How to integrate male services
How to integrate male services
Where do male services fit in the picture when it comes to your facility? While most family planning centers report a percentage of male patients who receive sexually transmitted infection care (74%) and contraceptive care (68%), males make up only 5% nationally of their overall caseload.1
Take a tip on how to increase male services in your facility from presenters at the 2010 National Male Family Planning and Reproductive Health Services Conference in Philadelphia. The conference was sponsored by the Male Training Center for Family Planning and Reproductive Health (MTC), a program of the Family Planning Council in Philadelphia in collaboration with the Center for Sexually Transmitted Disease and Reproductive Health Research, Prevention, and Training; School of Medicine; Johns Hopkins Medical Institutions in Baltimore. The conference was designed to increase the capacity of family planning agencies and other providers to address service needs of males in family planning and reproductive health care settings, with presentations aimed at strategies for building and maintaining an effective family planning program for males, including successful approaches to staff training, policy development and implementation, environmental assessment, and program evaluation. (To obtain an overview of the conference, visit the MTC web site at www.fpcmtc.org. Select "Conference Materials.")
Get the word out
The Family Planning Association of Northeast Ohio (FPANEO), based in Painesville, has been providing clinical services to males since 2001, says its executive director, Mary Wynne-Peaspanen, MEd, CHES. The target population for its male program are reproductive age men in Lake, Ashtabula, and Geauga counties in northeast Ohio.
How has the facility spread the word about the availability of such services? When it first started offering services, FPANEO got out the word in several ways: through its female clients, through an outreach worker, and through referral partners in the community, says Wynne-Peaspanen. Other than normal outreach and educational activities, the agency doesn't typically do any special outreach to males, except in cases of special grant funding that may enable it to engage in specific outreach targeted to males, she notes.
"In surveys, most men tell us they heard about us from a friend, family member, partner, or other client," notes Wynne-Peaspanen. "The age-old word of mouth system still seems to be the most effective."
Male services have been received very well, and the number and percentage of males served annually have increased steadily, reports Wynne-Peaspanen. About 8% of FPANEO's nearly 6,000 clients are male, she states.
Staff, being mostly female, were uncomfortable at first; not because they didn't want to provide services to men, but because they weren't sure they knew enough to do it well, says Wynne-Peaspanen. The agency originally hired a male nurse practitioner who did interviews and exams, while female staff checked clients in and out at the front desk, she notes. The male clinic began as a designated service; however, as the clinic got busier, female staff joined in to do interviews and exit interviews. When funding was lost for the male clinician and the dedicated clinic for males, men were integrated into the general clinics. Female clinicians now are trained to do male exams, she states.
Results of a 2010 male patient exit survey show men are accepting of care through general clinics. Just 14% of men said they would prefer a clinic time dedicated to males only; 76% said it did not matter.
Men want services
Understand that men might need affordable services through your clinic. In Bexar County, TX, 23% of its residents are uninsured, says William Sandburg, Family Planning Program male health educator at University Health System, San Antonio, TX. Some 174,000 men in the county do not have access to healthcare; the county's population in 2006 was estimated at 1.6 million, with 57% of its residents listed as Hispanic, 33% non-Hispanic Caucasian, 7% African-American, and 3% other.
The University Health System had been providing limited male services through its Title X Family Planning grant for several years, but upon being awarded a Department of Health and Human Services cooperative research grant in September 2008, the Male Family Planning and Reproductive Health Project was born, Sandburg explains. The first year of the project was programmed to initiate a comprehensive service model that focuses on three areas: restructuring the clinic environment; training of staff; and targeting out/in reach promoting clinical services.
Although the Health for Men Program began taking shape in September 2008, the University Health System developed historical expertise in this area by participating with Texas Department of State Health Services (TDSHS) in a Title X Male Involvement grant and the TDSHS Title X Family Planning grant.
How has the program gotten the word out about the availability of such services? University Health System has been very active in promoting the Health for Men program, says Sandburg. The program uses several collateral pieces to give patients an idea of what services they can receive at its ambulatory clinics, including bilingual service cards, bilingual brochures, bilingual posters, retractable banners, and other incentive items.
The Health for Men program also is represented at various health fairs and other community outreach programs throughout the city on an annual basis. Nine of the agency's clinics, conveniently spread out throughout San Antonio and Bexar County, offer Health for Men services, which makes staying healthy easier for men. The Health for Men Program has established numerous collaborations with community based organizations throughout the San Antonio community provide additional avenues to get the message out about its services, says Sandburg.
How has the addition of male services been received by patients, as well as staff? Since the preventive health clinics had traditionally provided well child and women's health services, there was some initial resistance, Sandburg notes. As part of the comprehensive service model, several staff trainings were conducted on the male exam, communication, and sexual health. As a result, the staff was able to demonstrate more comfort and sensitivity to providing services to men.
And as for patients? As Sandburg observes, the most common response from patients on the addition of male services can be summarized in the statement "It's about time!"
Reference
- Lindberg LD, Frost JJ, Sten C, et al. Provision of contraceptive and related services by publicly funded family planning clinics, 2003. Perspect Sex Reprod Health 2006;38:139-147.
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