title: Making waves: systems change on behalf of youth with HIV/AIDS.
abstract: OBJECTIVE
  To document the effects of five Special Projects of National Significance (SPNS), funded by the Health Resources and Services Administration (HRSA), on HIV care, related service systems, policy, planning, and funding for youth with HIV/AIDS.
  
  
  METHODS
  Literature on services and systems integration and technology transfer is used as a conceptual framework for the examination of HIV-informed, youth-specific changes at the local, state, and national levels. The Principal Investigators for each project and/or the Project Evaluators were interviewed several times to capture "snapshots" of evolving results from the Projects' varied activities in New York City; Newark, New Jersey; Chicago; and Miami. Some changes were consciously targeted, and others occurred serendipitously. This work covers the funding period from 1996 through 2000.
  
  
  CONCLUSIONS
  There were many "ripple" effects that emanated from these Projects' presence and activities. Important lessons were learned about why systems change is necessary to effectively serve youth with HIV, how to make constructive changes happen, and how to sustain changes once they are achieved. Successful strategies included, but were not limited to, consensus-building among stakeholders, participatory planning and decision-making, collaborative referral and linkage agreements, staff sharing, co-locating services, providing technical assistance, consultation, cross-training, and engaging consumers as partners in communicating new technologies and in advocating for change.
authors.affiliation: Mailman Segal Institute for Childhood Studies, Nova Southeastern University, Ft. Lauderdale, Florida, USA.
authors.forename: Geri
authors.initials: G
authors.lastname: Botwinick
authors.forename: Douglas
authors.initials: D
authors.lastname: Bell
authors.forename: Robert L
authors.initials: RL
authors.lastname: Johnson
authors.forename: Randall L
authors.initials: RL
authors.lastname: Sell
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Friedman
authors.forename: Sally
authors.initials: S
authors.lastname: Dodds
authors.forename: Kimberly
authors.initials: K
authors.lastname: Shaw
authors.forename: Jaime
authors.initials: J
authors.lastname: Martinez
authors.forename: Carl
authors.initials: C
authors.lastname: Siciliano
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Walker
authors.forename: Jo L
authors.initials: JL
authors.lastname: Sotheran
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D005380:Financing, Government; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D007407:Interviews as Topic; D009936:Organizational Innovation; D014481:United States