Open the door to men: Put out the welcome mat
There’s no elaborate formula for bringing men into your facility, says Bruce Armstrong, DSW, associate clinical professor with the Columbia University’s School of Public Health in New York City and head of the school’s Center for Population and Family Health.
Just broadcast the message effectively to the population you’re trying to reach, recruit a staff that knows how and wants to work with young men, and, indeed, the men will come, he says. Armstrong was instrumental in founding the Young Men’s Clinic in upper Manhattan, which is run by the Center for Population and Family Health and by Presbyterian Hospital’s Ambulatory Care Network Corporation, also in New York City.
Following are some suggestions on how to introduce men to the reproductive health scene:
• Make it a safe space. Dedicate a few hours to male-only sessions.
Many men may feel intimidated when entering what looks like an all-female facility, so schedule a few hours for male patients outside your normal patient mix. It’s all right to use female clinicians; in fact, many of the patients at the Young Men’s Clinic have developed a good rapport with the female staff members.
Catherine Quinn, MSN, CNP, a nurse practitioner who works in the young men’s and family planning clinics, says she’s had no problems with male patients. If she senses hesitation in a new patient, she offers him the option of seeing a male provider. Usually these patients will refuse the offer and enter into topics of conversation that provide Quinn with excellent teaching opportunities on sexuality, birth control, and other issues.
• Change the mindset. Men can be far more involved than just by wearing a condom.
Young Men’s Clinic workers use discussion groups in the waiting areas to help men think in new ways about sex and sexuality. As Armstrong explains, "We include things like Do you discuss these things with your partner? If there is no method available, do you think of other ways to express affection so that there isn’t risk for you or for your partner? Did you ever think you could go back and tell your partner there is this really nice clinic that you could come to, and that you’ll even come along with her and spend some time with her in the clinic, so she won’t be so nervous?’
"These are real ways that men can be involved, and we try to open up the many ways men can show they care and are involved."
• Role play to teach skills and dispel myths.
Waiting areas can serve as stages for instructional role-playing, Armstrong says. For example, not only can you offer demonstrations on how to use a condom, but you can get men talking about how to bring up the issue of condom use with their partners.
"These discussions don’t force anybody to speak," he notes. "There’s always five or six willing participants who want to discuss the issues, so the rest of the fellows can be quiet and listen in. Issues that are uncomfortable or embarrassing need to be articulated. If you can come up with alternative solutions, like using more lubrication with condoms or finding ways to speak to partners in a way you don’t feel so embarrassed, than that’s what needs to be discussed."
• Slides help patients get the picture.
The Young Men’s Clinic uses slides in the waiting room to show very basic images of the male reproductive anatomy, as well as illustrate different aspects of the male exam, such as a hernia check or a urethral swab. Slides also depict various sexual infections, such as a close-up of a herpes blister.
The slides aren’t meant to be scare tactics, but they do help open discussions and clear up misconceptions, says Armstrong. For example, the herpes blister slide helps educators get the point across that viral infections other than HIV have no cure. This fact crushes the "invincible" myth common to young men.
• How to get out the message: Talk to your female patients.
You don’t have to go far for your male patients: Just advertise your services with your female family planning clientele.
Columbia public health students conducted a short experiment in advertising the Young Men’s Clinic simply by talking about its services in the waiting areas during family planning clinic hours. Then they studied changes in the level of activity at the Young Men’s Clinic.
"The odds ratio was two times as likely that a new patient to our clinic was told about it and encouraged to come by his girlfriend or a friend who went to the female family planning program during those activities in the waiting room," Armstrong says. "And all it took was just a few hours in the waiting room each day of the week for a few months by our public health students."