men’s waiting room education project: utilizing technology to educate and motivate male partners...

Men’s Waiting Room Education Project:Men’s Waiting Room Education Project:Utilizing Technology to Educate and Motivate Male Utilizing Technology to Educate and Motivate Male

Partners in an Urban Health CenterPartners in an Urban Health CenterRobert M. Becker, M.S. & Dana Czuczka, MPH

Planned Parenthood of New York City

APHA 2003 San Francisco, CA

IntroductionIntroduction

In an effort to make our In an effort to make our health centers more male-health centers more male-friendly, Planned friendly, Planned Parenthood of New York Parenthood of New York City (PPNYC) established a City (PPNYC) established a unique waiting room unique waiting room education project to education project to educate and motivate the educate and motivate the male partners of our female male partners of our female clientele to become more clientele to become more constructively involved in constructively involved in family planning and family planning and reproductive and sexual reproductive and sexual health. health.


IntroductionIntroduction

A computer, LCD A computer, LCD projector, and VCR were projector, and VCR were installed in our waiting installed in our waiting room to run Microsoft room to run Microsoft Powerpoint slideshows Powerpoint slideshows and educational videos and educational videos emphasizing the positive emphasizing the positive role men can play in role men can play in sexual decision-making sexual decision-making and healthy and equitable and healthy and equitable relationships. relationships.


Background on SlideshowBackground on Slideshow

• Slides are created in-house by Education, Clinical Slides are created in-house by Education, Clinical Service, and Public Affairs staff.Service, and Public Affairs staff.

• Topics include: Contraception, Safer Sex, STD/HIV Topics include: Contraception, Safer Sex, STD/HIV Prevention, Healthy Relationships, Male Involvement, Prevention, Healthy Relationships, Male Involvement, Partner Support, Male Reproductive Health, Advocacy Partner Support, Male Reproductive Health, Advocacy for Reproductive Healthfor Reproductive Health

• Over 250 slides, loops continuously, each slide shown Over 250 slides, loops continuously, each slide shown for approximately 10-20 secondsfor approximately 10-20 seconds

• Slideshow on 6 days a week, all day, reaching Slideshow on 6 days a week, all day, reaching approximately 30 people per day/9000 per yearapproximately 30 people per day/9000 per year

• Cost of equipment and installation, approximately $5000Cost of equipment and installation, approximately $5000


Goals of the ProjectGoals of the Project

• To educate men (and women) within the To educate men (and women) within the health center waiting room about sexuality health center waiting room about sexuality and sexual/reproductive health using male-and sexual/reproductive health using male-positive, supportive messagespositive, supportive messages

• To motivate men to play a positive role in To motivate men to play a positive role in their own and their partner’s reproductive their own and their partner’s reproductive health health

• To create a male-friendly environment To create a male-friendly environment within the health center waiting roomwithin the health center waiting room


Sample Slides from the ShowSample Slides from the Show


Research QuestionsResearch Questions

• Comfort in the waiting room?Comfort in the waiting room?• Knowledge about sexual and reproductive health Knowledge about sexual and reproductive health

issues?issues?• Motivations to protect their own and/or their Motivations to protect their own and/or their

partner’s sexual and reproductive health?partner’s sexual and reproductive health?

What impact does the slideshow have on waiting room What impact does the slideshow have on waiting room occupants’…occupants’…

Additionally, what can viewers of the slideshow tell us Additionally, what can viewers of the slideshow tell us to improve the appearance, messages, and to improve the appearance, messages, and administration of the slideshow?administration of the slideshow?


Research DesignResearch DesignQuasi-ExperimentalQuasi-Experimental

Viewer SampleViewer Sample Comparison SampleComparison Sample

Partners and clients in the Partners and clients in the waiting room onwaiting room on

Thursdays through Saturdays Thursdays through Saturdays

Partners and clients in the Partners and clients in the waiting room onwaiting room on

Mondays through WednesdaysMondays through Wednesdays

Viewed slideshowViewed slideshow Did not view slideshowDid not view slideshow

Voluntary completion of 23-Voluntary completion of 23-item survey to gain feedback item survey to gain feedback

on slideshow, comfort in on slideshow, comfort in waiting room, knowledge, and waiting room, knowledge, and

motivations to protect motivations to protect reproductive healthreproductive health

Voluntary completion of same Voluntary completion of same survey as Viewer minus survey as Viewer minus feedback on slideshowfeedback on slideshow


Survey MeasurementsSurvey Measurements

VARIABLESVARIABLES VIEWERSVIEWERS COMPARISONCOMPARISON

Slide appearanceSlide appearance

Feedback on messagesFeedback on messages

Comfort in roomComfort in room

Knowledge about sexual and Knowledge about sexual and reproductive health issuesreproductive health issues

Acquisition of knowledge via Acquisition of knowledge via showshow

Motivations to protect own and Motivations to protect own and partner’s healthpartner’s health

Motivation as a result of Motivation as a result of watching showwatching show


Demographics of Survey ParticipantsDemographics of Survey Participants

DEMOGRAPHICSDEMOGRAPHICS VIEWERVIEWER COMPARISONCOMPARISON

Surveys collectedSurveys collected 168168 243243

Number of daysNumber of days 2727 2626

Gender (% M, % F)Gender (% M, % F) 23% / 77%23% / 77% 14% / 85%14% / 85%

Median ageMedian age 2323 2323

EthnicityEthnicity

Black/African Am.Black/African Am. 31%31% 26%26%

Latino/Hispanic/MexicanLatino/Hispanic/Mexican 25%25% 28%28%

White/Non-LatinoWhite/Non-Latino 28%28% 29%29%

Asian/Asia Am/Pacific Is.Asian/Asia Am/Pacific Is. 7%7% 6%6%

Native AmericanNative American 1%1% 2%2%


Viewer Data on Slide AppearanceViewer Data on Slide Appearance

n=168n=168Strongly Strongly DisagreeDisagree

DisagreeDisagree NeutralNeutral AgreeAgree StronglyStronglyAgreeAgree

Words easy to Words easy to readread 2%2% 3%3% 5%5% 31%31% 55%55%

Trouble Trouble understandingunderstanding 58%58% 25%25% 2%2% 10%10% 3%3%

Images Images appropriateappropriate 2%2% 3%3% 16%16% 43%43% 32%32%

Colors Colors ununattractiveattractive 21%21% 25%25% 33%33% 13%13% 4%4%

Pace/speed Pace/speed OKOK 4%4% 10%10% 18%18% 45%45% 18%18%


Viewer Data on Slide MessagesViewer Data on Slide Messages

n=168n=168Strongly Strongly DisagreeDisagree

DisagreeDisagree NeutralNeutral AgreeAgree StronglyStronglyAgreeAgree

Thought Thought messages messages were were importantimportant

1%1% 1%1% 7%7% 32%32% 57%57%

Thought Thought messages messages were helpfulwere helpful

2%2% 2%2% 8%8% 39%39% 45%45%

Learned Learned nothingnothing new new 21%21% 30%30% 18%18% 16%16% 10%10%


Comfort ComparisonsComfort Comparisons

ViewerViewer(n=168)(n=168)

ComparisonComparison(n=243)(n=243)

% Agree +% Agree +Strongly AgreeStrongly Agree 34%*34%* 28%28%

% Negative written % Negative written comments**comments** 7%***7%*** 28%28%

““I felt comfortable in this waiting room today”I felt comfortable in this waiting room today”

*Difference not statistically significant*Difference not statistically significant**Number of negative comments for this item/n**Number of negative comments for this item/n***Difference is statistically significant (p<.05)***Difference is statistically significant (p<.05)





% Agree +% Agree +Strongly AgreeStrongly Agree 46%*46%* 68%68%

% Negative written % Negative written commentscomments 7%**7%** 14%14%

““I felt bored in this waiting room today”I felt bored in this waiting room today”

*Difference is statistically significant (p<.01)*Difference is statistically significant (p<.01)**Difference is statistically significant (p<.05)**Difference is statistically significant (p<.05)





% Agree +% Agree +Strongly AgreeStrongly Agree 17%17% 17%17%

% Negative written % Negative written commentscomments 9%9% 14%14%

““The amount of time I waited here today was acceptable”The amount of time I waited here today was acceptable”

No statistical difference between groupsNo statistical difference between groups

Viewer KnowledgeViewer Knowledge% %

CorrectCorrectAlready Already KnewKnew

Learned Learned TodayToday

Condoms help to reduce a person’s risk of Condoms help to reduce a person’s risk of pregnancy and diseasepregnancy and disease 87%87% 83%83% 2%2%

It is important to check the expiration date of a It is important to check the expiration date of a condom before using itcondom before using it 88%88% 76%76% 8%8%

If a condom breaks, there is nothing you can do If a condom breaks, there is nothing you can do to help protect against pregnancy.to help protect against pregnancy. 80%80% 71%71% 7%7%

Emergency contraception are pills a woman can Emergency contraception are pills a woman can take up to 5 days after unprotected intercourse take up to 5 days after unprotected intercourse to help reduce the risk of pregnancyto help reduce the risk of pregnancy

75%75% 58%58% 20%20%

Withdrawal or “pulling out” is a good method to Withdrawal or “pulling out” is a good method to protect against pregnancy and diseaseprotect against pregnancy and disease 80%80% 75%75% 5%5%

Men are most at risk for testicular cancer in their Men are most at risk for testicular cancer in their fortiesforties 36%36% 32%32% 33%33%

If a symptom of an STD goes away, you do not If a symptom of an STD goes away, you do not need to get testedneed to get tested 83%83% 71%71% 7%7%


Viewer MotivationsViewer Motivations

Self report of motivations before and after Self report of motivations before and after watching slideshowwatching slideshow

Felt this way…Felt this way…

YesYes BeforeBefore AfterAfter

I plan to talk to my partner about condomsI plan to talk to my partner about condoms 68%68% 65%65% 8%8%

I plan to engage in unprotected intercourse I plan to engage in unprotected intercourse (not use a condom)(not use a condom) 17%17% 59%59% 8%8%

I plan to get tested for sexually transmitted I plan to get tested for sexually transmitted diseases (STDs)diseases (STDs) 65%65% 57%57% 10%10%

I plan to let my partner fully pay for our I plan to let my partner fully pay for our method of birth controlmethod of birth control 17%17% 60%60% 3%3%

I plan to help my partner use a method of I plan to help my partner use a method of birth controlbirth control 69%69% 55%55% 8%8%

Knowledge ComparisonsKnowledge Comparisons% correct for Viewers vs. Comparison (bold yellow denotes % correct for Viewers vs. Comparison (bold yellow denotes statistical significance)statistical significance) Vwrs.Vwrs. Comp.Comp.

Condoms help to reduce a person’s risk of pregnancy and Condoms help to reduce a person’s risk of pregnancy and diseasedisease 87%87% 93%93%

It is important to check the expiration date of a condom It is important to check the expiration date of a condom before using itbefore using it 88%88% 95%95%

If a condom breaks, there is nothing you can do to help If a condom breaks, there is nothing you can do to help protect against pregnancy.protect against pregnancy. 80%80% 86%86%

Emergency contraception are pills a woman can take up to Emergency contraception are pills a woman can take up to 5 days after unprotected intercourse to help reduce the risk 5 days after unprotected intercourse to help reduce the risk of pregnancyof pregnancy

75%75% 61%61%

Withdrawal or “pulling out” is a good method to protect Withdrawal or “pulling out” is a good method to protect against pregnancy and diseaseagainst pregnancy and disease 80%80% 88%88%

Men are most at risk for testicular cancer in their fortiesMen are most at risk for testicular cancer in their forties 36%36% 28%28%

If a symptom of an STD goes away, you do not need to get If a symptom of an STD goes away, you do not need to get testedtested 83%83% 92%92%

Knowledge Comparisons (Men Only)Knowledge Comparisons (Men Only)

% correct for Viewers vs. Comparison (bold yellow denotes % correct for Viewers vs. Comparison (bold yellow denotes statistical significance) (n=71)statistical significance) (n=71) Vwrs.Vwrs. Comp.Comp.

Condoms help to reduce a person’s risk of pregnancy and Condoms help to reduce a person’s risk of pregnancy and diseasedisease 89%89% 91%91%

It is important to check the expiration date of a condom It is important to check the expiration date of a condom before using itbefore using it 87%87% 94%94%

If a condom breaks, there is nothing you can do to help If a condom breaks, there is nothing you can do to help protect against pregnancy.protect against pregnancy. 87%87% 82%82%

Emergency contraception are pills a woman can take up to Emergency contraception are pills a woman can take up to 5 days after unprotected intercourse to help reduce the risk 5 days after unprotected intercourse to help reduce the risk of pregnancyof pregnancy

84%84% 47%47%

Withdrawal or “pulling out” is a good method to protect Withdrawal or “pulling out” is a good method to protect against pregnancy and diseaseagainst pregnancy and disease 84%84% 79%79%

Men are most at risk for testicular cancer in their fortiesMen are most at risk for testicular cancer in their forties 57%57% 32%32%

If a symptom of an STD goes away, you do not need to get If a symptom of an STD goes away, you do not need to get testedtested 95%95% 82%82%


Motivation ComparisonsMotivation Comparisons

% “YES” for Viewers vs. Comparison (bold % “YES” for Viewers vs. Comparison (bold yellow denotes statistical significance)yellow denotes statistical significance) Vwrs.Vwrs. Comp.Comp.

I plan to talk to my partner about condomsI plan to talk to my partner about condoms 68%68% 75%75%

I plan to engage in unprotected intercourse I plan to engage in unprotected intercourse (not use a condom)(not use a condom) 17%17% 23%23%

I plan to get tested for sexually transmitted I plan to get tested for sexually transmitted diseases (STDs)diseases (STDs) 65%65% 73%73%

I plan to let my partner fully pay for our I plan to let my partner fully pay for our method of birth controlmethod of birth control 17%17% 21%21%

I plan to help my partner use a method of I plan to help my partner use a method of birth controlbirth control 69%69% 77%77%


Some Qualitative Comments from ViewersSome Qualitative Comments from Viewers

• Pace/Speed:Pace/Speed: Some commented too fast, others Some commented too fast, others commented too slowcommented too slow

• Learned something new:Learned something new:““I didn’t know you should put condoms in your I didn’t know you should put condoms in your walletwallet””““Learned there are health clinics for menLearned there are health clinics for men””““Would like to see more facts that nobody knows Would like to see more facts that nobody knows about like condoms being kept in a cool placeabout like condoms being kept in a cool place””

• Other suggestions:Other suggestions:““Let teenagers design the slidesLet teenagers design the slides””““Include real life storiesInclude real life stories””““Include sound or musicInclude sound or music””““Would like to see gay and proud adsWould like to see gay and proud ads””


Additional Comments & SuggestionsAdditional Comments & Suggestions

Most frequent comments:Most frequent comments:• Need television, educational videos, movies, music Need television, educational videos, movies, music

playing (20%)playing (20%)• Complaints about wait time and appointments (15%)Complaints about wait time and appointments (15%)• Need magazines and educational brochures (11%)Need magazines and educational brochures (11%)• Crowded room, too few chairs, uncomfortable seats Crowded room, too few chairs, uncomfortable seats

(8%)(8%)• Complaints about staff attitude and service (7%)Complaints about staff attitude and service (7%)

Written comments related to questions Written comments related to questions about comfort and/or additional commentsabout comfort and/or additional comments ViewersViewers ComparisonComparison

% written responses (of 407 comments)% written responses (of 407 comments) 17%17% 83%83%


Viewer FindingsViewer Findings

• 89% thought the messages in the slideshow were important89% thought the messages in the slideshow were important• 84% thought the messages in the slideshow were helpful84% thought the messages in the slideshow were helpful• 51% learned something new51% learned something new• Those who watched the show had more than half fewer Those who watched the show had more than half fewer

negative comments about their comfort in the waiting roomnegative comments about their comfort in the waiting room• Those who watched the show had significantly fewer Those who watched the show had significantly fewer

comments (17% viewers to 83% comparison group) about comments (17% viewers to 83% comparison group) about their experience in the waiting room; this finding suggests their experience in the waiting room; this finding suggests the show provided significant attraction and/or detraction the show provided significant attraction and/or detraction from the viewers need to provide negative or critical from the viewers need to provide negative or critical feedback on their experience in the waiting roomfeedback on their experience in the waiting room

*Percentages equal aggregated “Agree” and “Strongly agree” *Percentages equal aggregated “Agree” and “Strongly agree” responses.responses.


Additional FindingsAdditional Findings

• Men in viewer groups demonstrated significant Men in viewer groups demonstrated significant knowledge increases on emergency contraception, knowledge increases on emergency contraception, testicular cancer, and STD testingtesticular cancer, and STD testing

• Men demonstrated significant acquired knowledge Men demonstrated significant acquired knowledge (“learned today”) on emergency contraception and (“learned today”) on emergency contraception and testicular cancertesticular cancer

• Viewers did better than the comparison group Viewers did better than the comparison group onlyonly on on typically “harder” knowledge items, i.e. emergency typically “harder” knowledge items, i.e. emergency contraception and testicular cancercontraception and testicular cancer

• Viewers were significantly more motivated not to engage Viewers were significantly more motivated not to engage in unprotected intercoursein unprotected intercourse

• There were no statistically significant differences in There were no statistically significant differences in motivation on any items for men only motivation on any items for men only


Next StepsNext Steps• Expansion of project to PPNYC’s two other health Expansion of project to PPNYC’s two other health

facilitiesfacilities• Increasing content to include information about Increasing content to include information about

women’s sexual and reproductive healthwomen’s sexual and reproductive health• New sequences of slides including “virtual visits” and New sequences of slides including “virtual visits” and

other slides to make waiting room occupants more other slides to make waiting room occupants more aware of what will happen on their or their partner’s aware of what will happen on their or their partner’s visitvisit

• Increased bilingual slides (Spanish)Increased bilingual slides (Spanish)• Stronger / more consistent use of educational videosStronger / more consistent use of educational videos• Focus groups to gain more feedback on use of Focus groups to gain more feedback on use of

slideshowslideshow• More research on improving viewers acquisition of More research on improving viewers acquisition of

knowledge and motivation to change behaviorsknowledge and motivation to change behaviors

men’s waiting room education project: utilizing technology to educate and motivate male partners...

Documents

male reproductive health

sexual health

reproductive health

sexualreproductive health

health centers

male partners

male positive

male friendly