Chapter 7: Step 4: Implementation & Monitoring
 

Selecting/Hiring IPC Agents

The decision to use Interpersonal Communicators or Peer Educators should be based on the characteristics of the high risk group and on programmatic goals. Interpersonal communicators (IPCs) are individuals who organize and conduct IPC sessions with selected target populations. They are individuals whose opinions are respected among their peer target group members, and who are curious, self-confident, sociable and energetic. IPCs typically have a higher level of education than the target population, although ideally they should be the same age and gender of those people with whom they interact. Most IPCs are paid employees, however, there are some circumstances in which IPCs may volunteer their services.

Peer Educators (PEs) are members of the target population in question, or have close associations to it. For example, if the IPC program is targeting sex workers, peer educators may be current or former sex workers. Youth are particularly receptive to peer educator interventions. Peer Educators usually work as volunteers or for financial incentives like transport money or profits from condoms sales. In some cases Peer Educators are paid.

Target group influencers can also be selected as IPCs for a given program. Target group influencers are not members of a given high risk group, but they may have close associations or regular contact with them in work or social settings. For example, brothel owners or managers may be target group influencers for commercial sex workers, while union executives or mechanics might be target group influencers for truckers. They wield influence among target group members because of their close relationship with them and can, therefore, act as agents of change within this group. With proper training, target group influencers can work as IPCs for the target group in question.

IPC Agents are integral to program success.  Their incorporation into IPC activities serves several fundamental programmatic functions.

1. Breaking of Barriers
   In most Behavior Change Communication (BCC) programs, barriers to behavior change are identified. Barriers may include misconceptions or incorrect information about a subject (e.g. mosquitoes can transmit HIV).  Other barriers might include lack of sufficient services in a given geographic area or the perception that such services do not welcome certain target group members.  Appropriate barriers could be discussed with the IPCs and reasons for these beliefs identified and corrected with proper information and/or behavioral actions.

1. Diffusion of Information and Knowledge
   IPCs can be ongoing agents of change, disseminating information to peer groups and modeling new behaviors.  They are chosen for their leadership, ability to actively engage participants in discussion, and their likelihood for acceptance among target group members. Their ongoing involvement will better address barriers and is more likely to effect a lasting change in behavior than a one-time intervention.

Selecting the IPCs is a challenge since the job requires a variety of skills as well as credibility with peers.  The IPCs must have good communication skills, be able to quickly absorb information about HIV and AIDS, and have a good rapport with the target population.  Careful selection of IPCs can reduce turn-over and the costs associated with training replacements.
 

What steps should be followed to select IPCs?

1. Establish clear selection criteria
   Determining the requirements and qualifications for IPCs in advance will help human resource personnel and program planners identify desirable candidates.  It is important that all program staff, both in the field and in the office, agree on the selection criteria to ensure uniformity in the selection process.

2. Determine the number of IPCs  required
   This number should be large enough to sufficiently reach target populations, but small enough to be cost-effective.  Suggested ratios vary from one IPC per six target group members for high density interventions to one IPC per 50 to 100 target group members in typical interventions.

3. Define the process for the identification of IPCs
   Determine the best locations for job or volunteer advertisements so that applicants will be the most likely to fit into the selection criteria.  Potential candidates can also be identified by having discussions with target populations, observing target group interactions, or having discussions with stakeholders.

If IPCs get discouraged working on their own, their morale may be increased if they work in teams.  When working in teams, IPCs can monitor each other, offer support when needed, and complement each others skills.

Characteristics of Effective IPC Facilitators
A profound characteristic of IPC activities has to do with the role of the interpersonal communicator who should be a skilled facilitator rather than a didactic educator.  The most effective facilitators inspire confidence and trust, they infuse the room with energy and passion for the process, are adaptable and authentic, are nonjudgmental and outcome driven, but are detached from the results.  One of the most important characteristics of an IPC facilitator is his/her ability to move the audience members forward in their thinking.  This helps to facilitate the behavior change process.
 

IPC Agent to Participant Ratio
An interactive conversation between an IPC agent and an individual member of a target population is undoubtedly the most effective form of communication.  Given cost constraints, working with small groups of six to ten is more cost-effective.  With groups any larger, the participatory opportunities become diluted, and individuals are less likely to truly make their own personal risk assessments and risk reduction plans.  Street theater performances may be the exception to this rule, however, audience members should be divided into small groups for post-performance discussions.

Deciding to work with Paid or Volunteer IPC Agents
There are advantages and disadvantages to both approaches, and the decision should be based upon prior experience, the demands of the job, and the context of the work.  Work outputs tend to be greater when incentives are provided.  Paid, full-time IPC agents can be more motivated and easier to manage and supervise than those volunteering.  Volunteers also tend to have a high turnover rate due to boredom and lack of income.  Even if IPC agents are not paid, other incentives such as transport reimbursement, training certificates, letters of recognition, uniforms, and free meals or snacks can also provide motivation. 

IPC Training
Training for all IPC staff will orient them on the program goals, messages and activities, their roles and responsibilities, and the most up to date, accurate information on HIV/AIDS.  Regardless of the previous experience of the IPC agents, a training will ensure that everyone is beginning with the same information and on the same page. Supplementing an initial one or two week training at the beginning of the intervention with several short trainings early on in the program can be an effective way to bring staff up to speed without bombarding them with too much information at one time. These staggered trainings should be focused on skills development, including knowing how to engage target populations, getting them to personalize issues, focus on personal risk assessments, and inspire behavior change.  Shorter trainings can be focused on individual themes or messages, and would also provide time for IPCs to practice in the field. 

Developing IPC Agent Skills
It should not be assumed that IPC agents will automatically have the skills to work with various target groups.  It is important to foster these skills in their initial participatory training sessions. Sending IPC staff to visit IPC field sites is a good means of motivation and inspiration.  It is also a good way for IPC agents to see what might be expected of them, and provide them with real-life examples of IPC behavior to emulate.

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