From Social to Sexual Networks: Developing a provincial sexual health websiteMark Gilbert, MDOnline Sexual Health Services, BCCDC

Health Care 2.0: Social Media CampQuality Forum 2012

March 9, 2012

Outline

• Why we’re doing it

• How we’re doing it

• What it’s going to look like

• How it’s been so far

Sexual Health Services

• Testing, treatment, contraception, counseling• Disparities in access and burden

– Rural versus urban– By population

• Increased service demands– Increasing STIs (chlamydia, gonorrhea)– Delays to care are missed prevention opportunities

Barriers to Conventional Services

Source: Klausner et al. JAMA 2000: 284(4):447-449.

“New era of STI prevention”

• Educational websites• Online partner notification• Online prescriptions• Social marketing campaigns• Social media • Interactive risk reduction programs• Virtual support communities• Internet-based testing• And more…

Mobile health

Rationale

• Highly acceptable • Patient-centred• Reach affected populations• Reduces barriers to access• Consistent quality• Better use of clinician resources• Cost-effective• Economies of scale

Source: Sandstra et al. Cyber-outreach: STI/HIV education online. Can Nurse 2008; 104(6): 24-28, 30-21

Impact

• Recent survey of sex workers, patrons (n=99)

– 36% had regular HCP with whom felt comfortable talking about sexual health

– 98% found service important, useful

– Reported impacts on:• sexual knowledge

(91%)• sexual behaviour

(34%)– 76% would be likely to

use internet-based testingSource: Hottes TS. Impact of a Nurse Cyber-Outreach Program for Sex Workers and Patrons, and Appeal of Internet-

Based Testing in this Population. 2012 National STD Prevention Conference.

Vision

• Using online and other new technologies to:– Deliver innovative sexual health services– Reduce barriers to accessing appropriate sexual

health care – Reduce overall burden of STI in BC

Clients accessing online services

Clients accessin

g clinic services

• e-mail based partner notification

• Interactive, sexual health website

• Internet-based testing for STIs

“ The trouble with quotes on the internet is that you can never tell if they are genuine. ”

- Abraham Lincoln

Rationale?

• Top searches on BCCDC site• High traffic to current website

STDresource.com • Foundation for online services, including cyber-

outreach• Interactive, integrated with social media

• Final development stages• Launch spring 2012

Current status

Create a Working Group

Establish partnerships

• Internal:– Working groups (design, functionality, content, process)

– Content Subject Matter Experts– PHSA Communications (communication strategy)

– PHSA Privacy Office (advise privacy)

– PHSA Legal (advise risk)

• External:– UBC Researchers– Consultants, vendors– Community Consultation working group (community

perspective)

– RHA/MoH Public Health partners (public health perspective)

– End Users (usability testing)

Website Vision (June 2010)

• To create a comprehensive sexual health website for British Columbians that:

– Provides local, relevant sexual health education and promotion

– Provides access to sexual health nurses

– Is a resource for BC health care providers & agencies

– Stays relevant through dynamic content, new and appropriate technology, and ongoing evaluation

Take stock - internal

Mar-08

May-08

Jul-08

Sep-08

Nov-08

Jan-09

Mar-09

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Jul-09

Sep-09

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Jan-10

Mar-10

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0

10000

20000

30000

40000

50000

60000

Site Visitors to STDResource.com

Unique visitorsNumber of visitsPages

Axis

Title

Take stock - external

Concept Jam (Dec 2010)

Website Strategy (Dec 2010)

• Options for supporting discussion

• Options for disseminating information

• Health care providers and community partners

• Outreach and Dissemination

Research and

Evaluation

ProgramPlanning,

development, Implementation,

maintenance, evolution…

Online STI Testing & Youth (2010-2012)

• Important aspects of youth’s social contexts affect their engagement in online sexual health services

• Study uses multiple data collection and analysis techniques

Data Analysis

Focus Groups

Individual Interviews

Youth Roundtable

Ongoing Development of SmartSexBC & GetCheckedBC

Youth’s Preferences on Sexual Health Websites

Youth desired:• Practical information• Peer-generated information• Professional approaches to

design and content• Organizational affiliation

prominently displayed

Sources: Shoveller J et al. Youth and Online Sexual Health Services (CJPH 2011, in press)Davis W et al. Lessons for the development of sexual health resources for youth. Presentation, Nov 2011.

“I would be more likely to read than to post. I guess I would just feel weird knowing that anyone else can read it. It would be a mental thing even though they don’t know who you are.”

Website development (Feb 2010-April 2011)

• Wireframes, technical requirements• RFP, vendor evaluation and selection• Logo, colour palette• Design & Layout• Further specification of requirements (interactive features)• Content planning & development & editing & editing &

editing…• Image collecting, photo shoot• Build• Role-based training• User acceptance testing & final testing• LAUNCH

…many, many, many meetings!

Know the risks

What to do if…About STIs Get tested Ask UsSex TalkFor Health Providers

(landing page)

Got symptoms?

(landing page)

Prevention

Just diagnosed

Tests & Exams

Confidentiality

Results

HOME

Pleasure

Dating, Hookups &

flings

Protection

(landing page)What to do7 scenarios

Top 10

(landing page)Blog

(Twitter?)(E-newsletter sign

up?)Link to BCCDC

Journal ClubTrend Watch

Condom broke

unprotectedGeneral worry

pregnant+ sex

partnerBlack out

Sexual assault

Handouts

What to expect

(carousel)

A to Z

About UsTerms of

UsePrivacy

Sex Concerns

Landing page

STI Profiles

Carousel pages

New KnowledgeClinical Practice tips

Program updatesEvents &

Announcements

STIs in BC

Clinic Finder Ask a Question

Hot Topics

News & Events

(landing page)

New partners

Chat

Just In

Sign-in

Not just creating a website!

• Conceptual and Final Privacy Impact Assessment• Policies/procedures

– Privacy policy, Terms of Use (for website)– Nursing, online outreach– Operational (e.g., account management)– Blog content guidelines– Content style guide– Social media / Administrator procedures– Complaints & quality assurance

• Legal & Professional Practice review • Communication strategy• Promotion strategy• Maintenance & sustainment plan

Highs…

• Making something useful• Everyone gets it• Fantastic, collaborative, supportive teamwork• Satisfaction of research : program partnerships• Pushing the boundaries

…and Lows

• Unexpected challenges• Resource constraints: $, people, time• Competing priorities• Delays• Pushing the boundaries

Lessons we’re learning

• It’s not the year 2000 anymore• Need infrastructure in place to support online

presence• Can’t please everyone• Things take a lot longer than you think they will• Devil’s in the details• Many things are out of your control• So much more than just building a website

• Giving clients control means giving it up, and instead focus on mitigating the risks

…to a URL near you

• Devon Haag• Mark Bondyra• Travis Salway Hottes• Jenny Matthews• Ian Roe• Ellen Fraser• Wendy Davis• Derek Kline• Elaine Jones• Amanda Bonnell• Sandi Mitchell• Wendy Conway-Brown• Liz Elliot• Nadine McGraw• Lisa Schaffer

Props to:

For updates, comments, questions:

Lovebytes blog:Bclovebytes.wordpress.com

Email: OSHSP@bccdc.ca mark.gilbert@bccdc.ca

Twitter: mpjgilbert