if questions arise” from Appendix E, “I used words/examples the instructor had
used in our modules - 1 passed on booklet to person” in Appendix F, and in Appendix M
“Resource material. Provided a good knowledge base re: meaning o f acronmyms, transmission,
protection and definitions”. The workbooks were helpful to adult learners because they allowed
participants to review the material at a later time if they chose, they provided written information
and reduced the need to take notes, they included exercises which could be useful and applied
outside o f the workshops, and they provided an opportunity for the learning to be further
disseminated after the workshops.

The participants identifled the andragogical approach that was the underpinnings o f this
educational program. The participants responded very positively in their analytical comments. It
then follows that the andragogical approach was a key factor in the success o f these workshops.

Was this a transformational learning opoortunitv?
In Scott (1998), transformational learning was defined as encompassing three aspects: social,
personal and knowledge transformations. Respondents commented that “I enjoyed the chance to
examine my feelings”, it was an “open atmosphere exposing o f myths and taboos”, “the way it

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was presented allowed me to see where I needed work because my values and beliefs play a part
in how I analyse and then work with my clients”, and the “content on marginalized people was
thought provoking”. As Cranton (1998) stated “When we are led to question our assumptions,
critical reflection, the central process in transformative learning takes place” (p. 198).

Question Q asked survey participants to identify their least liked aspects o f the workshops.
Interestingly, a number o f comments reflected people’s discomfort with this type o f discussion as
suggested by the following quotes; “The section on homophobia - thought the (perceived) goal
o f exercise reached a little high. Education does not always bring ACCEPTANCE”, “would have
liked more emphasis on people confronting, acknowledging bias, prejudice”, “A large part
appeared to be political indoctrination”, and “The fact the workshop commenced with an
exercise that indicated/accused all participants as homophobic/racist” . The process o f
considering one’s own beliefs and attitudes, and the identification o f the source o f these is not
always an easy or a comfortable process. For some individuals, it can not only be very
uncomfortable but also not acceptable:
The thought that we were asked if OUR attitudes towards
homosexual people had changed. I think most people’s beliefs
are entrenched and as long as everyone we affect is treated with
respect and consideration - no one can ask anyone to change their
beliefs and attitudes.
(from Appendix P)

Cranton (1998) discussed Mezirow's theories o f transformational learning. These theories are
reflected in the goals o f the “Reducing Barriers by Building Partnerships” program, specifically
by encouraging individuals to add to their knowledge base, to explore their beliefs and
assumptions, and to consider applying these transformations to the behaviors and attitudes they
bring to and use in their work settings. Transformative learning stresses the need for learners to
be reflective about their learning.

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The learning environment in the “Reducing Barriers by Building Partnerships” workshops
exemplified the philosophy o f adult education and was a strong example o f a transformational
learning opportunity. Question R asked respondents if the workshops were useful to them in their
work and in their personal lives, and in both situations the participants answered overwhelmingly
“yes” (79.7% and 63.9%). This indicates that the workshop series has been a valuable experience
in the educational lives o f its participants. The program meets the four criteria for
transformational learning as identified by Scott (1998, p. 179). These workshops therefore
exemplify the successful implementation o f a transformational learning opportunity due to the
positive results and positive feedback on the discussion o f attitudes, beliefs and values and their
relation to daily work and personal behaviors and actions.

Determinants o f health

The Northern Interior Regional Health Board’s Health Services Plan: 2000 - 2003 identified ten
o f the key determinants o f health. This workshop series addressed six o f these determinants:
social support networks, (employment and) working conditions, social environment, personal
health practices and coping skills, health services, and culture. The results o f this research have
indicated that changes in knowledge have been significant, knowledge that relates to health and
social service employees' and volunteers’ understanding o f the broader issues affecting health
and health services. The issues o f marginalization, stigmas, historical context, and discrimination
impact on the social environment, employment and working conditions, and culture. The goals o f
the program had identified the strengthening o f partnerships between service agencies, which
speaks to the determinant o f social support networks. The technical knowledge will assist in the
instruction o f personal health practices and coping skills. This research resulted in the

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documentation o f change due to this educational program. It is evident that the "Reducing
Barriers by Building Partnerships" was not just a prevention education program, nor was it solely
focused on technical health issues. The mandate and the resulting impact o f this educational
program have resulted in a strengthening o f six health determinant areas, a strong achievement to
be recognized and celebrated.

Original goals o f the educational program
The original goals o f the “Reducing Barriers by Building Partnerships” HIV/AIDS education
program were listed as “to provide knowledge and foster insight in health care and social service
agencies in order to ensure sensitive, adequate, accessible service and care for those living with
HIV/AIDS in Prince George” (Walmsley & Keith, 1998, p. 4) and “to strengthen social
environments in social and health service agencies for persons living with HIV and AIDS”
(Walmsley & Keith, 1998, p. 4). The results have indicated that there was a strong change in the
knowledge level o f participants in the workshop series, with 60.8% to 81.3% o f respondents
reporting medium to lots o f change in their knowledge levels. The goal o f fostering insight
relates to not only the changes in knowledge but also the changes in attitudes. About half o f the
respondents reported that their attitudes remained the same, with a number o f individuals
commenting in an overall manner that they came into the workshop with previous standards o f
compassion and understanding. Additionally, 34.9% to 45.9% o f the respondents reported
changes in attitudes regarding the situation o f the client groups and changes in confidence levels
regarding working with the client groups. These results indicate that there was some progress
made in terms o f fostering insight in the health and social service agency employees. The goal o f
ensuring sensitive, adequate, accessible care for those living with HIV/AIDS was not directly

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addressed within this research, as the research focused on the employees rather than the clients.
However, as the research did ask for information on changes in the behaviors o f employees,
information was collected that relates to the goal even if it does not directly address the goal.
This research asked respondents if there was change in the empathy they demonstrated at work,
and 38.6% to 44.1% indicated that they were more or lots more empathetic in their work places.
This addresses the aspect o f sensitive provision o f service. The anecdotal or textual responses
provide a number o f important examples o f changes in actions in the work place, changes that
would have a positive impact on the clients' access to adequate service and care. Examples of
these comments include “Obtained a better understanding o f the resources available, at the local
level, therefore able to provide the best possible treatment for the client”, “more calls to
community agencies”, and “connecting people to other support systems”. This research provides
information that the knowledge and abilities o f health and social service agency employees and
volunteers have improved as a result o f the HIV/AIDS education program.

The second goal o f strengthening social environments within health and social service agencies
is also addressed by the above numerical changes in attitudes and behaviors. The yes/no
questions did result in lower percentages o f change information, as their percentages ranged from
29.4% to 38.7%. The above discussion on the internalization o f new information, the amount or
lack o f reflection in the completion o f the surveys, and the length o f time since participation
would also be relevant to these results. The textual information does indicate some important
examples o f changes, and these validate the achievement o f the second goal. The questions
regarding changes in the discussion o f (client) groups at work and the changes in the work place
due to staff participation especially speak to this goal. Comments such as “way less politically
incorrect comments and/or jokes”, “brought us closer as a result o f shared experience” and

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“more understanding coworkers” indicate that changes have occurred regarding social
environments in the work place.

Our work places are microcosms o f our community. This research also addressed the
strengthening o f social environments outside o f the work place, as a recognition that the greater
community is also a very important facet in meeting the needs expressed in the original funding
application by AIDS Prince George.

Social learning theorv
The Literature Review addressed the aspect o f direction in terms o f attitudinal and behavioral
change. Wade and Tavris (1998) state that changes can occur in both directions. This research
addresses changes in attitude first in the survey, then requests information on changes in
behavior. However, this was the order o f the survey and not an imposed order regarding the
direction o f change. Although it may appear that this research addressed changes in knowledge
leading to changes in attitude leading to changes in behavior, this is not the only progression
addressed. The overall impact o f the workshops is far beyond that as identified in this research,
as individuals will learn firom the changes in the behaviors o f their co-workers and from the
changes in the environment on an ongoing basis. This speaks to the impacts o f advocacy as
discussed above. Differences in the way workshop participants communicate will lead to
differences in the way their co-workers, clients, friends and families think and perhaps result in
changes in their attitudes and behaviors. Examples o f these comments include “Over the last few
years I find myself trying to educate people I come in contact with, because I find most people
very stuck on old beliefs”, and “I speak with knowledge and therefore pass on what I have
learned to stop stigma o f stereotyping”. These actions will potentially result in a snowball effect

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o f change. If past participants work towards addressing stigmas and negativity, they will educate
others who will also potentially begin to work towards a more equitable and accepting society.
These comments and ideas are reflective o f Bandura's Social Learning Theory (Campbell, 1999),
the recognition that change may come from within or as a result o f direct interaction, but may
also come from the observation o f or interaction with the environment. This also indicates that
the change process will be ongoing, and not end simply because the educational participation has
ended. This workshop series has been well grounded in theory, and as such, exemplifies the
second characteristic identified in Kirby et al, that is " the effective programs were based upon
theoretical approaches" (1994, p. 353).

Impacts bevond past participants
The impacts o f participation in these workshops also extends to individuals associated with
participants, individuals who may be employees or volunteers themselves, individuals who may
be clients, and individuals who may be family members or fnends o f the participants. This
information is derived from the 23 textual responses relating to “Knowledge learned and passed
on” (see Table 26). Examples o f the above situations are provided by respondents in saying “1
share the information learned with co-workers who are working with HIV individuals or
couples” (Appendix G), “Perhaps increased comfort, confidence client groups/volunteer service
people seem to ask educative questions that 1 answer and can provide direction for more
info/services” in Appendix H, and “Share HIV/AIDS information with friends/family”. This
indicates that the impacts o f participation are exponential, affecting a much broader range o f
individuals than just those who participated in these workshops. As this research defined its
population as only those who participated in the workshops, it is therefore not possible to
measure or even to speculate on the expanded impacts o f the “Reducing Barriers by Building

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Partnerships” program. However, the notion o f the broader range o f impacts is truly exciting to
envision.

Implications for practice

The implications for practice portion o f this thesis will move the conclusions further into the area
o f applicability. This section will first address the question "Was change necessary" for the
participants o f the "Reducing Barriers by Building Partnerships" workshop series, and the
implications o f this discussion. This section will also consider implications regarding andragogy,
transformational learning, and module attendance.

Was change necessarv?

The research results have indicated that over 50% o f the respondents reported "no change" in
their attitudes and beliefs. O f the 376 textual comments, 31 responses addressed the issue o f no
change due to prior knowledge, attitudes and behaviors. O f these responses, 17 provided
information that they had previously provided service in a positive manner with comments such
as “Like I said before, I have advocated for clients for a long time. That is part o f my job”, “I
have always been careful about confidentiality and shared information” and “Have always
supported clients regardless o f health issues”. The question which then arises can be stated as
“Was change necessary?”

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The positioning o f this research needed to be very carefully addressed as it was very important
the participants did not feel that they had been judged, or provided with an implied message that
change was needed. It was critical to the ongoing provision o f services in this sector that the
implementation o f this research project did not result in negative connotations towards service
providers. It was also critical that the research not result in negativity towards AIDS Prince
George, the host o f the ongoing workshop series. The development o f the research instrument,
and the implementation o f the research process were intended to gather information in a nonjudgmental and welcoming manner, in order to provide insight and understanding into the
research question areas.

The Literature Review provided information that organizations are a microcosm o f our
communities. The definition o f attitude included the information that an attitude is a point on a
continuum from very positive to very negative. The “Reducing Barriers by Building
Partnerships” workshops address the aspect o f continuum in a number o f their content areas,
including the continuum o f personal sexuality and the continuum o f attitudes towards the gay
and lesbian population. Given the aspects o f the microcosm o f our community, and the
continuum o f attitudes, it was reasonable to expect that participants in the workshop would
reflect their communities and represent the full spectnun o f the continuum. Some individuals
will have been enlightened, empathetic, respectful and flexible in their provision o f services
before the workshops. It then follows that some participants will fall at the other end o f the
spectrum in a variety o f areas. The results o f this research confirm that this spectrum does exist.
The comment “Just reiterated what I already knew. I’m empathetic and understanding and open
- minded” provides an example o f an individual with positive attitudes and behaviors, while the
comment “About how it is normal to be gay and everyone should embrace their lifestyle:

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ABNORMAL. AIDS PG mandate seems to be acceptance o f the gay lifestyle, and if you don’t,
YOU ARE THE ODD ONE OUT” is a strong example o f an individual who is on the negative
end o f the spectrum regarding attitude toward the gay and lesbian population. Therefore, the
assumption was not that all participants should experience changes in all areas. The workshops
and the research recognized that there was probably room for change in some individuals in
some areas as investigated.

The existence o f the spectrum also presents the need for modification in viewing the numerical
results. Given that some individuals entered the workshop series with previous knowledge, the
fact that 60.8% - 81.3% reported "medium to lots" o f learning is that much more positive. Given
that some individuals entered the workshops with a positive attitudinal and behavioral base, the
fact that 34.8% - 45.9% o f respondents reported "medium - to -lots" o f change in the attitudinal
and behavioral variables is again much more positive. Given that with the existence o f the full
spectrum, it was possible that some individuals are the far negative end o f the scale would
probably not have been influenced to change through this relatively short workshop series, the
results again appear in a more positive light. Therefore, this educational program did initiate
change to many o f the individuals within the middle portion o f the spectrum.

Andragogy

In the Literature Review, Scott's comment “Adult education is primarily interested in people, the
changing o f people to become better citizens, better workers, better contributors to society”
(1998, p. 186) provided a basis for the implementation o f this adult education opportunity. In the

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Conclusions portion o f this thesis, the results indicated that the educational approach was
andragogical in nature, and that this was a key factor in the success o f the workshops. The
implications for practice that arise from these conclusions provide direction for planners and
practitioners for and o f adult learning situations, and can be very simply stated as follows.

Adult learning opportunities need to be well grounded theoretically. Planners need to be
respectful o f their audience, develop the material and the presentation style to reflect the needs of
the learners, and allow learners to contribute their own rich body o f knowledge to the learning
experience. The power o f the instructor needs to be shared: the facilitation o f input from the
participants; the sharing o f the instructional role with individuals who speak from a different
voice such as guest speakers or panel members; and the implementation o f instructional
strategies in a variety o f mediums to address the range o f learning styles. Examples o f this
include visual learners who can benefit from written materials in workbooks, aural learners who
can benefit from lecture or taped materials, and kinesthetic or experiential learners who can
benefit from hands • on work or exercises. Adult learners come from a wide variety o f
backgrounds, with varying knowledge, skills, family or religious experiences, work or life
experiences. An andragogical approach is critical to the effectiveness and acceptability o f an
adult learning opportunity.

Transformational learning

The Conclusions section stated that the "Reducing Barriers by Building Partnerships" program
was an example o f a transformational learning experience. The results and textual information
proved the workshop series was successful. What are the implications for practice?

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The participants o f this educational program were health and social service agency staff and
volunteers. This program was a work place training initiative. Participants began by learning the
technical details o f HIV/AIDS, and moved on to addressing difficult and challenging issues, yet
their feedback was positive! This strongly indicates that it is possible to provide work place
education with a transformational learning component. It is possible to challenge people, gently
and carefully, to consider their attitudes and beliefs and the impacts these have in their work
places. It is possible to encourage social change through a work place education program, and it
is possible to present "a social vision about the future based on a value system that includes the
struggle for freedom, democracy or equity, and authenticity" (Scott, 1998, p. 178). Practitioners
need to learn from these results and conclusions, and should not fear the inclusion o f
transformational learning opportunities within their training situations.

Module attendance

The “Reducing Barriers by Building Partnerships” workshop participants were health and social
service agency employees and volunteers. Respondents were then, by definition, presently or
previously employed or volunteering in these agencies. The respondents’ participation in the
modules ranged from 67 out o f 75 (89%) in Module One, to 44 out o f 75 (58.7%) in Module
Five. This question helped in defining the attendance population in each module, and a definite
trend is indicated. The decline in the attendance numbers as participants moved through the
modules reflects the original encouragement to begin attendance at Module One and work
through them in order whenever possible. However, these figures also indicate that there is a
large body o f individuals who were not able to complete their attendance o f all five modules.
This dilutes the effectiveness o f the workshop series, and leaves the sense o f an unfinished

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opportunity among a considerable body o f individuals. Practitioners need to consider means to
address this within the ongoing planning and promotion o f the modules. Encouragement needs to
be given to health and service agencies to track the attendance o f their employees, to provide a
variety o f opportunities for access to the modules in recognition o f the variety o f work schedules
which exist today, and to lengthen the contact with an educational agency in order to
accommodate the needs o f the employees. Use o f technology such as electronic mail to publicize
workshops, and spreadsheeting software to track participation will potentially lessen the work
load o f this function.

It was noteworthy that many individuals (17 out o f 75, or 23%) could not recall their last year o f
attendance in a module. This is further reflected in the written comments about the difficulty o f
remembering content and details when a workshop occurred two or three or more years
previously. The bulk o f the attendees in 1998 and 1999 may reflect the busiest years in terms o f
the hosting o f the workshops by AIDS Prince George, but also may reflect the unwillingness or
inability o f potential respondents to recall workshops held a number o f years previously. The
survey was distributed in the fall o f 2000, and the lower number o f respondents fi’om 2000 may
reflect the timing o f the distribution (part way through the year) as well as the reduced staffing at
AIDS Prince George during that year.

Respondents provided textual information on the challenges o f remembering content and its
impact due to the length o f time since participation. These comments are dispersed throughout
the results, including comments in Appendix E, “I’m sure there have been times at work when
something has happened, but the workshop was 3 years ago”. Appendix H, “Hard to remember”,
the comment “Can’t remember” once in Appendix M and twice in Appendix N, the comment “I

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can’t remember much o f what we did, its been a long time” in Appendix P, and nine comments
in Appendix Q as summarized in the results section. The challenge o f presenting a workshop
series is to make the information interesting, relevant, current, memorable and integrated into
practice. As adults, these participants came to the workshops with varying learning needs,
interest areas, and previous knowledge. One individual commented “It’s been many years since
I’ve taken the workshops, but the information learning has stuck with me, unlike many other
workshops”. Evidently, for this individual, the information’s relevance made it particularly
memorable. Because o f the diversity inherent in adult learners, there are no easy solutions to the
dilemma o f the passage o f time. There will also not be a single solution in the length o f time that
individuals will remember a workshop, as this too will vary from person to person. The
demographic information in Question B and the textual responses from the participants clearly
indicate that the passage o f time was a difïiculty for approximately 5 -1 0 out o f the 75 survey
respondents. Practitioners need to be aware o f the differing situations o f participants, and solicit
their input to ensure that the content is current, relevant and memorable. Participants may be able
to provide suggestions for follow - up mechanisms, and ongoing consultations with sponsoring
agencies may provide insights into the effectiveness o f the learning experience.

The final section o f the demographics requested information on the attendance situation o f
respondents. It is very positive that over two-thirds o f the participants (46 out o f 66 or 69.7%)
reported that they voluntarily attended the workshops. It can be surmised that this means they
attended because they chose to, that they were interested in increasing their knowledge in the
content areas, and that they were willing to commit time and energy to their learning process. It
is interesting that although only one-third o f the attendees were present on a mandatory basis,
almost two-thirds o f attendees were remunerated. Generally speaking, when an employer

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requires a staff member to attend a workshop, union contracts require that the employee’s time
be considered work time and the individual’s wages must be paid. Therefore, the twenty
mandatory attendees would probably have been paid for their time, and over half (26 out o f 46 or
56.5%) o f the voluntary attendees must also have been paid their wages. This indicates a
willingness by the remaining voluntary attendees to attend workshops without receiving
remuneration, possibly as a means o f professional and/or personal development. These figures
also indicate employer support for educational experiences in the workplace. Because this
research has identified very positive effects o f participation in this workshop series, it would be
important for this research information to be disseminated to the health and social service
agencies. Practitioners also need to encourage organizations to recognize the value o f ongoing
training opportunities, and be prepared to defend and advocate for the continuation or expansion
according to identified training needs.

Delimitations and Limitations

The delimitations o f a research plan are those areas that are under the control o f the researcher,
while the limitations are areas not under the researcher's control. In this research project, there
were a number o f both. This section will briefly explore these.

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Delimitations

The delimitations o f the research “HIV/AIDS Education for Work Place and Personal Change”
can be categorized into three areas; the operational definitions, the research instrument, and the
generalizability. It was a challenge to operationally define the change process in a manner related
both to personal change and to work place change in sensitive yet realistic language, as discussed
in the Definition o f Terms portion o f this thesis paper. I consulted with present and past AIDS
Prince George staff in assisting in the process o f refining the survey questions, and in
operationalizing the definition o f change. This was accomplished through several consultation
meetings. As also mentioned previously, these operational variables needed to be positioned in a
way that invited personal reflection on change without alienating the participants through
implying that they needed to change. The range of information received provides the feedback
that the operationalization o f the variables was successful.

The second delimitation o f this research relates to the design o f the survey instrument. As this
was original research relating to a unique educational program, there was no existing survey
instrument. I created this instrument based on the research questions, and on feedback during the
consultation process. While the survey did provide a large amount o f information, the process o f
implementing and evaluating the instrument resulted in the identification o f several areas for
change or improvement.

The survey was distributed through the health and social service agencies that had participated in
the “Reducing Barriers by Building Partnerships” workshops. The contact person in each agency
was responsible for distributing the surveys to their agencies’ past participants. The success o f

107

this distribution process varied (see Table 4 for numerical information). In retrospect, I would
recommend a change in the covering letter (see Appendix C). The covering letter should have
had a section for the past participants’ name to be written in, with accompanying instructions that
the respondent tear o ff the covering letter before turning the survey in to ensure the anonymity o f
responses. This would have encouraged the contact persons to directly distribute the survey to all
remaining past participants within the agency. Also, the covering letter o f the survey asked
respondents to “please fill in the survey question areas that relate to the modules that you have
taken”. Some respondents missed this piece o f information, and filled in portions o f the tables for
modules which they had not taken. These data pieces were eliminated prior to the recording or
entry o f the data in the software programs so there was no actual impact on the results.

The content o f the survey instrument could have been improved. The demographics section did
not include a question on previous formal education levels. This was a drawback, as such a
question could have provided valuable information on not only the amount o f prior education but
also the professional or non-professional status o f respondents. Three o f the respondents referred
back to their university or their professional training. A second question could have inquired
about previous training in HIV and AIDS diseases and associated processes. Three o f the
comments refer to such previous educational experiences, as mentioned in Appendix Q “Have
been to other HIV/AIDS workshops”. A third question for inclusion could have been “Why did
you take these workshops?” This question could have provided information on areas such as
personal motivation for attendance, the individual’s learning needs, and the success o f public
relations strategies. A fourth question could have asked if participants had previously had
education in AIDS/HIV, in First Nations history, in gay and lesbian issues, and in regards to
other marginalized groups such as intravenous users. A further change would involve the use o f

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numbers instead o f letters in defining each question on the survey. The capitalized letters proved
to be confusing because o f the use o f letters to define each appendice. The survey change scales
asked respondents to rate their level o f change. This resulted in trend information. Another way
o f structuring this might have been to use two scales for each variable, the first asking the
respondent to assess their level prior to the module and the second for their level following the
module. This would have provided more specific information on not only the levels o f change,
but also the positioning o f each individual on the spectrum both prior and following their
educational experience. However, this would have lengthened the survey. The survey would also
have been more difficult for the respondents to fill out in relation to each o f the modules, but
may have provided a much better picture overall o f our respondents.

The third delimitation o f this research relates to generalizability. The investigation o f the AIDS
Prince George’s educational program, “Reducing Barriers by Building Partnerships program”
was carried out within a constructivist framework, using quantitative research methods.
Constructivist thought recognizes that “individuals perceive or construe the same event in
different ways” (Cranton, 1998, p. 194-5). This reflects the views in adult education that
individuals vary in their backgrounds, experiences and knowledge. Therefore, their perspective
on an educational experience will also vary. This thesis research used a quantitative methodology
to reach past participants o f a specific educational program, in order to both hear their unique
perspectives as well as look for patterns in responses and in impact statements. The “HIV/AIDS
Education for Work Place and Personal Change” research was also very specifically contextual
relating only to the delivery o f these program modules in the specific location o f this region o f
the province o f British Columbia. Therefore, only portions o f this research are generalizable to
other work place education programs. The numerical results and the specific comments belong to
this offering o f this program. The implications for practice are generalizable to other adult

109

education opportunities. The recommendations are both specific and generalizable according to
their identified audiences.

Limitations

The limitations o f this thesis research also fell into several categories: the response procedures,
the definition o f change, and the meaningfulness o f the change. In terms o f response procedures,
the survey was o f a voluntary nature, and was distributed in work place settings. The attrition o f
staff and volunteers has been addressed in the Distribution section.

The second limitation was that the survey asked for people’s perceptions o f their own change,
rather than observing the change itself. Participants were asked to engage in self-refiection, and
to provide honest responses based on their own self-knowledge and insight. Not all individuals
are comfortable with self-reflection. The returned surveys certainly showed a great variety in the
depth o f the responses. Some individuals chose to write lengthy, thoughtful comments while
others chose to only complete the closed questions. While this limitation may have influenced
the response rate and results, the process o f participation did add to the benefits o f the original
participation in the program, thereby continuing the original goal o f strengthening social
environments.

The meaningfulness o f the change, as expressed by respondents in the survey process, needed to
be analyzed and applied carefully. For the respondents who indicated that change has occurred, it
must be noted that we can only apply this information in the context o f the staff and volunteers
o f the health and social service agencies. In other words, we cannot extrapolate this to mean that

110

the individuals with and impacted by HIV/AIDS will therefore also have experienced changes in
their experiences with agency staff and volunteers. It must be emphasized that this research does
not speak to the experiences, past or present, o f individuals with/or impacted by HIV/AIDS. It
was beyond the scope o f this research to address the impacts on the clients themselves. This
research speaks only to the self reported experiences and self-perceptions o f the staff and
volunteers who provide services to individuals with or impacted by HIV/AIDS.

The survey's concluding section asked respondents to indicate if the workshops were useful to
them in the work place and in their personal lives. These results were quite strong as 79.7% said
the workshops were useful for work, and 63.9% indicated the workshops were useful outside o f
w ork. This is a stronger response than a similar but related earlier question set, and presents a bit
of a contradiction. The results o f previous questions asked if participants thought o f the
workshops while at work (50.7% said yes) and outside o f work (50.8% said yes). While the two
questions sets differ slightly, they are related. One can surmise that since the process o f learning
in adults builds upon previous knowledge and experience, the addition o f new knowledge or
changes in attitudes can sometimes occur subconsciously. Adults may internalize information
without consciously recognizing this process. Therefore, the respondents may have been able to
acknowledge that the workshops contained relevant and useful information but not necessarily be
able to specifically identify the application to either work or personal situations. A potential
second factor lies within the process o f completing a survey. Some respondents may have
carefully considered each question and taken the time to think through and record their thoughts.
Others may have quickly written their responses and not had or taken the time to reflect on each
question. The third factor has been discussed previously: the length o f time since participation in
the workshops has affected the conscious memory o f the workshop content and impact. Some

I ll

respondents indicated that it was difficult to recall specific information after the passage o f time
since participation. Regardless o f the speculations regarding the difference in the results o f the
two questions, the respondents have strongly indicated that the workshops were useful to them in
both their work and their personal lives.

Suggestions for Further Research

The thesis research “AIDS/HIV Education for Work Place and Personal Change” has examined
the impacts o f participation by health and social service agency staff and volunteers in a work
place educational program. This research has shown that the participation has resulted in
significant changes in knowledge, and some changes in attitude and actions. The research leaves
a number o f areas for further exploration and possible research questions;
a) Do people with/impacted by HIV/AIDS report changes in health or social service agencies?
b) Have individuals with/impacted by HTV/AK)S benefited from changes in staff/volunteers?
c) What are the attitudes o f health and social service agency staff towards the client groups
before the workshops, immediately following the workshops, and at six month and one year
intervals following the workshops?
d) How can retention o f knowledge be improved?
e) How can changes in attitudes and actions be reinforced and encouraged?
f) What are the barriers to creating attitudinal and behavioral change?

112

In adult learning situations, each individual brings a unique history o f educational experiences,
family environment, religious participation, personality and many other factors. It would be
interesting to explore, via a qualitative approach, the following questions:
g) What are the components in the workshops, and what are the personal factors which resulted
in positive changes in a select few individuals in knowledge, attitudes and behaviors?
h) What are the components in the workshops, and what are the personal factors which resulted
in negative changes in a select few individuals in knowledge, attitudes and behaviors?

Recommendations

The "HIV/AIDS Education for Work Place and Personal Change" research has resulted in
insights into the changes in knowledge, attitudes and behaviors among past participants o f the
"Reducing Barriers by Building Partnerships" workshop series. The conclusions and implications
for practice have solidified the findings and translated them into a path for the future. The
following recommendations provide specific direction to three categories: the field o f adult
education and training, the area o f health and social service agency organizations and specifically
those whose primary function is addressing HIV/AIDS, and the specific organization AIDS
Prince George.

Adult education and training
I) It is recommended that organizations planning and implementing adult education or training
opportunities ground their approach theoretically in the principles o f andragogy. The diversity o f

113

the adult learner demands that their uniqueness be considered philosophically, strategically, and
practically.
2) It is recommended that organizations planning and implementing adult education or training
include the opportunity for transformational learning theory where appropriate.
3) It is recommended that any implementation o f a multiple-module educational program give
careful consideration to the encouragement o f participants to complete the full series. Given the
unique needs and schedules existing in today's work place, this may involve creative
management o f workshop scheduling and ongoing repetition o f the offerings o f various
components. It is recommended that usage o f current technology be improved to address these
scheduling and public relations needs.

Health and social service agencies, specificallv HIV/AIDS organizations
4) It is recommended that the "Reducing Barriers by Building Partnerships" educational program
be considered for implementation in communities throughout British Columbia and Canada. As
the module content and the presentation style are both critical components in the effective
realization o f the goals o f the program, it is recommended that they be emulated in any new
offering o f this workshop series.

AIDS Prince George
5) It is recommended that AIDS Prince George further develop the component of, and
understanding o f advocacy within the "Reducing Barriers by Building Partnerships" program.
Given the implications o f Social Learning theory, and the ongoing possibilities for change, this
will strengthen the overall impact o f this educational program.

114

6) It is recommended that AIDS Prince George implement a process to follow up on the number
o f past participants who did not complete the module series, in order to ensure that the maximum
impact o f the educational program is achieved.
7) It is recommended that AIDS Prince George develop strategies to inform the community o f
the results o f this research, to consult with the community on the implications o f this research,
and consult with the community on the future development o f the "Reducing Barriers by
Building Partnerships" educational program.

Summarv

This thesis research was a wonderful opportunity to investigate an existing educational program.
The program is strongly grounded in theory, strongly supported by its developers and host,
strongly supported by the body o f past participants, and now strongly documented through this
research. The "Reducing Barriers by Building Partnerships" program exemplifies a successful
work place educational initiative.

115

BIBLIOGRAPHY

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Babbie, E. (1983). The practise o f social research (3rd ed.V Belmont, CA: Wadsworth
Publishing Co.
Campbell, K. N. (1999). Adult education: Helping adults begin the process o f learning.
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Cranton, P. (1998). Transformative learning: Individual growth and development through
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Dworkin, J. (1992). AIDS education for health care professionals in an organizational or
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Eiser, J. R. (1994). Attitudes, chaos and the connectionist mind. Oxford, UK: Blackwell.
Galbraith, M. W. & Zelenak, B. S. (1991). Adult learning methods and techniques. In
Galbraith, M. W. (Ed.), Facilitating adult learning: A transactional process. Malabar, FL:
Krieger Publishing Co.
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HIV/AIDS update: Year end 1999. Vancouver, B. C.: British Columbia Centre for Disease
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Cognitive and attitudinal impacts o f a university AIDS course: Interdisciplinary education as a
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APPENDICES

Appendix A

Reducing Barriers by Building Partnerships Modules and Descriptions

Appendix B Survey
Appendix C

Survey Covering Letter

Appendix D Question E-b: Attendance Explanation
Appendix E Question 1-b: Thoughts at Work Regarding Learning
Appendix F

Question J-b: Thoughts outside o f Work Regarding Learning

Appendix G Question M-a-2: Changes at Work Regarding Discussion o f (Client) Groups
Appendix H Question M-b-2: Changes at Word Regarding Provision o f Services
Appendix 1

Question M-c-2: Changes at Work Regarding Advocacy

Appendix J

Question N-b: Changes in Work Place due to Staff Participation

Appendix K

Question O-a-2: Changes in Personal Life Regarding Discussion o f (Client)
Groups

Appendix L

Question O-b-2: Changes in Personal Life Regarding Advocacy

Appendix M

Question P: Most Liked Aspects o f Workshops

Appendix N

Question Q: Least Liked Aspects o f Workshops

Appendix O Question R-b: Usefulness o f Workshops in Work Place
Appendix P

Question S-b: Usefulness o f Workshops in Personal Life

Appendix Q

Question T : Other Comments Regarding the Workshops

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Appendix A

REDUCING BARRIERS BY BUILDING PARTNERSHIPS
MODULES AND DESCRIPTIONS
The following lists the titles and subsequent learning objectives for each o f the "Reducing
Barriers by Building Partnerships" modules.

A) HlV/AIDS 101: Upon completion you will:
1. Understand the significance o f the acronyms HIV and AIDS.
2. Know how HIV is transmitted and understand the components o f the Transmission
Equation.
3. Know the components of the HIV Continuum and how the infection progresses fi’om
HIV to AIDS.
4. Be able to state how to protect yourself from HIV infection

B) The Impact o f HlV/AIDS on Those Infected and Affected: Upon completion you will be
able to:
1. Identify and respond to common emotional reactions o f individuals infected
and affected by HIV/AIDS along the HIV continuum.
2. Recognize the physiological manifestations o f the virus along the HIV continuum and
be able to respond to the effects o f these health problems on accessibility o f service.
3. Respond to the needs o f those infected and affected by HIV/AIDS who are
experiencing grief, loss, and the necessary preparations for anticipated death by exploring your
own feelings and thoughts around these issues.

119

Appendix A continued

C) Homophobia. Heterosexism and HIV/AIDS: Upon completion, you will have:
1. Explored the basis for your own sexuality and your values about sexuality.
2. Explored your personal feelings and attitudes about sexual orientations different from
your own.
3. Examined how the stigma o f homophobia creates barriers which affect interactions
with people living with HIV/AIDS and their significant others.

D) HIV/AIDS and First Nations People: In this workshop you will;
1. Examine the effects o f colonization on First Nation health.
2. Begin to understand the multiple losses experienced by First Nations people and how
these losses relate to increased risk o f HIV infection.
3. Examine how culture could shape the delivery o f service to First Nations people living
with HIV/AIDS.

E) HIV/AIDS in a Diverse Community: Upon completion you will:
1. Understand the concepts of diversity and marginalization.
2. Examine your assumptions about others, what you base these assumptions on, and how
they affect your interactions with others.
3. Practice techniques that challenge habitual assumptions.

(AIDS Prince George, 1999)

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Appendix B

Reducing Barriers by Building Partnerships
AIDS/HIV EDUCATION W ORKSHOPS
Participant Survey
DEMOGRAPHIC INFORMATION
A)

Please check off the Building Partnerships modules which you attended:

Module
Attended?
Module I (Mod-1) HIV/AIDS 101
Module 2 (Mod-2) Impact of HIV/AIDS on Those Infected & Affected
Module 3 (Mod-3) Homophobia, Heterosexism, and HIV/AIDS
Module 4 (Mod-4) HIV/AIDS & First Nations People

Yes

No

Module 5 (Mod-5) HIV/AIDS in a Diverse Community

B)

Please check the year that you LAST attended a Building Partnerships module:

Year

(check
one)

2000
1999
1998
1997
1996
Don't know

0)

Please place a check mark beside your gender: Female_
Male

D) Please write in your current age:

E)

Please place check marks b eside your attendance options (in both a and b questions).

a) Mandatory attendance

OR Voluntary attendance_____

b) Paid attendance time

OR Non-paid attendance time

OR other (explain)____

121

Appendix B continued
KNOWLEDGE: This section explores the amount of learning that occurred.
F) Please place a check mark in the square that rates the amount of knowledge you learned in
each of the Building Partnerships modules.
Module
Mod-l)AlDS/HIV10l
Mod-2) Impacts o f AIDS/HIV
Mod-3) Hotnophobia/Heterosex
Mod-4) First Nations
Mod-5) Diverse Conminity

None

Very Little

Uttle

1

Medium

Lots

j
1

G) As a result of taking the module, do you feel there have been ch an ges in the amount you
UNDERSTAND about the situation of any o f the client groups (listed below)? Please check the
amount of change._______________________________________________________________________
None

iVlodule
Mod-1) Individuals with HIV/AIDS
Mod-2) Families/friends o f ......
Mod-3) Gay and lesbian people
Mod-4) First Nations people
Mod-5) Other marginalized/diverse
people

Very Little

Uttle

Medium

Lots

1

ATTITUDES: This section asks vou about anv chances in attitudes or beliefs that mav have occurred.
H) A s a result of taking the module, do you feel there have been ch an ges in your ATTITUDES
towards the situation of any of the client groups (listed below)? Please check the amount of
change.
Lots more
negative

Module
Mod-1) Individuals with HlV/AlDS
Mod-2) Families/lriends of.....
Mod-3) Gay and lesbian people

More
negatlw

About the
same

More
positlw

lAts more
positive

Mod-4) First Nations people
Mod-5) Other marginalized/diverse
people

I) Have there been tim es at work when som ething has happened which made you think about what
you learned or talked about during the Building Partnerships w orkshops?
a) Y es.

No

b) If Yes, then please write down what happened/what you thought about (write in a general
way: please do not include confidential client/staff information)

122

Appendix B continued
J) Have there been tim es outside of work when som ething has happened that made you think
about what you learned or d iscussed during the Building Partnerships workshops?
a) Yes_

No

b) If Yes, then please write down what happened/what you thought about.

K) Have there been changes in your own CONFIDENCE level in working with individuals (in the
client groups) a s a result of your participation in the Building Partnerships workshops? Please
check the amount o f change.

Module
Mod-1) Individuals with HIV/AIDS
Mod-2) Families/friends of.....
Mod-3) Gay and lesbian people

Lots less
confidence

Less
confidence

About the
same

More
confidence

Lots more
confidence

j
j

Mod-4) Fiist Nations people
Mod-5) Other marginalized/diverse
people

BEHAVIORS 8J0R ACTIONS: This section asks about any possible changes in your behavior or actions
both within and outside of your work place.
L) Do you feel there have been changes in the amount of EMPATHY that you demonstrate when
you are working with any of the client groups (listed below)? Please check the amount.
Lots less
IVlodule
Mod-1) Individuals with HIV/AIDS I
Mod-2) Families/friends of.....
Mod-3) Gay and lesbian people
Mod-4) First Nations people
Mod-5) Other margmalced/diverse
people
i

Less

About the
same

More

Lots more

M) Have you noticed any changes in the way you carry out your work in any o f the following
areas...?
a) The way in which you d iscu ss any o f the (client) groups with co workers
1) Yes_

No

N/A

2) Please comment (please write in a general way: do not include confidential client/staff
information)

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Appendix B continued
b)

c)

The way in which you provide services to the clients/groups?
No______________

N/A___

1)

Yes_________

2)

Please comment (please write in a general way: do not include confidential client/staff
information)

The amount of advocacy you do for/with any of the clients/groups:
1)Yes ___________

No___________

N/A__________

2) Please comment (please write in a general way: do not include confidential client/staff
information)

N) Have you noticed any changes in your work place a s a result of staff member participation in
the Building Partnerships workshops?
No__________

a)

Yes_________

b)

P lease com m ent (please write in a general way: do not include confidential client/staff
information)

0 ) Have you noticed any changes in your personal lives (outside o f work) in any of the following
areas...?
a) The way in which you d iscu ss any of the marginalized (client) orouos ?
1) Yes___________

No__________

2) P lease comment:

b)

The amount o f advocacy you do for/with any o f the marginalized (client) orouos?
1) Yes___________
2) Please comment:

No__________

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Appendix B continued
CONCLUDING COMMENTS: This section asks you some general questions about the Building
Partnerships workshops.
P) What did you like the MOST about the Buiiding Partnerships w orkshops you attended?

Q) What did you like the LEAST about the Building Partnerships w orkshops you attended?

R) Were the Building Partnerships workshops usefui to you in your workpiece?
a) Yes___________

No__________

b) Piease com m ent (please write in a general way: do not include confidential staff/client
information)

S) Were the Building Partnerships workshops helpful to you for situations outside of your work
place?
a) Yes___________
No__________
b) Please comment:

T) Are there any other com m ents that you would like to make about the Building Partnerships
workshops?

THANK YOU for taking the time to fill in this survey--------

PLEASE place your completed survey in the envelope/box described in this survey’s covering letter.
Thanks

125

Appendix C
Reducing Barriers bv Building Partnerships
HIV/AIDS Education Workshops
Survey Covering Letter
Dear Survey Participants:
This covering letter will give you a brief overview of the research "HIV/AIDS education for work place
change”. I hope you will take a few minutes to read this information, and then fill out the attached survey.
My name is Christine Jam es. This survey is my thesis research for my Masters in Education degree at
UNBG. I wanted to do a project that would be helpful to the community, and I am very interested in
training that is related to our work places.
The purpose of this research is to find out if your knowledge, attitudes, beliefs or actions changed after
you took part in any of the “Reducing Barriers by Building Partnerships" workshops offered by AIDS
Prince George. Everyone who took anv of the modules is asked to please fill out this survey. It is
being distributed to all of the health or social service agencies that encouraged their staff to take these
workshops. Your participation is CONFIDENTIAL, ANONYMOUS, and VOLUNTARY. The only people
that will see your survey are myself and my committee at the University. The surveys will not be looked at
by staff at your agency or at AIDS PG.
Please do not discuss your survey with anyone else, as it might influence their answers.
This survey will take you 10-20 minutes to fill out. Please fill in the survey question areas that relate to the
modules that vou have taken. Whether you have taken one or all five of the workshops, your comments
are still needed. The questions ask you to think about the course, and to give us your thoughts on how
the workshops affected you. This survey will help to understand what (if any) changes have occurred
within people, within your workplaces, and within our community as a result of the Building Partnerships
workshops. Have they m ade a difference? If so, what? If they haven’t, then we also learn from your
answers.
Please fill in this survey by:

______________________________________________________________

Please put your completed survey in the brown envelope (marked AIDS/HIV Education Survey) that is

I will analyze the results, and send out a summary copy of the research information to your agency/work
place.
You will also be welcome to view a copy of my thesis in the library at UNBC next year (hopefully II), or
contact the AIDS Prince George office a s I will also give them a copy of the completed thesis.
For further information, please feel free to contact me (Christine Jam es) at:
(Home phone) 250-962-8645
(e-mail) CLJames@telus.net
If you have any questions about this research, please contact the Chair of UNBC Education, Dr. Paul
Madak at 960-5555. If you have any concerns or complaints about the research, please contact the Office
of Research and Graduate Studies at UNBC, phone: 250-960-5555.
THANK YOU FOR YOUR PARTICIPATION IN THIS SURVEY III!

126

Appendix D
Question E-b: Attendance Explanation
Hospice training
(paid) by agency
Recommended (attendance)
paid and unpaid
Both-attended on days worked/days off

Total: 5 responses

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Appendix E
Question I-b: Thoughts at Work Regarding Learning
Staff feel prepared re precautions (general conversation)
Wearing gloves all the time
We face situations on daily basis in which we have to use our knowledge o f social issues & the skills to
provide the support and understanding that people need to get through difficult situations. It is difficult
to point out at a one situation in particular.
Sexual health, resources & testing, symptoms - identifying
How to comment when negative comment made regarding First Nation people, homosexuals were discussed
That we do not have specific policies in place in regards HIV/AIDS. It seems many in our workplace do
not want to discuss issues impacting on HIV ie. Racism, homophobia, etc
A negative response/amusement with tact taken - everyone is homophobic & racist
Attitudes of some human/social service workers/professionals towards marginalized groups-lack o f
understanding about systemic discrimination
Switching from mugs to disposable cups to cut back on cold & flu germs that could put clients who are
infected HIV &/or AIDS at risk
Not specific story but it makes me stop to think about my values so I can provide a more non-judgemental
service
Just questions re: how HIV is contacted
Being able to pass on the knowledge gained (using the resource material) to staff if questions arise
Client questions
When clients divulge the fact to me that they have to be diagnosed with AIDS/HIV or Hep. I thought- I'm
glad I had the training as am better informed to their situation.
Requests for bed covers for night sweats. Transportation for Vancouver counselling sessions
Uninformed comments from other staff .Joint mtg with participants & AIDS Society. When participants request
assistance with items not usually requested (frequency)
Requests for finances for needs previously not adequately understood
Medical professionals using word "contamination" Do not touch or go near person. Very uneducated as to
the transmittal o f HIV/AIDS. Also numerous professionals don't understand the difference between HIV
&AIDS - How can people be uneducated in this day & age?
I'm sure there has been times @ work something has happened, but the workshop was 3 yrs ago. I think we
all think about things we learn from the workshops we attend. We need more education & workshops
I paid more attention in general to handling blood. More aware o f the risks
Have not had direct patient contact (hands on)
In working w/a client who had just been diagnosed I used what I had learned about what the
impact/grieC'stigma was for that person & examples given in helping deal w/feelings & social judgements
Attitudes o f myself and others
Knew someone with HIV - more understanding
Work together to achieve a common goal
How great to see so many community members in attendance
I am more aware o f making judgements about how some contracted AID/HIV
Better understanding o f IV drug users & the issues that arise w/their rigs when shooting - also don’t hold
back from giving out needles when doing needle exchange program
I work in a Health Unit as a Public Health R N I test for HIV. It helped me be more open & aware o f the
higher risk activities & diverse people I come in contact with
I felt more comfortable & confident when interacting with high-risk youth, in particular one individual
who suspected that she may be HIV positive
On a regular basis -with clients

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Appendix E Continued
Very important to disinfect the dishes, wear gloves when changing bandages, do
A needle-stick injury to self (Lancet) could have been from one o f five people - thought about the consequences of
worst scenario - reaction from other staff if I had contacted HIV

Total: 33 responses

129

Appendix F
Question J-b: Thoughts outside o f Work Regarding Learning
Can’t remember
Speaking o f STD's & HIV-someone made a comment o f it just being a "gay" disease ! was shocked
Discussing information w/friends who are also front line professionals & frnding out that many have misinformation. I
have loaned my modules out on many occasions
When topic came up in conversation was more assertive about cutting off negative talk
In Amnesty International work with Gay Pride parades other Gay related events in the region
When discussing the Gay & Lesbian lifestyles & how AIDS PG AGGRESSIVELY “promotes the gay lifestyle” by teaching
that sexual behavior & lifestyles are not different than anyone else's. And should be accepted. This is pushed big time
Listening to people use homophobic & racist language. How some people in larger community still see HIV as a "gay
disease or punishment for immoral behavior"
Ran across homophobic people & tried to change their opinions
Same as above
Same as I
A general discussion about contraceptives with friends
Probably
Discussion with own children
Not worrying about physical contact w/'"street"people. Having a daughter w/a condition had more impact on my
understanding & empathy
Same as 1 b
While working in food distribution (voluntary) services the issue has arisen. Questions about risk
Uninformed or rude comments, racial, sexist jokes etc-I leave or speak up stating I don't agree or appreciate or want to
hear that
Discussions with people about perceptions relating to people with HIV/AIDS
When some "friends" heard where 1 volunteered ,they asked my husband "Aren't you worried she'll bring AIDS home?"
These "friends" are fairly educated, hold fairly high positions in the community, & I was appalled at their reaction at
first, then I proceeded to education them with the right type of info on HIV/AIDS
The people who live in neighbourhoods near Queens way (particularly children) where prostitution and drugs are prevalent
In both scenarios, the 1 thing I learned was how sexuality is more o f a spectrum than black & white straight/bi/gay/lesbian.
This helped my general understanding of many who are in between these points. Otherwise I didn't feel I learnt a lot.
Based on my attitudes before the course
Info that ink bottles used in tatoos should be changed between clients, needle change is not enough. Info that HIV test may
not show positive until up to 6 months past exposure.
In speaking about HIV/AIDS w/someone who was judging with no awareness o f facts. I used words/examples the instructor
had used in our modules (I passed on booklet to person)
Attimdes o f my self and others
Don't pass judgements
as above
Generally...! have become a more inclusive/open-minded person.
A close friend revealed his sexual preference, & I think I was more open minded
An overall greater understanding of those people marginalized by society
Increased empathy & understanding o f an individual's plight with HIV. I did not know this person directly, however, I
was familiar w/his spouse
Friend with Hep C - precautions he is taking to protect his (family...) in his care - re: cleanliness practise - use of
bleach, sharing o f razor, toothbrush: Discussion/education with this individual

Total: 31 responses

130

Appendix G
Question M-a-2: Changes at Work Regarding Discussion o f (Client) Groups
Yes in general concern, re HIV transmissions
If HIV is present I bring it forward as a piece o f the work
We have a fairly aware workplace w/lots o f discussion. We're sensitive regarding marginalization. As well we are a
feminist organization. We carry out discussion w/the same amount of empathy & awareness as before the BP workshops
Increased confidence in approaching subject o f HIV/AIDS and what may be perceived as supportive vs not supportive
interventions
By being better informed I am able to discuss the situation & ask more informative questions
I share the information learned with co-workers who are working with HIV individuals or couples
Have explained 'truth' vs. myth that come out in conversations
Hasn't changed as a result of this workshop
I have always been careful about confidentiality and shared information
I have always tried to advocate on behalf o f ALL o f my clients - wherever indicated
I think we all have a better understanding & therefore can now speak with knowledge & not from assumptions
I orient new & existing staff-it helped
Expressed more confidence in my ability to work with, and if possible, relate to the client
Have always supported clients regardless o f health issues
I am very open minded about clients etc
Being able to make others aware o f the issues that impact people's life and the choices they are able to make with the
knowledge they have- Being so aware o f people's needs & share that with others before judgements take place.

Total; 17 responses

131

Appendix H
Question M-b-2: Changes at Work Regarding Provision o f Services

Just that my information on AIDS is more correct
Perhaps increased comfort, confidence client groups/volunteer service people seem to ask educative questions that I
answer & can provide direction for more info/ services
More caring
A clearer understanding has helped me be more empathetic
1 feel 1 gained more of an understanding as to what the client faces, so I would be able to work with the client in a more
nonjudgemental way,to deal with what faces them, instead of focusing on the horrible disease.
Use more empathy with client and family
1 consider myself to be empathetic and work diligently in my care delivery
Same as above. I have more confidence in what I am speaking about
NEEDLE EXCHANGE CLlENTS.l do not feel 1 have to give needles on a 1-1 basis. If someone only brought in 2 needles
& wanted 10 needles- that's OK
1 am more aware o f my own body language- how I ask questions etc- more sensitive to their experiences
Obtained a better understanding of the resources available, at the local level, therefore able to provide the best possible
treatment for the client
Hard to remember. We have used universal precautions since day 1- however staff may have relaxed in attitude re:stigma
attached to individuals ??'?
Being more empathetic, less critical o f their choices- More supportive- More focused on the need to teach peopleKnowledge that will help them increase their choices.
Giving information in a fun way. Also using the modules to give clients small pieces o f information over time for learning
that meets their learning needs
Have a greater knowledge base
More empathetic
More aware o f making services more accessible
HIV/AIDS has never been an issue. We treat them the same as any other client. We have always had open discussions
on the topic

Total: 18 responses

132

Appendix I
Question M-c-2: Changes at Work Regarding Advocacy

Easier to talk with people about HIV and AIDS as I feel I know more
1 always advocate for clients
This has not changed for me 1 grew up with 1st Nations people & I did a research paper on HIV/AIDS in university so
my knowledge & acknowledgement level was probably OK before the course
More calls to community agencies
We try to do relative to family need
Not my job
Connecting people to other supportive systems
A strong belief in advocacy has always been an active part of my work w/families
In general conversation
Especially with staff
I do this anyway, their HIV status is not a factor in this
We were strong advocates before the training. We have always been conscious o f helping to give voice to persons who
are marginalized in our society. Our clients are a marginalized group
Not r/t this workshop
Perhaps more response to questions of service providers and low (no) health risk in providing food (volunteer work)
But not in the sense o f legal advocacy or as an associate at a meeting
Able to explain need better & necessity of item required
1, at one point requested a specialized caseload for persons living with HIV/AIDS
I am part of an AIDS support/Ed group & have also been involved in developing many community events about
HIV/AIDS

Total: 17 responses

133

Appendix J
Question N-b: Changes in Work Place due to Staff Participation
More knowledge & comfortable
More understanding coworkers
I think that initially staH' in general are more aware &om what they learn. People remind each other to use gloves more
than we used to
I admired those who admitted & confronted their issues over homophobia. It took courage in todays’ political climate.
Those from my workplace who went probably weren't the ones who had the most homophobia issues.
I'm not sure who attended. I suggest nursing staff would benefit from these work shops
Using universal precautions
more
Knowledge o f issues helps the work team work in consistent manner with our clients
More awareness and '’sharing?
See previous page (Needle Exchange program a t
)
Increased knowledge & confidence among my co-workers. This created a more supportive atmosphere for both clients
& myself (when in need of a second opinion or someone to "vent" to)
Everyone seems more open minded
More awareness- Less fear- More
empathetic
A better more accurate knowledge base
Brought us closer as a result o f shared experience
Greater understanding & knowledge. Less prejudice
More empathy
Most o f staff still do not want to talk about issues of marginalization
Most staff members were not pleased with the training contents
Regarding accessibility!
More knowledge
base
Greater comfort level with clients, knowledge, topic
But I do think some people may be more comfortable as they are no longer misinformed as to the dangers etc of working
with those who may be affected
More awareness o f conversation & who might be
around
Initially.. One co-worker acknowledged his inappropriate vocabulary around clients. For a brief time there appeared to
be some awareness
A bit less o f off-colour joking
Many coworkers resented tone o f 1st Nations component- felt (agency...) &workers were being attacked- therefore ears
were shut & important info not internalized

Total: 28 responses

134

Appendix K.
Question O-a-2: Changes in Personal Life Regarding Discussion o f (Client) Groups
Stop people from judging others when they don't have the "whole picture"- Be more empathetic
More understanding & empathy
Way less politically incorrect comments &/or jokes
More understanding
Has crossed over to my volunteering Amnesty International work
Have always been respectful
1 find I advocate for people more (in informal settings)
I'm less tolerant o f homophobia & with persons who "blame" HIV/AIDS on the homosexual community. I didn't tolerate
it before, but now I'm more likely to give voice to my feelings
s/a
Advocate
Not just this workshop but a combination o f learning
Yes, as mentioned above in volunteer work that provides food to people
Share HIV information with friends/family
Easier to help stop 'myths' etc....
When people make assumptions, or judgements, I address the underlying issues that people may be uneducated too
Over the last few years I find myself trying to educate people I come in contact with, because I find most people very
stuck on old beliefs
Let people in my life know about what 1 learned
1 speak with knowledge & therefore pass on what 1 have learned to stop stigma o f stereotyping.
Less prejudice
Absolutely- the biggest change in fact I almost never let a negative statement re: HIV/AIDS, gays/lesbians/IDU's etc
go by without "gently" commenting on a more generous point of view

Total: 20 responses

135

Appendix L
Question O-b-2: Changes in Personal Life Regarding Advocacy
Wish we could do more, however resources dictate
Do not really advocate but have personal friendships with members o f some o f mentioned people
1 still do the same in regards my work
see M) c
same as above
General comment: Received in depth training in social work program at university that addressed marginalized groups,
radical strucniral social work, oppression etc thought the workshops re-afrlrmed my beliefs and attitudes- from before
Knowing the history, ie. Aboriginals, you can begin to understand why they may be there ,as well as how the
systematic marginalization is embedded into our society, and everyone deserves equality
Like I said before I have advocated for clients for a long time. That is part of my job
As above. People judge out o f ignorance. I just pass on what I learned. My suggestion to all is to take modules
Well yes in my work. I have had to address HIV/AIDS issues at many levels- the street to the Board Room.

Total: 10 responses

136

Appendix M
Question P: Most Liked Aspects o f Workshops
I learned that I was homophobic & didn't believe I was
Shared info in a relaxed atmosphere that encouraged participation
[ enjoyed the knowledge from experts & the chance to examine my feelings. Tolerance is not necessarily a good thing
Open atmosphere exposing o f myths taboos
Nothing
How issues o f racism & homophobia are brought forward
Meeting people in the community
Education. Good facilitators
Putting condoms on woodies
Values - Beliefs- systems- Self-disclosures- how it brought people together
Information was given in fun with demonstrations & interactive exercises
A lot of good discussion was generated. I liked the high interactive environment immensely
Openness
Group discussions
Can't remember
Basic easy to understand info
Openness of the facilitators
The health related information, the impact of HIV/AIDS on people in contact with someone infected
General format
Resource material. Provided a good knowledge base re: meaning o f acronyms, transmission, protection & definitions
Raising issues to awareness. Increased understanding o f what is supportive, what to ask, how to ask, when to listen
Education & Direct dialogue around topics many individuals don't discuss
Participatory
The information I received
Facilitator knew the subject
It was a rehash o f previous info & knowledge
HIV/AIDS fact
content
Very informative-gave good perspective o f how discrimination, the disease etc affects people we work with
It was presented in a clear way that made it much more understandable
The way it was presented allowed me to see where I needed work because my values & beliefs play a part in how I
analyse & then work with my clients
Learning with coworkers
The kind o f interaction with other staff (positive) coming away from the workshops feeling good & having learned.
Opportunities to explore issues.
It was open, personal & not guarded. It was pretty nitty gritty. That was good.
Discussions with colleagues. Factual information about the illness
The discussion with my colleagues
Good discussions & participation. Worthwhile program for public education, nursing staff etc. I think social workers
are generally aware- or I would hope so
Presenters were very knowledgeable and able to field questions well
The facilitators were so knowledgeable & would answer any/all questions
The amount o f information that was presented & how it was presented. The 1st Nations workshop as a real "eye" opener
The humanness & realness o f facilitators and the knowledge they shared
Did similar workshop previously and good to get a refresher
The intimacy and sharing
Interactive
All o f the individuals from this community coming together to increase knowledge
Difficult to recall- individuals who were positive, sharing their stories

137

Appendix M
Continued

Community support
Listening to First Nations person with HIV speaking
The female native HIV+ individual who talked very openly about her life with drugs & HIV
P. Geo. Staff excellent! We had 80+ people attend & almost all stayed the full 2 days. Great for our community
It was a flm, informative workshop- lots of participant involvement
Very informative
Content on marginalized people was thought provoking
The facilitators were excellent. They maintained a warm and pleasant attitude despite the weary topics
Participatory
Very informative, getting alone with others
Straight up casual yet informative and interesting
Good Instructors - humour, were at ease with the group - good participation from group

Total: 58 responses

138

Appendix N
Question Q: Least Liked Aspects o f Workshops
N/a
N/a
The thought that we were asked if OUR attitudes towards homosexual people had changed. I think most peoples' beliefs
are well entrenched & as long as everyone we affect is treated with respect & consideration- no one can ask anyone to
change their attitudes or beliefs
I would have liked to participate in all five modules
Nothing
A slight condescending auitude towards certain groups (eg. Church) - There should be no labeling of other beliefs
Can’t remember
Having to articulate the groups' work to others The p
First Nations workshop
That I didn't have the opportunity to take all the workshops-1 was away on LOA
Length. 6 - 2 hour sessions
Nothing
The section on homophobia thought the (perceived) goal of exercise reached a little high. Education does not always bring
ACCEPTANCE. Felt that class mates who expressed tolerance but not acceptance were being told they were phobic
The fact that the workshop commenced with an exercise that indicated/ accused all participants as homophobic/racist
Although recognize difficulty o f doing so with professional/community colleagues- would have liked more emphasis on
People confronting/acknowledging bias/ prejudice
The section that had us look at identifying with an ethnic group. For 3rd generation and beyond Canadians this can
sometimes be impossible to do
I appreciated it all
Not enough time to discuss the issues that came up
I would like AIDS PG to come to my workplace for workshops
A large part appeared to be attempted political indoctrination
Don't remember
Nothing comes to mind
Having S parts may mean people are unable to commit for the entire series & so miss out on info
N/A all e.xcellent
1 can not think o f anything. Maybe there could be more about how to effectively counsel our clients
2 very snowy days! Hurrah for the PG AIDS society for coming
Nothing
Not really applicable in work setting or with client population
Nothing. I was VERY satisfied.
Somewhat repetitive
N/A
Would have liked more instruction with dealing with AIDS clients in community setting ie. LTC more education in
the medications
The First Nations woman went off on a tangent about the injustice o f residential schools. Yes, but I didn’t do it to
you

Total: 33 responses

139

Appendix 0
Question R-b: Usefulness o f Workshops in Work Place
Important information for professional development due to client group we work with
More understanding from more knowledge
All o f the above comments
Accurate & current information. Simple booklets for reading
Not at this time
Not in concrete ways as much as perception
The principles of understanding a marginalized group are broad
In education us re issues around AIDS
Made us realize that we need separate policies regarding HIV. Also brought forward how much work needs to be done
on the "isms" in our place
Interesting to listen to different ideas
We see a wide variety o f people here & encouraging use of condoms
Not particularly. It did not expand my knowledge nor change how I viewed the issue
Reinforced extant understanding & knowledge- updated statistical info
They were useful & enjoyable however I didn't find that they had a lot of new information
Added to knowledge base
A good review/update in some areas & learned new info in other areas
At the time they increased my knowledge
More current info- easily accessed
Good for staff to get knowledge, ask questions in a safe environment
Many people did not seem to know the basics o f universal precautions...how HIV is contacted etc
I am the financial controller & do not have an active role with the client base
Increased knowledge & awareness
Good series. Raised awareness. Saw variety o f views etc. in my workplace
For co-workers
Ensured we all had a similar base o f info
Being better informed gives me a much better understanding & seems to make the client a little more comfortable when
They realize I know something o f what they are dealing with.
Very informative
Great review o f info already aware. Reinforced should not be fearful of ?people? with Partially- good and relevant info was negated in parts due to "accusatory " tone
Knowledge. Comfort- increased with understanding
As stated previously, it made me more aware o f some o f the issues these people face on a daily basis
More education/knowledge = more understanding
I can't remember much o f what we did, its been a long time. I remember using info from workshop afterwards, in my
Workplace & feeling good about it.
Have clients with HIV. We do not have as many as we should
I appreciated receiving current medical information about HIV/AIDS
Could have been
Not particularly- though interesting
They answered a few o f my concerns
As I deal w/ HIV/AIDS people & with people who live lifestyles that put them into contact with this, the understanding
gained from modules helps me deal with issues arising
Bring a refocusing on the issues when dealing with my clients and for my own safety
First Nations info was very helpful
Reinforced many of the positive things that we do at the Health Unit. Reinforced networking for HIV in our community
As 1 have already said
Provided me with more information to teach/share with my volunteers
They could be if we as a hospice group were to encounter HIV/AIDS clientele

140

Appendix 0 Continued
Better understanding of how HIV/AIDS affects people
As stated in previous answers
Greater understanding o f issues-broader knowledge base helps to know what to look for & pay attention to with clients

Total: 48 responses

141

Appendix P
Question S-B: Usefulness o f Workshops in Personal Life
Provide me with more info for people who don't know or understand (eg. It's NOT only gay people who get HIV)
Discussing w/fnends & family as many have misinformation or unnecessary fears from lack o f accurate information
Am more discerning as to what info I pass on
As above
See above re Amnesty International work, understanding o f gay/lesbian acquaintances
I have discussed the teachings of AIDS PG with friends & family members & the slant that is portrayed by AIDS
instructors & the filthy graphic comment made by them
I had been doing education in moments already
Again, educating people who know little
Same as above
See R
It helped me to better articulate my feelings & beliefs when I've come across intolerant/ignorant people
Pass the info on to others
Unsure
1 can speak more specifically my knowledge is not hearsay
Not really. 1 had informal information on AIDS so I had a base o f knowledge to start with
Increased knowledge and awareness
Volunteer work
Same
Good info on HIV/AIDS to share with children
Same as above
So 1 had educated information that 1 could pass on to family, friends and others
Things we teamed at the workshops were useful in many settings and gave you things to think about
Understanding o f people in general. Also a great place to send growing children for sex ed. If it comes better from a
3rd party !
1 did not require consciousness raising or a change in my values and beliefs
1 only was able to attend the introductory presentation, but it gave a good overview
Personal understanding & explanations. Passed on to my children and grandchildren
Can always use the awareness it brings
Just for the general knowledge
But not to the same degree as in my former workplace. This is due to my exposure to high-risk clients
For educating others
Just reiterated what I already knew. I’m empathetic and understanding and open-minded.

Total: 31 responses

142

Appendix Q
Question T: Other Comments Regarding the Workshops
Are they still being offered?
These workshops are vaiuable-they didn't significantly impact my knowledge/skill base only because I have previously
done HIV/AIDS training, First Nations, & Sexuality/diversity/unleaming racism work etc
(F*):To clarify- It's not that the modules weren't informative, its just that I already knew a lot o f it. This does not mean
that it wouldn't be more effective for the majority o f people with a lesser knowledge base.
Excellent information given in an open way
Very good
Enjoyed the workshops & feel they were/are worthwhile for our community. It's too bad we can't educate others/general
public in our community as well
Without participating in all modules 1 don't think 1 should comment
Useful information
The workshops were very good
1 liked them
1 believe the workshops should be offered on ongoing basis for people who didn't have the opportimity to take them
before- & for people just getting in the field
A very worthwhile course. Recommend it highly
1 appreciate the chance to take part
No
About how it is normal to be gay and everyone should embrace their lifestyle: ABNORMAL { table G*) AIDS PG
mandate seems to be acceptance o f the gay lifestyle, & if you don't, YOU ARE THE ODD ONE OUT. Should try
teaching AIDS education-where-how-what. It was a disgusting experience for me & many others who left the modules
or never returned. Problem is they left with more negatives then when they started.
I was already aware of this issues & information. I had been involved in an AIDS service organization before so there was
little change for me
Excellent ! Knowledge, understanding = Less discrimination & fear
No
I think that these type o f workshops should be mandatory for all workers-medical, helping profession, general public,
because there are many uneducated people & they FEAR HIV/AIDS & they act accordingly (M-a*) Confidentiality
is utmost for clients that have HIV/AIDS, so it was/is imperative to monitor what I would discuss with coworkers
(not so much), the helping professional (especially) due to the reaction if they connected client with agency
It has been so long it would be nice to be refreshed to some degree on these
(B-year*) Please note: although I have been told that I attended the workshop, I have little recollection, therefore am
unable to fill in the survey with any degree o f accuracy or insight
This workshop was over 3 years ago. Very difficult to remember specifics
(G*) I don't believe my understanding has changed. I have always had an appreciation o f groups listed from S.W.
perspective
I took this course in April 1997, fortunately I found my old notes to jog my memory otherwise I think the time lag before
evaluating it has been too long to ensure people can remember what they learned. I also was able to attend only one
session
I would just like to say the people who facilitated our training were great & I think follow up modules if possible would
be o f great benefit to all agencies.
Sorry but its been too long and my memory isn't as sharp
Cannot remember workshop/very little
Yes- so much time has passed since- lots o f influences since then
Difficult to recall workshop. Lots o f education/experiences since '98, various influences
Can't remember content. Have done lots o f reading re:HIV/AIDS as well. Have been to other HIV/AIDS workshops,
can't remember if knowledge is from this workshop or others attended over the last 2 years.
(K) don't work with this client group
Great workshop! Well done! Thank you!
*(A)I can't recall but maybe (MOD-S) was incorporated into the first 4 sessions.

143

Appendix Q Continued
I was impressed by the amount o f information that was covered-& would be interested in attending the modules I
missed
It’s been many years since I've taken the workshops but the info. Learning has stuck with me (unlike many other
workshops).
It was well done
(F*) I have a lot o f previous knowledge due to involvement in workshops in BCCW & Aurora Treatment Centre
for Women

Total: 37 responses