New Careers in Family Planning By Francine S. Stein A new Planned Parenthood training program, underway in four U.S. communities, has begun to fill a gap in the family planning manpower field where expanding U.S. services will require from 5,000 to 13,000 family planning aides over the next three years. The program is an essential part of the U.S. Labor Department-funded New Careers movement, which aims to open channels of upward social and economic mobility for poor people who have been denied opportunity for personal ad vancement because of insufficient educa tion, cultural deprivation and racial prej udice. The new program has three goals: • To provide meaningful training and employment for non-professionals, selected from among the poor, in a compre hensive family planning program. • To analyze and define what curriculum and training are required to provide nonprofessionals with on-the-job experience in the delivery of family planning services, remedial and continuing education and human relations training. • To create a 'New Career' - Family Planning Assistant - comparable to other entry level positions in health services, with upward career mobility. The Training Setting Sixty-six men and women, aged 22-45, are now receiving training to become Family Planning Assistants in Dallas, Newark, New Orleans and New York's Suffolk County. The training sites provide a mix of public and private family planning agencies with varying levels of clinic and community programming; two are Planned Parenthood Affiliates, one is an Francine S. Stein is director of Planned Parenthood-World Population's New Careers Training Program for Family Planning Assistants. • See "Estimating Manpower Needs," p. 37. 42 Office of Economic Opportunity family planning project and one is a state-wide, private, non-profit program. The Planned Parenthood centers in Dallas and Newark have been the main stay of family planning services in their communities for over 30 years. Both had traditionally operated from one central clinic facility with limited satellite or hospital-based activities. Newark had a field program, Dallas did not. With the advent of New Careers both centers are better meeting city-wide needs for expanded service which had placed heavy demands on them for expertise and personnel. Newark assumed training and employment responsibility for two years, while Dallas served one year as the training agency which then placed Aides in other community health programs for the second year of the program. When the Economic Opportunity Council of Suffolk received its first OEO family planning grant three years ago, it undertook the first medical outreach program for the poor in the county. Suffolk is almost a 'rural model' with the bulk of services depending on provision of transportation to people hidden in isolated poverty pockets throughout the county. Family Planning, Inc. (of Louisiana), a model for program development, is the largest agency in the New Careers program, with considerable service specialization. Associated with Louisiana State and Tulane Universities, it has extensive research and evaluation components, and has from its inception trained non-professionals for a variety of patient recruitment, follow-up, data processing and record keeping activities. Program Staff The Planned Parenthood grant provides each site with professional and supporting staff, including: a training supervisor with primary responsibility for program devel opment and administration, a counseling supervisor, a part-time clinic superva and a secretary. Local agencies are rexp sible for staff recruitment, but Planned Parenthood assisted in their selection. Fro fessionals are men and women, some bew to the agency, some new even to fam planning, some long involved in the kal program. Newark has registered nursena all three staff positions, and the other three sites have employed medical par sonnel only for clinic supervations. Trainees The training agencies were responable for recruitment and selection of andes a cording to minimum federal require ments of age (22 or over) and inome level (OEO poverty index) Emphases wo placed an screening in rather than scre ing out trainees, however, and individual qualities indicating interest and hearing potential were sought, rather than pr education and experience. Sixty-six black, white, Indian and Spas ish-speaking aides were selected. five an men; only one had worked previous a medical service, most were housew or service workers. Over 80 percent had been receiving public assistance. I had completed high school and only three had begun college work Training, Education, Employment • Aides train on the job in all aspects of Family Manning Perspectiv ually tailored to the needs and preferences of each aide. The program aims for the most rapid possible personal development in attaining high school equivalency and college level skills related to health fields. Aides are released from on-the-job training for two days each week for education, specialized training and counseling. In the program's first few months all trainees were involved in remedial education: In Dallas, the high school equivalency classes were conducted at El Centro College. In Newark, trainees were tutored on the program site by the Newark State College. Suffolk provided an individual tutoring program: Some aides worked for high school equivalency in adult basic education programs operated by a variety of high schools in the county; others enrolled in Suffolk Community College. Louisiana designed its own intensive remedial program to bridge the gap between previous education and future learning, and helped the trainees arrive for themselves at meaningful and realistic personal and program goals. Continuing education programs have been initiated on each site to combine career objectives of each aide with advanced job training needs as specified by the employer agencies. The majority of the trainees have begun college level work in programs which emphasize human services. Clerical and technical courses are included where appropriate to the job setting. Most degree programs follow a two-year design. A variety of colleges and universities will be involved in continuing education. In addition to on-the-job training and formal education, New Careers has identified personal and group skills important in all human services, such as planning, scheduling, communication, decision mak ing and problem solving. New Dimensions in Training, a Philadelphia consultant team, is working with aides and staff in designing core-learning techniques and curricula for human relations training. and methods to assure that the aides' practical experience and know-how are incorporated in the program. Fundamental to the New Careers philosophy is the concept that all training is directly related to employment. Each training agency has guaranteed employ ment to those who successfully complete the program. As a commitment to this employment the agencies pick up 50 percent of the aides' salaries in the second year of training. In this second year on-the-job assign Volume 1, No. 2 October 1969 ments will vary from site to site. In New Family planning activities throughout Career Model Planned Parenthood-World Population up. Each procedure comprises a distinct training task, and each aide is rotated through every task for orientation and training. Figure 1 shows how the training units build on each other sequentially to provide trainees with the skills and information required to become a Family Planning Assistant. Figure 1. New Career Ladder Training Tasks Reception Intake Supply Sales and Management Examining Room Medical and Social History Community Education (including outreach and follow-up) First Year Jobs (Aides) Reception-Intake and Supply Sales and Management Reception-Intake and Medical and Social History Examining Room and Medical and Social History Examining Room and Medical and Social History and Patient Education Medical and Social History Patient Education and Community Education Second Year Jobs Clinic Associate Community Associate Third Year Job Family Planning Assistant 43 New Careers in Family Planning constitute a large part of the front desk responsibilities in the clinic. Taken together, the units for Reception and Sales offer the training base for a medical records clerk; and the skills acquired by receiving patients and ordering and main taining supplies can be transferred to a variety of businesses and personal services. • Examining Room Assistance puts the trainees into direct relationship with medical professionals in such activities as setting up a clinic, caring for instruments, sterile techniques, preparing the patient for examination, assisting with the examination and Pap smears. In the first three units an aide can be trained entirely in the work setting and can function without detailed knowledge of family planning. • With Medical and Social History there is a shift in training emphasis so as more closely to relate the information which the aide needs with his ability to communicate this information to others. At this stage the aide will begin to make significant judgments affecting the health of clients. The interview, a one-to-one relationship, initiates the need for an enlarged communication skill. • Patient Education involves the aide in describing the services of the clinic and all birth control methods to small groups of new family planning patients. • Community Education pits the aide against the maximum number of unknowns. Here the aide must be concerned with patient recruitment and attitudes who is behind every door and what her attitude to family planning may be. Information and communication techniques required at this stage are most sophisticated, and the returns to the agency from all training will be most quantifiable in this community outreach component. 44 During the first year the aides are trained in these tasks both individually and in combination (see Figure 1) in an on-the-job setting. And on-the-job train ing is supplemented with classroom teaching of a specialized family planning curriculum, which includes: the history and importance of family planning; human reproduction and basic anatomy; birth control methods, health and poverty issues in family planning; communication arts and techniques for community resource, referral and organization. The curriculum is clear, concise and precisely relevant to the education and experience of the trainees, and balances their need for background information with immediate job-related demands. Second Year Jobs In the second year individual tasks are combined for assignment as a Clinic Associate or Community Associate. At this level, it is assumed that the worker no longer will need direct, continuous super vision, but will still need and want additional training and education. The Clinic Associate works with nurses, physicians and family planning administrators to carry out a variety of tasks within the clinic setting. The Community Associate is primarily involved with patient recruitment and community organization and education, working as an assistant to social workers, public health nurses, health educators and teachers. The Associates will work at both jobs during this year so as to acquire skills needed for both in-clinic and outreach activities, applicable in any family planning setting: hospital, Planned Parenthood center, health department clinic, OEO clinic, etc. After the two years of training and education the Associate is qualified as a Family Planning Assistant, who can be expected to function as a family planning professional in helping to establish a satel lite clinic, a mobile unit or an outreach program, as well as to undertake sigu cant responsibilities within the clinic such as in-patient education, medical assistance and clinic administration. Since few existing family planning pro grams have a fully comprehensive serce, from intake to outreach, the New Carm training program actually helps buid sential program components. Fore ample, Aides in the Suffolk program pre viously had been almost entirely reach, with comparatively meagerm activities. Concurrent with New Careers, Suffolk has opened three new characts and plans to establish another four As the par tient load grows, the aides will be spend ing more of their time at in-claic act ties, rather than in the field. The New Careers staff in Newark has sengh ened existing service units and helped itiate family planning servicesa agron which had not previously offered them Evaluation In order for these manuals to provide • What measures for job performanos • What is the relationship of New Ca Because New Careers is a unique, neering program committed to develo ing a format which can be replicated various settings, Planned Parenthood has tried to assure all participants, both tra ees and staff, of maximum opportunity to influence program development Ferod site workshops are held to review gram and evaluate progress, and to keep the program constantly useful and mean ingful to the agency and the aides. Family Planning Perspectivem Senator NELSON. Thank you very much. The hearings are closed. (Whereupon, at 12:20 p.m. the committee adjourned subject to the call of the Chair.) |