The goals of my project were…So why were these goals and this topic important to me? Well *switch slide*
A vast literature suggests that MSM do not receive adequate health care, however *switch slide*
Research indicates that MSM living in rural communities may be at even greater risk of poor health.In response to this, the UBCO MSM Health Survey was conducted *switch slide*
Some alarming key findings came from the results of this survey. For example…It was clear from these results that the MSM population in the Interior of BC was not receiving adequate health care.
Therefore, there was a need to engage and educate the local physicians about the health issues facing MSM in their community. *chat about different dissemination options* After some brainstorming with Dr. Holtzman, we decided to create an online presentation to communicate the key findings to local physicians.
Started the presentation with a definition and explanation of the term MSMThe 6 key findings from the UBCO MSM health survey followed this slide.
This is an example of one of the 6 key findings I presented to the physicians.For the key finding about discrimination, I provided a participant’s quote. He said….
So these were simple, yet effective means of improving practice.For each suggestion I provided an example and explanation for how to appropriately do so.
This was the slide for the first suggestion.*go through it*It was important to disseminate the survey results to the physicians, but it was equally important for me to collect information from the physicians.
Although it was extremely important to disseminate the results and suggestions to physicians, it was equally important to collect information from the physicians.I created 5 very basic quiz questions which directly addressed the key findings provided in the presentation. This allowed me to assess if the physicians were paying attention and if their awareness of the Lastly, I created a brief questionnaire to assess the content and impact of the presentation. For example, *list some example questionnaire items*
In developing the powerpoint presentation, I connected with Kevin Saya-Moore, Project Coordinator for the Engaging Physicians Project, and Dr. O, the Champion Physician of the Engaging Physicians Project. It was great to receive feedback and advice from Kevin, a member of the BC Interior MSM population, to ensure I was using correct terminology and offering impactful suggestions.And i really appreciated Dr. Toye’s recommendations and edits as he was a part of the population I was targeting - physicians practicing in the BC Interior
Explain the process of uploading the presentation and contacting the physicians with the study invitation and presentation link
To date, we have had 27 physicians start the study and 11 physicians complete the study. We don’t know why the physicians chose not to complete the study…topic? Time? Other? *demographics*Although we do not have enough participants to scientifically examine the data at this point, I will share some of my preliminary results with you
As well, *chat about the graph*However, we do understand that this may not represent the preferences of all physicians practicing in the BC Interior as these 11 physicians are the 11 who chose to participate and complete the study.
It’s not about the docs personal opinions about MSM, it is about docs meeting the needs of their patients and offering appropriate health care.
Add 6 key findings & 5 suggestions
1. a. MSM living in the BC Interior, and around the world, often do not receive adequate care for their physical and mental healthb. By providing adequate care for MSM, you are indirectly extending your care to women and other men who are not MSMc. Substandard care of MSM is a primary factor in the surge of HIV among MSM as well as lower health outcomes overall. d. All of the above
Karly Drabot & Kevin Saya-Moore, "Improving the Health of Men Who Have Sex with Men: Engaging Local Physicians"
Improving the Health of Men Who Have Sex with Men: Engaging Local Physicians Funding Provided By: Irving K Barber School of Arts and SciencesInstitute of Health Living and Chronic Disease Prevention UBC Okanagan Principal Investigator: Susan Holtzman, PhD Undergraduate Researcher: Karly Drabot S Page 1 of 20
Project Goals(1) Increase physician awareness of the key issues and concerns facing men who have sex with men (MSM) in the Interior of BC(1) Provide concrete suggestions and guiding principles for how to best address the needs of MSM(1) Evaluate the effectiveness of the method of dissemination
Previous Research on the Health of MSM• TWICE as likely to have unmet health care needs • 50% of all new cases of HIV • 70% of all new cases of infectious syphilis• 17 times more likely to develop anal cancer • 3 times more likely to seek treatment from a psychologist • 2 to 14 times more likely to commit suicide
BUT…• Majority of research has been conducted in major urban cities• Research on MSM living outside these major urban centres is severely lacking
The UBCO MSM Health SurveyIn 2010, Dr. Holtzman‟s Health Psychologylaboratory conducted one of the first healthsurveys of MSM living in the Interior of BC • 160 MSM living in the BC Interior • Well-established, well-validated measures of health and well- being • Questions regarding satisfaction with health care providers and treatment
Key Findings1. ONE QUARTER (25%) reported that they had NEVER been tested for HIV2. Over ONE THIRD (37%) had not told their health care provider that they have sex with men3. 45% reported clinically significant levels of depressive symptoms 6
Key Findings4. 43% reported engaging in risky sexual behaviour* with a male in the past three months5. ONE QUARTER (24%) reported feeling “uncomfortable” or “very uncomfortable” talking to their health care provider about their sexual health6. 11% reported feeling discriminated against by their health care provider in the past 12 7
Design 1. Address six key findings from the Online UBCO MSM Health SurveyPowerPoint 1. Provide suggestionsPresentation for improving practice and communication with MSM patients
Before we continue…• Not all men who have sex with men (MSM) consider themselves gay• The term “MSM” includes men who may or may not identify as gay or bisexual
Key Findings Key Findings “I cannot find a doctor to take me as a patient. They always tell meHIV + Study to go to Vancouver, which is a 4+ hour drive from here.” “I cannot ﬁnd a doctor to take me as a patient. They always tell “I cannot find a doctor to take me as a patient. They always tell Study ParticipantParticipantParticipant (HIV+)Quote Quote me toto go to Vancouver, whicha 4+4+ hour drive from here.”! me go to Vancouver, which is is a hour drive from here.” • 11% reported feeling discriminated 11% reported feeling discriminatedprovider against by their health care against by their health care12 monthsthe past 12 months in the past provider in • Perceived discrimination can Why is this W hy is this • lead to a range of negative Perceived discrimination can important to important to lead to a range of negative physical and emotional you? health consequences health physical and emotional you? consequences for M SM . for MSM.
5 Guiding Suggestions1. Create a welcoming office2. Use gender-neutral language and adopt an inclusive attitude3. Take a frequent sexual health history4. Encourage regular HIV and STI testing5. Screen for common mental health concerns 12
Tip # 1 Post a rainbow sticker on Post a rainbow wall or on your office sticker your office wall or window window to communicate that you provide thatopen to communicate an you provide an open office. office. *Many MSM report that this small gesture would make a big difference. *M any M SM report that this small gesture would make a big difference. Educate your MOAs and staff concerning the Educate your M OA s and staff concerning theneed for increased awareness on MSM issuesneed for increased awareness on M SM policies. and institutional anti-discrimination issues and institutional anti-discrimination policies.
Evaluate Effectiveness of the Online PresentationMultiple Choice QuizAssess if participants were payingattentionQuestionnaireAssess content and impact ofpresentation
Development of PowerPoint PresentationKevin Saya-Moore Project Coordinator, Engaging Physicians Project Living Positive Resource CentreDr. Toye Oleyese Champion Physician, Engaging Physicians Project
Reaching the Physicians Website Study InvitationReed Scott Coordinator, Practice Support Program
Results27 opened the study link 11 completed the study • 6 male & 5 female GPs • Age: 34 to 57 • Practicing: 7 to 34 years • Heterosexual
In the future, how would you prefer to receive this type of information? Please select all that apply.121086420
Results• 10 (of the 11) physicians agreed that this new information provided would have an effect on their practice
Implications & SuggestionsMSM Health Survey • Great need to increase physician awareness of MSM and ease stigma against MSM living outside of major urban cities in CanadaOnline PowerPoint Presentation • Need to recognize MSM within the health care system • Need for funding and resources to address and reduce MSM stigma • Need for further research on effective dissemination methods within the medical community
Dr. Irving K. Barber Endowment Fund AIDS Community Action ProgramAcknowledgement Public Health Agency of Canada Dr. Susan Holtzman s Dr. Toye Oleyese Mr. Saya-Moore Mr. Reed Scott
Quiz Questions Correct Responses1. Why is the information in this presentation important for you and your practice? 11/1 11. How many MSM in the BC Interior have not told their physicians that they have sex with men? 10/12. What percentage of MSM reported clinically 1 significant levels of depressive symptoms at the time of completing the survey? 8/113. Approximately ____ of MSM in the BC Interior have not been tested for HIV. 7/114. What are some simple, yet significant, ways to better serve MSM in the BC Interior?
Quiz Answers1. a. MSM living in the BC Interior, and around theworld, often do not receive adequate care for their physicaland mental health b. By providing adequate care for MSM, you are indirectlyextending your care to women and other men who are notMSM c. Substandard care of MSM is a primary factor in thesurge of HIV among MSM as well as lower health outcomesoverall. d. All of the above2. 37%3. 45%4. 1/45. a. Create a welcoming office 24 b. Use gender-neutral language and adopt an inclusive
Questionnaire Results1. 11/11 agreed that the information in the presentation was clear and concise2. 8/11 disagreed that the presentation took up too much of their time (3/11 reported „neutral‟)3. 4/11 agreed that the information provided was new to them (4/11 indicated „neutral‟ and 3/11 „disagreed‟)4. 10/11 agreed that this new info provided would have an effect on their practice