E5 Working It Online Internet Partner Notification Jackson
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E5 Working It Online Internet Partner Notification Jackson

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  • Populations which never have internet contacts? None! These days, there is no person we can assume doesn’t have internet access and/or an online presence.
  • We don’t just want to ask the OP about the contacts’ information! We also need to ask the OP for THEIR internet aliases. Why? Because they may be named in a later interview only by an email or an online handle. This can help us find them.
  • A follow-up call a day or two after the interview is also useful; it’s an opportunity to show that you care about the patient (building rapport), remind the patient that they have homework, and occasionally to obtain additional contacts on the spot – never fail to ask “who else?” every single time you talk to the patient.
  • Many patients may neglect to look in their accounts at home after they leave. If the DIS suggests viewing that information together, just like suggesting that the patient look through her/his mobile phone or PDA, the patient can then access that information immediately and even view profiles with the DIS to gather as much information as possible about contacts so that those contacts can quickly be located, notified, and tested.
  • Remember: *Never assume patients don’t go online. For example, though a DIS may assume otherwise, homeless and low-income people may have internet access through a shelter or a public library. Low socioeconomic status or educational attainment is no reason to neglect to ask for a person’s email address or ask about her/his online activity. *Many people have more than one email address or online handle. They may use a different username on each profile site. Ask SPECIFICALLY what username the patient uses for each method of communication mentioned. *Never assume the OP doesn’t know other locating information beyond an email or a screenname! If they had sex, where? If they had sex at the contact’s home, how did the patient get there? What are the cross-streets? Name of the apartments? What does the dwelling look like? What else do they remember learning about that person – where s/he hangs out, works, etc.?
  • Again, remember to always get as much information to fill out the other portions of the field record as possible!
  • People don’t have online profiles and online presences because they want to hide. They have them because they want to be found – follow the trails they leave and find them!
  • Remember that sometimes people have moved to a new place, and they may receive this email and call from wherever they are, even foreign countries in some cases. If they state they no longer live within that area code, simply state that the health department of their last address is whom contacts them. Throw them off of the OP.
  • And don’t forget to document FULLY the whole call!
  • This may be different from program to program. Reveal the exposure and motivate the client to test! MAKE THE APPOINTMENT!
  • However you work it online….

E5 Working It Online Internet Partner Notification Jackson E5 Working It Online Internet Partner Notification Jackson Presentation Transcript

  • Working It Online: Internet Partner Notification 17th TEXAS HIV/STD CONFERENCE Jen Jackson, Program Consultant DSHS HIV/STD Prevention & Care Branch
  • Why are we here?
    • To enhance partner services through effective use of internet resources to reach people who are part of online sociosexual networks
  • Where do people meet online?
  • Who are we talking about?
    • Any patient for whom the field record includes an email or online handle as part of the locating information
    • Everyone we interview
    • Which population(s) never have internet contacts?
  • Get the Information
    • What questions can we ask patients and contacts which help us gather internet-related locating information?
  • Remember: There is a fine line between fishing and just standing on the shore like an idiot.
  • Get the Information Open-Ended Question Examples “ Where do you meet most of your sex partners?” “ How often do you meet partners online?” “ Which chat rooms do you use?” “ What is his/her email address?” “ What is his/her screen name?” “ Who is in your phone right now that we can contact?”
  • Give ‘em Homework!
    • “ Check and see what email handles are in your computer at home.”
    • Give the patient partner information sheets to take home, so you can capture more necessary information.
  • Log In Together
    • Have a computer available where you and the patient can log in to emails, profile sites, chat rooms and look for information together.
  • Work the Network
    • Don’t forget social networking sites like Facebook and MySpace!
    • There are MSM-specific social networking sites – from BigMuscle to Dlist – ask about them!
    • Don’t forget clusters!!
  • AVOID ASSUMPTIONS
    • Patient doesn’t go online
    • Patient has only one email or handle
    • OP doesn’t have other locating information than email or handle
  • Enter the Field Record
    • Handle given = [email_address]
    • First name = Unknown, unless first name is given
    • Last name = [email_address]
    • Note section = add any additional information to help locate the partner and the complete email address
    • Complete description and exposure dates as stated by patient
    • Remember: The email address or online username MUST be entered into STD*MIS under AKA for future reference.
  •  
  • Is Meeting Online a Risk?
    • Not on its own
    • It’s what happens AFTER the meeting
    • What if nothing happens after they meet?
    • Don’t forget to ask how a meeting was arranged and who else was involved
  • Work the Contact
    • Work as you would any other contact
    • Use all available notification methods si mul ta ne ous ly
    • Document online notification efforts on field record as you would any other
  • Follow the digital breadcrumbs…
    • search AKAs in STD*MIS
    • Google the email address – not just the whole address ( [email_address] ) but also the username (SexyKitty4U)
    • search username on multiple sites
    • personal data in email addresses is common – name, DOB, hobby, etc.
    • people leave trails, follow them!
  • Send the Email
    • Communicate the urgency
    • Make it professional – edit your product for spelling, punctuation, etc.
    • Send from a department address, never a personal one
    • Include a confidentiality statement
  • First Email - Sent 1 st Day
    • Date: sent on Day 1 of the investigation
    • To: BOBsINLUV@worldnet.com
    • From: jinvestigator@tshd.state.tx.us
    • Subject: URGENT HEALTH MATTER
    • My name is John Investigator, and I am with the
    • Texas State Health Department. I have urgent and
    • confidential health information to discuss with you.
    • I can be reached at my office at (555) 234-5678.
    • Please contact me as soon as possible.
    • Thank you,
    • John Investigator
  • “ The information I need to discuss with you is sensitive and of a highly personal nature. I will maintain strict confidentiality and I need you to do the same. Any dissemination, distribution or copying of this communication is strictly prohibited. Do not forward this email to others. If you are not comfortable discussing confidential matters via email, I will be glad to call you or you may call me at (XXX) XXX-XXXX.”
    • To: BOBsINLUV@worldnet.com
    • From: jinvestigator@tshd.state.tx.us
    • Subject: HEALTH DEPARTMENT MATTER
    • My name is John Investigator and I work with the Texas State
    • Health Department. I attempted to contact you on 01/01/10; I have
    • some very important health information to share with you. This is
    • a very urgent matter, and because of the confidential nature of
    • this information, it is vital you contact me.
    • Please call me at (555) 234-5678. I can be reached at this number
    • from 8am to 5pm, Monday through Friday or you can contact me
    • using my e-mail address, jinvestigator@tshd.state.tx.us or my cell
    • phone at (555) 255-5888. To assist you in confirming my identity, I
    • have included my supervisor’s name and phone number: Josefina
    • Boss, Program Manager, (555) 234-5679. Please do not delay in
    • contacting me.
    • John Investigator, Disease Intervention Specialist
    • Texas State Health Department, South Central District Office
    • (555) 234-5678
    Second Email – Send 3 rd Day
  • No Response After 4 th Day
    • Get supervision involved
    • Reinterview the OP for more information
    • Review searches – what did you miss in your research?
    • Send something like one of the following on day 7
    • To: BOBsINLUV@worldnet.com
    • From: jinvestigator@tshd.state.tx.us
    • Subject: CRITICAL HEALTH MATTER
    • I am John Investigator with the Texas State Health Department.
    • This is my third attempt to contact you through this e-mail
    • address. On 01/01/10 and 01/03/10, I sent you an email asking
    • you contact me ASAP, because I have urgent health information
    • to pass on to you. It is vital that you contact me immediately. As
    • this is my only means of contacting you at this time, I hope you
    • take this message seriously.
    • I can be reached at my office Monday–Friday 7:30AM through
    • 4:30PM or at my e-mail address, jinvestigator@tshd.state.tx.us, or
    • my cell phone at (555) 255-5888. To confirm my identity you can
    • contact my supervisor at (555) 234-5679. Please do not delay!!!
    • John Investigator, Disease Intervention Specialist
    • Texas State Health Department, South Central Office
    No Response - After 4 th Day
  • No Response - After 4 th Day
    • Date: sent on Day 7 of the investigation
    • To: BobsINLUV@worldnet.com
    • From: jboss@tshd.state.tx.us
    • Subject: SUPERVISORY HEALTH MESSAGE
    • My name is Josefina Boss and I work with the Texas State
    • Health Department. You have received a prior email from one
    • of my employees, John Investigator. As John’s supervisor, I
    • am concerned that we have not heard from you. We have
    • some urgent and confidential information we need to discuss
    • with you, so please call John at (555) 234-5678, or myself at
    • the number below.
    • Josefina Supervisor, Texas State Health Department
    • DIS Supervisor
    • (555) 234-5679
  • STILL No Response?
    • At 10 th day of investigation, if...
      • No other avenue to reach patient
      • OP has been RI’d for more information
      • No response whatsoever to emails
      • No other research to be done...
    • Close the field record with H disposition.
    Le Sigh!
  • BEFORE YOU SEND…
    • Flag the email:
    • Flag with a “read receipt”
    • Choose “high sensitivity”
    • Choose “confidential”
    • What about subject headers?
    • May need to vary from what is in the examples
    • Sometimes NO header works best
    • See what gets the best response rate
    • Always include your area code when listing your phone number due to the use of cell phones.
    • China may call.
  • Do Not Send These!
    • Personal, confidential, or identifying information
    • Threats, harassing remarks, disrespectful language – keep it professional!
    • Emails with multiple copied addresses
  • Attach the Email…
    • Document on FR date/time email sent
    • Print copy of email from “sent” box (records time & date of email)
    • Attach a copy of email sent to the FR
    When the contact calls…
    • Ask how they were contacted:
    • Phone call
    • Note on door
    • Email/Online
  • HEADS - UP
    • If the contact states s/he received an email, we may not know her/his name.
    • Ask for the email or username by which they were contacted.
    • Enter this as the last name in STD*MIS until you have the contact’s actual last name.
  • Confirm/Gather Information
    • Same technique as usual:
    • “ As we stated in the email, we have some highly confidential information for you, so I need to confirm you are the person we are looking for.”
    • “ What is your first and last name?”
    • “ What is your birth date?”
    • Don’t forget to document the phone number from which the contact called!
  • Clear the Line
    • Who else on the line (or nearby) can hear our conversation?
  • REVEAL THE EXPOSURE
  • After the Call
    • Make sure you got the contact’s phone number!
    • Fully DOCUMENT the phone conversation
    • Make sure the username/email address is in AKA field in STD*MIS
  • The Contact Responds by Email...
    • Respond appropriately and conserve confidentiality
    • Always request further contact, preferably by phone or in person
    • Don’t be afraid to get supervision involved!
    • Print and attach what you receive and how you respond
    • DOCUMENT all communication on field record.
  • The Contact Fails to Respond
    • As with any other field record –
      • Send another email
      • If you’ve sent two emails, get supervisory guidance
      • What other methods to locate?
      • RI the OP for more information
      • Have OP send email or contact them
    • Read confirmed, but no response
      • We may have a live one...
  • Alternative Notification Methods
  • Profile Sites
    • ManHunt, Adam4Adam, etc.
    • When profile username isn’t also an email address
    • Make sure you have department permission
    • Use a health department account for notification
    • Follow guidelines agreed-upon with site administrators
    • NEVER use personal accounts for notification
    • NEVER pretend to be someone you’re not – no phony profiles
  • IPS
    • I nternet P artner S ervices group
    • Contract with Houston HD – statewide resource
    • Provides online notification services for programs which do not have permission to access profile-only sites
    • Used simultaneously in conjunction with traditional methods if there is other locating information
  • Who should I contact for IPS??
    • Tamika R. Martin, MPH, CHES
    • Senior Public Health Investigator
    • Bureau of HIV/STD and Viral Hepatitis Prevention
    • Houston Department of Health and Human Services
    • 8000 N. Stadium Drive, 5th Floor
    • Houston, TX 77054
    • 713.791.6955 office
    • 713.798.0830 fax
  • IPS Guidelines
    • Document screen name(s) & social networking website(s) the infected client communicates with the exposed contact
    • Consult with supervisor for contact information of the current IPS.
    • Provide the IPS codes only to assist in identifying the nature of notification (P1 to 700; S3 to 900, etc.)
    • Include contact information for themselves and their Supervisor
    • IPS conducts follow-up, within 2 business days of notifying a contact, with investigating agency to determine if contact responded to initial message and decide whether a follow-up message is necessary
    • IPS will, within 7 business days from the request for notification, contact the investigating agency to determine if the contact was seen by a health care agency
    • Disposition of contacts in less than 7 days should be reported to the IPS immediately
    • DIS and FLS are encouraged to forward the IPS any additional websites clients provide during interviews in order to establish a statewide profile for that site.
  • The apollooza Tour Starring: inSpot.org
  • “ Gotta get myself…gotta get myself…gotta get myself connected….”
    • E-mail: often, a preferred method of contact
    • Online Connections: chat, personals, cruising/social networking sites
  • “I Need You Tonight…”
    • “ Your moves are so raw”:
    • Insufficient public health resources to utilize partner services for STDs other than HIV and syphilis.
    • “ I’ve got to let you know”:
    • Expanding services for STD partner self-notification to the web.
    Herpes Scabies HPV Molluscum Trich Crabs NGU Hepatitis
  • “ Who are you? Who who…who who?”
    • “ Hello, it’s me”:
      • Self notification tool (for those diagnosed with an STD)
      • User-friendly IPN service, created in 2004 by ISIS Inc ( http://www.isis-inc.org )
      • Purpose: To utilize current technology to prevent the transmission of disease and educate communities
  • “ Here’s a little story, I got to tell…”
    • inSpot was first launched in San Francisco, CA
    • Moved to servicing specific states, targeted cities, and some international locations
    • Recent changes to InSpot – National inSpot (U.S.)
    • inSpot currently services: Canada, United States, Guam, American Samoa, Northern Mariana and Puerto Rico
  • “More than words….”
    • Default Language: U.S. English
    • “ Voices Carry”: Other language selections
      • Canadian English
      • French
      • Spanish
    Hello, eh? Bonjour! Hola!
  • “I want you to want me.”
    • “ Where it’s at…”: (web address)
    • http://www.inspot.org
    • inSpot currently provides:
      • Tell them: STD self-notification through a variety of anonymous or confidential e-mail postcards
      • STD info: Up-to-date information on STD signs and symptoms
      • Testing: Links to local testing
      • Resources: Links to websites with more information
      • Tips for self-notification
  • “ What I am is what I am…”
    • What inSpot is:
      • A tool for notification of partners of persons with gonorrhea, Chlamydia and other STDs for which health department notification services are not available.
    • What inSpot is not:
      • inSpot is not an alternative to Partner Services.
      • It does not contain any tracking software to identify individuals or confirm testing/treatment.
      • It is not a site that compiles names of people with STDs to “out” those infected and it does not post names on the internet.
      • Not a data collection tool:
        • Keeps a count of number of e-cards sent and received
        • Collects optional demographic and disease data
  • “ Is it worth it? Let me work it.”
    • How can public health use inSpot?
      • Referrals to inSpot can be made by:
        • Health Departments
        • CBOs
        • Community Clinics
        • Family Planning Clinics
      • Referrals can be made by anyone who counsels patients about notifying their sexual partners of a possible exposure:
        • Providers
        • Nurses/Nursing Assistants
        • Case Managers
        • Health Educators
        • Risk Reduction Specialists
  • “ I always feel like somebody’s watching me…..”
    • The preferred method for notification for syphilis and HIV is DIS notification; however DIS may refer clients to inSpot Texas for e-mail self-notification to augment sexual contact notification efforts.
  • “ Peeeeeek-A-Boo!”
  • “ I wish that I had Jesse’s Girl.” * * All celebrity STDs have been impersonated. Man, it really burns when I pee!
  • “ Wow. This STD is no fun. I guess I should tell my partners so they can get tested and treated!”
  • “ Okay…my language is English (U.S.) and my region is Texas. Hmmm…time to pick a card.”
  • “ Yup. I guess sometimes there ARE strings attached. This is a good card to send them.”
  • “ Wow. A security question. I guess they really don’t want bots spamming inSpot e-cards!”
  • “ Okay..what’s next? Time to create my message, huh?
  • “ Okay…message created. All six email addresses entered.”
  • “ What’s next? Optional demographics used for statistical purposes only? Hmm…ok. I’ll fill it in.”
  • “ Time to preview this card so I can send it and get back to work.”
  • “ Rock!! Hey, that was easy!” (Hey there, baby…what are you doing later…?)
    • Sending an inSpot card is as easy as 6 simple steps:
      • Select language
      • Select region
      • Pick a card (enter the security words)
      • Create message (optional statistical data)
      • Preview
      • Send
  • “ Wait! Oh yes, wait a minute mister postman!” What’s that in my inbox? Oh look! An email from Jesse!
  •  
  • “ Oh no! I better get tested!!!
    • Gmail Chat
    • Jessej
    • Fun49
    • Mom
  • “ Oh look! I can find testing services in my area on this site!”
  • “ Wow! There are 10 clinics right in my zipcode!!
  • “ Here’s where the story ends.” Boy, I sure am glad I let my partners know!
  • “ How do rumors get started…”
    • How will inSpot be promoted in Texas?
    • Print materials: posters, flyers, cards
    • Locations: health depts, CBOs, community clinics, family planning clinics
    Sample inSpot card – front Sample inSpot card – back
  • “ I’ll send an SOS to the world. I hope that someone gets my…”
    • inSpot Marketing Activities:
      • Banner Ads
      • Posters
      • Cards
      • Training and Information
      • Webpage
      • Periodic inSpot Reminders
  •  
  • “ Treat me like your mother.”
    • POST NO HATE
      • Any expressions of hatred, bigotry, abuse or harassment will not be tolerated by inSPOT.org. The people responsible for sending hateful or harassing words are subject to immediate and permanent suspension from the site. inSpot asks that all users refrain from profanity and defamatory comments on their cards.
    • PLEASE REPORT ANY PROBLEMS
      • If you are having problems with a person who may have maliciously sent ecards from the site, please contact inSpot at [email_address] . If you feel another person is violating these community and membership guidelines, please contact the site as well, or if you have questions about or problems with sending/receiving ecards yourself.
      • inSpot Community Guidelines:
      • http://www.inspot.org/Confidentiality/tabid/67/language/en-US/Default.aspx#nohate
  • “Everybody’s Down”
    • Take inSpot for a test drive!
    • Send a card – Make sure your co-worker knows that the card is coming from you!!
    • Find a clinic
    • Check out the links
    • Check out the guidelines
  • Remember, no matter how you work it online…
    • DOCUMENT!
    • DOCUMENT!
    • DOCUMENT!
    • Document every search, every email, every chat contact (or attempted contact), every referral that you have made.
    • Take credit for your hard work!
  • Remember: Thorough documentation is kind of like peeing in your pants…
    • Everyone can see it, but only you get the warm feeling it brings!
  • “ You know my name. (Look up the number.)”
    • Have questions or suggestions??
    • Need inSpot materials??
    • Wanna hang out?
    • Jen Jackson
    • 512-533-3089
    • [email_address]
  • Thank you!!!