Loving Support Through Peer Counseling: A Journey Together .

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Loving Support Through Peer Counseling: A Journey TogetherTraining Facilitator GuideWelcome to “Loving Support Through Peer Counseling: A Journey Together.” The USDA Food andNutrition Service (FNS) developed this training program to assist State and local agencies withimplementing successful, sustainable peer counseling programs that give participants in the SpecialSupplemental Nutrition Program for Women, Infants and Children (WIC) the support they need to reachtheir breastfeeding goals.Curriculum OverviewThe training curricula update the 2004 FNS project, “Using Loving Support to Implement Best Practicesin Peer Counseling,” which included two training curricula: “Using Loving Support to Manage PeerCounseling Programs” and “Loving Support Through Peer Counselors.” This updated training curricula,“Loving Support Through Peer Counseling: A Journey Together,” includes current science inbreastfeeding management and best practices among successful peer counseling programs in WIC. Trainthe trainer events were conducted for State agencies in each of the seven USDA geographic regions inthe Fall of 2011.The project includes curricula for two different target groups.For Program Managers“Loving Support Through Peer Counseling: A Journey Together – FOR WIC MANAGERS” is based on the“FNS Loving Support Model for Successful Peer Counseling Programs,” with specific guidance onprogram components that contribute to effective, sustainable peer counseling programs. The curriculumincludes 10 sections and numerous reproducible tools that can be tailored to fit State and local agencyneeds.Section12TitleProject OverviewPeer Counseling:Making a Difference forWIC FamiliesKey Topics Addressed Vision for peer counseling in WIC Overview of the training curricula How peer counseling programs increase breastfeedingrates among WIC participants Research with peer counseling programs1Loving Support Through Peer Counseling: A Journey Together

345678910Program PlanningProgram Developmentand ImplementationStaffing ConsiderationsScope of PracticePractice Settings forPeer CounselorsTraining PeerCounselorsMentoring andSupervising PeerCounselorsRetaining PeerCounselors Role of the State and local office Conducting program assessment Engaging community partners Budget and allowable costs Tracking program success Gaining local clinic buy-in and support Creating a breastfeeding-friendly WIC clinic Clinic policies that support peer counseling success Definition of a peer counselor Qualities of the ideal peer counselor Recruitment strategies Career ladder for peer counselors Scope of practice for peer counselors Limitations of peer counselors Making contacts Documentation “Yield” concept Job descriptions for other levels of staffing Phone counseling and managing 24/7 availability WIC clinic education Facilitating peer counselors in hospital settings Home visits Classes and support group meetings Options for training peer counselors Ongoing training opportunities Observations and shadowing opportunities Mentoring peer counselors Building supervisory skills Troubleshooting common supervisory challenges Why peer counselors leave Strategies for improving retention Celebrating successes2Loving Support Through Peer Counseling: A Journey Together

For Peer Counselors“Loving Support Through Peer Counseling: A Journey Together – FOR PEER COUNSELORS” has beenredesigned with new evidence-based breastfeeding strategies, new activities, and innovative teachingstrategies designed to encourage interactive learning. The curriculum is divided into four major sectionsand 12 total flexible modules, plus an optional module on providing WIC peer counseling services inother settings such as hospitals, home visits, classes, and support groups.SectionSection 1TitleKey Topics AddressedThe WIC Peer Counseling ProgramModule 1Becoming a WIC PeerCounselor Role of the peer counselor in the WIC ProgramHow peer counselors make a differenceBasic job responsibilities of peer counselorsTypical day for a peer counselorModule 2Helping Moms say YESto Breastfeeding! Reasons to breastfeed for both babies and momsComponents of human milkHow human milk differs from infant formulaHow WIC supports breastfeeding mothersRole of the peer counselor as part of the WIC “Circle of Care”for new familiesSection 2Counseling and Communication SkillsModule 3Helping MomsOvercome CommonBarriers Addressing common barriers to breastfeedingMaking the infant feeding decisionEncouraging families members to provide supportMyths and facts about breastfeedingExceptions to breastfeedingModule 4How to Talk with MomsAbout Breastfeeding Participant-focused counseling techniquesConnection before content (establishing rapport)3-Step counseling strategyAssessing a mother’s readiness to changeDealing with participants who are resistant or difficult tocounselMulti-cultural awareness and sensitivityHandling misinformation given to mothers Maintaining client confidentialityDocumenting contactsIn-person visits in WIC clinicsEffective telephone skills and use of cell phonesUsing social and electronic mediaModule 5Ways to Reach NewMoms3Loving Support Through Peer Counseling: A Journey Together

SectionSection 3TitleKey Topics AddressedGetting Started with BreastfeedingModule 6Encouraging ExclusiveBreastfeeding Why WIC promotes exclusive breastfeedingWhy breastfeeding mothers begin infant formula feedingBarriers to breastfeeding exclusivelyHow the breast makes milkFactors that impact milk productionHelping mothers gain confidence in their ability to make milkModule 7Supporting NewBreastfeeding Moms The important first hour after baby’s birthSkin-to-skin contactBaby-led breastfeedingLaid-back breastfeedingAssessing positioning and latchHow to know baby is getting enoughEarly practices that support breastfeedingModule 8Helping Moms WhenThings Don’t Go asPlanned Preventing and managing common maternal concerns such assore nipples, engorgement, plugged ducts, mastitis, and lowmilk productionAddressing infant concerns such as jaundice, weight loss,reflux, fussiness, and high appetite periodsWhen to yield Section 4Talking with Mothers About BreastfeedingModule 9Talking with PregnantWomen AboutBreastfeeding Stages of pregnancyTalking with pregnant women about breastfeedingPreparing for breastfeedingDealing with lossModule 10Talking with MothersAbout Breastfeeding inthe First Month Recovery from childbirthDealing with emotional challengesUnderstanding the secrets of baby behaviorPractices that support breastfeedingNormal infant feeding and stooling patternsModule 11Talking with MothersAbout BreastfeedingWhen Baby Grows Growth patterns and appetite spurtsWorking breastfeeding into a busy lifeIntroducing solid foodsTeethingWeaningModule 12Talking with MothersAbout BreastfeedingWhen Mother and BabyAre Separated Preterm infantsSick infants and mothersReturning to work/schoolOccasional outingsExpressing and storing human milk4Loving Support Through Peer Counseling: A Journey Together

SectionOptionalModule 13TitleProviding PeerCounseling Services inOther SettingsKey Topics Addressed Working in the hospital settingProviding support groupsTips for teaching classes with new momsAbout the Theme: A Journey TogetherThe curriculum theme is “A Journey Together,” reminding both staff and peer counselors that helpingWIC moms breastfeed and the peer counseling program is a rewarding journey to anticipate and enjoy.For Peer Counselors: The job will be a new experience, somewhat like taking a trip to a new place forthe first time. Many peer counselors have limited work experience, particularly in professional or healthcare fields, yet through the process of training, mentoring, and counseling mothers peer counselors willembark on an exciting journey of building new skills that will affect them forever.For WIC Moms: Their personal breastfeeding journey is enhanced when they have the education andsupport to help them reach the destination they have in mind. Their peer counselor journey alongsidethem as their partners, helping them grow confidence and skills along the path.For WIC agency staff: Implementing a peer counseling program will be its own journey for staff andprogram managers. WIC staff become partners with peer counselors in that journey, supporting themand making the preparations and positive practices that ensures a successful outcome—WIC momsinitiating and continuing breastfeeding.The journey theme provides many opportunities for trainers to create a fun learning environment, withactivities and visuals that help peer counselors remember key teaching points by linking them toexperiences and visual analogies that are familiar to them. The cover resembles a photo album orscrapbook to chronicle that journey, and numerous activities and visuals are incorporated to play outthe theme in fun and memorable ways.Format of the ModulesEach module provides detailed instructions and teaching options. Facilitator notes include an overviewsection with: Core competencies and learning objectives Short description of the module with key topics addressed Handouts and worksheets used Activities with materials needed to teach each one AV equipment needsFacilitator notes also include a photo of the corresponding slide and detailed talking points. The level ofdetail provided is designed to give background information for the presenter. Facilitators areencouraged to reframe the talking points in their own words.5Loving Support Through Peer Counseling: A Journey Together

Facilitator notes also include detailed instructions for: Activities – with purpose, materials needed, time to allow, step-by-step instructions, points fordiscussion, and take-away messages to leave with the trainees. Numerous activities and optionsare provided so that trainers can select those that are most useful given their time constraintsand the learning needs of trainees. Teaching Tips – options for demonstrations, videos, animations, discussion ideas, and optionsfor using navigation options in the presentation. Make it Your Own – suggestions for ways to tailor the information to fit individual agency needs.Curriculum MaterialsThe curriculum package includes the following materials:For Training Managers Binder with tabbed dividers for each of the 10 sections. Detailed speaker notes. Handouts organized into sections that make it easy for program managers to reference. PowerPoint platform with slides and relevant videos. Memory stick with all materials loaded. Series of webinars that address the core messages of the curriculum, archived at the WIC WorksResource System.For Trainers of Peer Counselors Binder with tabbed dividers for each of the four sections and 12 modules. Detailed speaker notes. Handouts organized by module for easy reference. PowerPoint platform with slides and relevant videos, animations, picture stories, and othertraining resources. YouTube videos and podcasts developed for the program and posted at WIC Works. “Facilitator Prompts” with brief key messages, handouts, activities, and navigation options foreach slide. Memory stick with all materials loaded. Copy of Breastfeeding: A Parent’s Guide by Amy Spangler.For Peer Counselors Peer Counselor Handbook – with a summary of key messages for each module. Peer counselorscan review the handbook before the training, or afterwards for reinforcement and reference. Passport to Success – a skills checklist for peer counselors to track their progress in learning newskills.6Loving Support Through Peer Counseling: A Journey Together

Training Materials Training guide. Set of six posters featuring the theme and key messages. Certificates of attendance for continuing education. Nametags. Writing pens.The Interactive, Relational ApproachThe peer counselor presentation program uses an innovative design approach that allows for flexiblelearning and strengthens the connection between the trainer and peer counselors to enhance learningand retention. The curriculum presentation platform is highly visual and provides flexible navigationoptions to allow presenters to quickly and easily move throughout the presentation platform to respondto specific questions, share videos or picture stories, access additional resources as needed, and to meettargeted individual learning needs of peer counselors. The approach complements the participantfocused approach in WIC by enabling peer counselor trainees to set learning priorities, and enhanceslearning through emotional triggers from photo images, picture stories, video, and audio.RationaleWith the advent of presentation software such as PowerPoint , which is used by millions of peopleworldwide, a standard presentation paradigm became the norm for presenters. This standard approachincludes rigid (linear) slides that move sequentially from topic to topic and do not change after thepresentation is set up. It has multiple bullet-point text, and small or nonexistent photos. The subsequent“top-down” teaching approach puts the trainer in charge of the information. This approach quicklybecame the standard teaching mode, even though there is little if any research to support itseffectiveness in improving retention and learning.1The interactive, relational approach used for the peer counselor curriculum challenges that paradigmwith its focus on two powerful evidence-based learning techniques:1. Highly visual imagery.2. Navigation that allows for interactive learning.Visual LearningResearch shows that the brain seems to process text both visually and verbally. Thus, slides heavy withbulleted text may conflict with the words a speaker says and actually cause participants to feeloverwhelmed and lead to boredom. Photo images, on the other hand, are processed almost exclusivelyvisually and therefore do not cause the same conflict. Photos can greatly enhance the learningexperience. Large photos, in particular, capture attention and lead to better encoding of information.1Lane RA. (2007). Relational Presentation: A Visually Interactive Approach. Tuscon, AZ: Aspire Communications.7Loving Support Through Peer Counseling: A Journey Together

In one study, the eyes of participants shown a series of news articles were first drawn to photo imagery,starting with the largest images. Readers typically scanned three quarters or more of the pictures before2turning their attention to the text. In a related study, readers of news magazine articles were morelikely to select and read articles that had photos.34 What the brain processes visually has the power tohelp learners absorb and remember the information better. According to Paivio’s dual Coding theory,the brain appears to have separate channels for visual and verbal information. Information presentedboth visually and verbally at the same time can produce superior results compared with presentinginformation in either format separately.5 Hence, presenters who provide meaningful full-screen photoswhile verbally discussing the content enhance their ability to engage participants in the experience andcreate a more positive learning outcome.Look at these slides to see the different impact that the visual slide has in capturing attention andconveying a message compared to a slide with bulleted text.SHOW THEM!The new language for powerfuland meaningful presentations!2Garcia MR & Stark P. (1991). Eyes on the News. St. Petersburg, FL: Poynter Institute.Zillmann D, Knobloch S & Yu H. (2001) . Effectsfo photographs on the selectibe reading of news reports. MediaPsychology, 3:301-324.4Knobloch S, Hastall M, Zillmann D & Callison C. (2003). Imagery effects on the selective reading of Internet newsmagazines. Communication Research, 30(1):3-29.5Moreno R, Mayer R, Spires H & Lester J. (2001). The case for social agency in computer-based teaching: Dostudents learn more deeply when they interact with animated pedagogical agents? Cognition and Instruction,19(2):177-213.38Loving Support Through Peer Counseling: A Journey Together

Navigation that allows for interactive learningInteraction is a critical part of most human communication and relationship building.6 Whetherimmersed in a spontaneous childhood story, participating in a planning session with co-workers, orengaging a friend in café conversations, humans inherently feel a desire to connect with, and react to,other people. This helps us take in knowledge and make sense of our world.7 This need does not goaway simply because people are in a classroom or learning situation. Numerous studies show that8interactive learning opportunities provided through face-to-face learning, computer-basedlearning,9and website design10 all contribute to enhanced learning and retention and enhancerelationship building.11The peer counseling training curriculum, “Loving Support Through Peer Counseling: A JourneyTogether,” incorporates both of the innovative relational presentation components of powerful visualand interactive learning approaches. The curriculum allows trainers to adapt their message and teachingstyle to the needs, desires, and understandings of their audience.The Peer Counseling Presentation PlatformThe innovative peer counseling platform includes the following key components which are pictured andexplained in detail:1. One Idea Per Slide. There is only one idea per slide in a large text title, rather than multipleteaching points that can cause learners to become overwhelmed and/or bored.2. Full Screen Photos. Most slides have a full screen photo to engage trainees and help tell thestory or explain the message visually. Often these photos evoke an emotion that helps theaudience relate to the message. Photos are carefully cropped to draw the eye to the mostimportant aspects of the photo.3. Stories. Photos that show what you are explaining rather than merely being decoration aremore powerful. Many of the slide images depict the main content message. In addition, picturestories (photos with audio stories) and digital storytelling (stories through video) are included6Burgoon JK, et al. (2000). Interactivity in human-computer interaction: A study of credibility, understanding, andinfluence. Computers in human behavior, 16(6):553-574.7Lane (2007).8Burgoon K, Buller DB & Floyd K.(2001). Does participation affect deception success? A test of the interactivityprinciple. Human Communication Research, 27:503-534.9Bodemer D & Faust U. (2006). External and mental referencing of multiple representations. Computers in HumanBehavior, 22:27-42.10Chung H & Zhao X. (2004).Effects of perceived interactivity on Web site preference. Journal of ComputerMediated Communication, 10(1):no pagination specified.11Jo S & Kim Y. (2003). The effect of Web characteristics on relationship building: Journal of Public RelationsResearch, 15(3):199-223.9Loving Support Through Peer Counseling: A Journey Together

to allow peer counselors to relate to the experiences of real people. These methods have apowerful effect on learning.4. Single Platform. All modules are linked together in a single presentation platform withhyperlinks that allow the presenter to quickly and easily move throughout the presentation asneeded. A dashboard lists all modules, videos, picture stories, animations, and othercomponents. At any time, the trainer can return to this dashboard quickly to move to otherareas of the platform. In fact, trainers can potentially move to any slide in the entire platformwith no more than three clicks.5. Navigation Panel. Each slide has a navigation panel at the bottom to enable trainers to see at aglance what slides are included in the module. Slides can be shown or skipped depending ontime constraints and relevance to the program.6. Separate Areas. The presentation platform provides several separate sections with key teachingcomponents that can be used as trainers desire. These separate areas include:a. Videos that tell a story to explain key teaching points.b. Picture Stories that use audi

Peer Counselor Handbook – with a summary of key messages for each module. Peer counselors can review the handbook before the training, or afterwards for reinforcement and reference. Passport to Success – a skills checklist for peer counselors to track their progress in learning new skills.

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