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NHS Gloucestershire insight summary and recommendations. Date: February 2010. contents. this document provides a summary of the insight captured during research with young people across Gloucestershire
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NHS Gloucestershire insight summary and recommendations Date: February 2010
contents • this document provides a summary of the insight captured during research with young people across Gloucestershire • it also provides our recommendations for the next stage in the Chlamydia screening strategy from the NHS
contents • research phases • insight summary • recommendations
research phases • two research phases were managed by Corporate Culture to inform the current strategy on screening by NHS Gloucestershire • both qualitative and quantitative methodologies were employed in order to give depth and personalisation to responses plus robust data to quantify attitudes • the qualitative phase • face to face depth interviews • the quantitative phase • on-line survey • on street questionnaire top up
introduction • the following slides present the key insight gathered at both phases of the research and where relevant both quotations and figures will be included, if more detail is needed on any of this information please refer to the individual reports • key themes • knowledge gaps • risky behaviour • denial • dispelling myths • role of different communication channels
insight summary • knowledge gaps • behaviour is based upon ‘patchy’ knowledge • a key finding is that up to 30% of the young people we spoke to were unsure of who to ask for information • practising ‘Safe Sex’ was not always connected to be protected from STI’s • the connection between having sex and thinking about testing was not clear for most, ‘It won’t happen to me’ • current awareness needs to be built on, i.e. 75% know the test is free, 48% want ‘Peace of mind’ “It shows more of a connection, as he doesn’t mind sleeping with me without a condom, so he must really like me, as most boys, if it was just, like, sex, they would wanna use a condom, just ‘cos they don’t know who you’ve slept with and where you’ve been and that” Female
insight summary “say if you meet someone and you haven’t really slept with many people and you’ve just met this person and they haven’t slept with many people, sleeping with them without safe sex, you just think you’ll be safe, you’re not gonna catch anything and it’s gonna be alright” Female • risky behaviour • reactive rather than preventative • need to establish a ‘Mind Frame’ shift so linking starting to have sex with being safe (both using condoms and having a Chlamydia test) • ‘It doesn’t apply to me’ – being clear with communications so that the ‘risks’ of taking this view are clear for everyone “pregnancy’s the first thing on everyone’s mind, they don’t really think about STDs at the time” Male
insight summary • denial • peer led information leading young people to incorrectly not see themselves as at risk • using the fear of the results as an excuse not to get tested • current contact (letter) is screened out by these type of individuals...as not relevant to them • use of other contraception seen as practising ‘Safe Sex’ “you wanna know [if you have Chlamydia], but then you don’t wanna know, because you don’t know how you’re gonna react to it” Male
insight summary • myths • linked to denial, that anyone who is sexually active can be affected • thinking they are safe if the female is using other types of contraception • making assumptions about partners background • test itself – gaps in knowledge about type of test available for Chlamydia “I’m not the sort of person to get Chlamydia” Female
insight summary • role of communications – getting it right • expanding on the basics • value of peer to peer, getting young people to pass on personal experiences (ease of test, relief to be ‘clean’) • talking about it in itself is the key to understanding • what goes where – young people expect to see certain information in different places (school, GP’s) • initial contact letter doesn’t create the right ‘interruption’ required (this is typical of most NHS letters, cervical etc) • clarity is important – posters can try and say too much • role of GP to gain confidence of young people, give clear explanations for the Chlamydia and other STI screening “I thought it was junk mail” Female “looks so official, like I was in trouble” Male
building on new work – ‘worth talking about’ • our insight tells us that initiating conversations about Chlamydia is an important role of the strategy NHS Gloucestershire • who delivers this will affect it’s impact, young people versus the family GP? • however filling the knowledge gaps needs to be clear and delivered in an engaging way so young people connect their own behaviour with needing to be aware of Chlamydia • dispelling myths and addressing young people’s attitudes (including denial) will come from peer to peer story telling backed up by clear information available from their GP surgery/pharmacist/school nurse
success and failure of current communications Posters • Poster 1 thought of as the better of the two with some people who recognised it • Most said it was good as it contained the all the key info, whereas the NEET females said it had ‘too much writing.’ Other comments suggested it might be too ‘soft’ in its approach and should communicate how serious Chlamydia is, especially its effects • Poster 2 did not receive a positive reaction as it doesn’t contain much information or feature an image relevant to them or Chlamydia Sticker badge • Only a few recognised this, but many commented that it is irrelevant and that it looks more like something for underage drinking and puts across message that only girls can get Chlamydia Van • There were mixed opinions on the van • Only one person had seen it before, but they didn’t know what it was for • Some like the idea of getting tested there and then but others would not be comfortable in approaching the van
success and failure of current communications Letter • Most received it and most read it although some just skim read • The reason for not reading the letter was that it looks like junk mail • Is generally thought to be a good idea but executed in the wrong way • Address to them personally as it currently looks too general – ‘doesn’t apply to me’ • The intro is too soft, it needs to get across more info about why they should be tested at start of the letter • It should be less formal, as it ‘makes you think you are in trouble’ • Females in education said everyone at school discussed it the next day although was more joking about than seriously talking about Chlamydia • There is the issue of what parents think – some said that their parents had opened it and questioned them about it, asking whether they had requested the letter. Possibly should say that it is a private letter on the envelope Contact Card • A lot of participants recognised this, although it was the blue and red/orange colouring that they recognised rather than the card itself • Should contain more info and contact details, then used as outlined later
what makes a good communication - messages What has been done? Awareness • Make people aware of Chlamydia as an STI and basic information Inform • the effects of having Chlamydia (infertility etc.) • the testing methods available • that the test is easy, painless and free • that Chlamydia easily treatable • It can happen to anyone Action • outline why they should get tested • where to find out more information • contact number / website • where to get tested Key message • It can happen to anyone – make it personal so that the message strikes home
what makes a good communication - methods How / Where • A lot of people said social networking sites, especially Facebook • A few suggested local radio, but questioned how many young people listen to these stations • Many talked about posters in school/college common rooms, some wary about putting them in general school as they will be seen by younger children • Bus stops / on buses, would give young people time to read them • Posters near condom machines in toilets • More education in schools (starting at a younger age), from someone external rather than a teacher. Some cite ‘The Sex Education Show’ on Channel 4 as the right way to educate young people on these issues • Going into sixth forms to give a talk and then encouraging people to get tested there and then. Those who had this experience said it was very good Idea 1 - from females in education • With posters, they don’t want to stop and read them in school because people may see them reading them and assume they’ve got an STI • Therefore, utilise advertising on the back of toilet cubicle doors, as people are on their own and will have time to read the ad Idea 2 - from males in apprenticeships • Hand out contact cards to people on nights out entering pubs and clubs, as people will put them in their pockets and then discover them in the morning when emptying their pockets
suggested next steps Bridge the ‘inform’ gap, between ‘awareness’ and ‘action’ in comms Inform young people about Chlamydia and how serious it is with messages that strike home e.g. ‘you may not want kids now, but imagine how you’d feel in the future if you couldn’t…’ It needs to be obvious that it can happen to anyone as some young people have a notion that they are ‘above’ getting an STI or they are not the type of person who would contract one Education and Discussion There is a need for a higher standard of sex education in schools and from a younger age; although this has improved in recent years, it needs to be from someone external as pupils wouldn’t feel comfortable asking their teachers questions. ‘The Sex Education Show’ on Channel 4 was cited as an example of how to do this effectively Get young people talking to their parents about these issues. Most participants said they wouldn’t talk to their parents as it would be embarrassing, but those who did had a much better understanding on the subject and from an earlier age. Therefore there may be a need to educate parents on these issues and encourage them to be approachable and open with their children
suggested next steps Compulsory Testing Some said that if Chlamydia was as important and as big a problem as made out then testing should be compulsory If testing is not made compulsory then mandatory visits to sixth forms whereby an informative talk is given and self tests are offered would be advisable. Respondents who have experienced this spoke positively of it and it had evidently shaped their mindset on the subject TestingMind Frame Get people in a testing mind frame when they start having sex, so testing is seen as routine and preventative rather than a reaction to something that has already happened Positive Test Experience Get the test experience right first time or you knock confidence on a sensitive subject. Some respondents were put off from being tested again after a bad first experience, whereas those who had a good experience felt a lot more comfortable about going for another test in the future
