Project Co-ordinator for C-Card Schemes
NHS Lanarkshire
The Blood Borne Virus and Sexual Health Promotion Team operate the Condom Distribution Schemes (CDS) within Lanarkshire and are hosted within the Health Improvement Department. Improving the visibility of sexual health, especially amongst younger populations is a key concern; in 2015 68% of all diagnoses for chlamydia were amongst individuals under the age of 25. Young people under 25, especially females, define the cohort most at risk of being diagnosed with an STI (FPA, November 2016). In addition to contracting an STI from unprotected sex, the risk of pregnancy also increases. ISD Scotland July 2017 data tells us that women under 20 living in the most deprived areas have up to five times higher pregnancy rates than those living in the least deprived areas compounding the importance of ensuring that contraception is easily accessible to the younger population.
The team conducted a pilot “Condoms by Post” project whereby service users could receive a packet of condoms via the post by completing a request form online. The purpose of the pilot was to highlight Lanarkshire’s C Card Centres where members of the public can visit to obtain supplies of free condoms, and encourage service users to access these areas. The next stage of the pilot project was to evaluate and understand the experiences of our service users.
How did you meet Flo?
Working within Health Improvement Department you hear about a number of new programmes or processes that are becoming available for staff to utilise. A member of the BBV and Sexual Health Promotion Team had reported that there was a tool named Florence (or Flo) being used across Lanarkshire to support patients with aspects of their health using their own mobile phones to engage via text messaging. These service users reply to Flo with, for example, their blood pressure readings to improve their confidence and ability to self-manage and be remotely monitored by clinicians. The CDS initially made contact with our local Telehealth Programme Manager to discuss the best way to drive this opportunity forward.
What did you want to achieve?
Initially, our main aim for Flo was to make sure that we received enough data to evaluate the “Condoms by Post” project. We hoped to maximise the likelihood of receiving feedback by harnessing Flo’s ability to engage with patients offering us an ideal opportunity to harness a proven tool to engage patients and service users which seemed perfect for our cohort who did not like to communicate in person, particularly in relation to a sensitive subject.
Previous feedback suggested that people feel embarrassed talking about any areas of sexual health, which also includes condoms. Introducing Flo seemed like an ideal opportunity to break down this barrier. We realised that Flo could be used to remind our service users about the help that was available to them. We therefore developed a secondary aim, which was to provide extra support and information to our service users in a convenient and discrete manner.
How was Flo introduced to service users and the team? It was important early on to ensure that we had consent from our service users to join in with Flo, so during the planning stage before the development of the protocol, the following information was added to the online form to maximise the responses from service users. This ensured that the team had the appropriate permissions to contact service users:
The CDS team members received a training session from our local Telehealth Programme Manager to understand how to add service users to Flo and assign the agreed protocols, allowing Flo to interact and understand how service users felt about the service.
To ensure the CDS team received the meaningful feedback to support project evaluation, the CDS team and Telehealth Programme Manager developed a protocol with a small number of questions for Flo to ask service users within an 8 week timescale.
We agreed the timescale to ensure that Flo kept the service users attention avoiding lengthy questions, and also to ensure enough time was given for the service users to use the service by visiting a C Card centre and obtaining additional supplies of condoms.
What happened next?
The CDS team made good use of the protocol to benefit the service. At the 4 week period a message was sent from Flo to service users reminding them that free condoms are available from C Card centres, and also motivating service users to use the BBV and Sexual Health Promotion Team’s existing website to gain additional knowledge and resources.
In the end, Flo not only helped us to evaluate the project, but we also recruited her as a useful and discreet reminder to service users of additional services available to them.
The Telehealth Programme Team was a tremendous support to the CDS team when creating and implementing this work. The guidance the team offered was invaluable, alongside the support and advice they provided whenever required, this made a huge difference to implementation.
I would absolutely recommend using Flo to other colleagues who are considering integrating her within the workplace. Through consultation with users in relation to the work within the BBV and Sexual Health Promotion Team, the feedback being received is that people are in fact communicating more online due to its convenience and accessibility. To support this, there is now published literature available demonstrating that a high number of people access their information online and also on the go via their mobile phones.
Using Flo is a method of communicating in a way that backs up this evidence and research.
Integrating Flo meant that the CDS team efficiently received the information we needed to evaluate the “condoms by post” pilot helping us to deliver the best service possible to our service users. 85% of our service users also responded that they found Flo easy to use.
For more information please contact janet.robison@lanarkshire.scot.nhs.uk
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