Paving the Way in a Virtual Vacuum: Successes

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Paving the Way in a Virtual Vacuum Successes
Lessons Learned from the New York City
Internet-based Interventions Advisory Group

• Kenny Neal Shults
• Management Consultant, FITA-MHRA
• SexTech Conference
• January, 2008

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Your thoughts

• How many have fully developed policies,
  procedures, protocols or standards that guide
  your Internet-based projects?
• How many of you collaborate or share information
  and resources with other Internet-based service
  providers? How so?

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Agree or Disagree

• Oral sex is medium risk sexual activity
• Online health professionals always identify
  themselves as such when in any web-based venue
• Staff Internet compulsivity or addiction is a
  valid concern that could impact you and/or your
  agency
• Its ok to pretend to be just another chatter in
  order to facilitate a health discussion (bait and
  switch)
• There should be a cap on how many hours staff
  spend online conducting Internet-based work
• Online staff should be monitored in any way
  possible to ensure they are not crossing
  boundaries, working not surfing, etc.

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Questions

• Is it ever appropriate to engage a client
  without first revealing that one is a health
  professional working for a service provider?
• What kinds of training and supervision do staff
  members need in order to work effectively in this
  environment?
• What kinds of guidelines need to be established
  up-front so that situations that are inherently
  social and sexual remain safe and
  comfortable/appropriate for staff?
• What kind of hours should staff be asked to work
  to ensure that clients are reached but that
  workers boundaries are also respected?
• What kind of liability could agencies face as a
  result of unethical or inappropriate service
  delivery?
• Setting up profiles in chat rooms should there
  be there rules or standards?

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Internet-based encounters

• What do you think is the most important
  distinction between Internet-based and
  face-to-face health education encounters?
• Do you think that having different service
  providers in web-based venues, with differing
  views on the aforementioned issues, has an impact
  on the community? How?

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IIAG

• The IIAG is an advisory body made up of
  individuals representing CBOs, NGOs, and local
  and State health departments to meet the IIAGs
  mission to increase the quality of NYC
  Internet-based health promotion and prevention
  service provision by advising the department of
  health on relevant issues and standards of
  practice.

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IIAG Mission

• To enhance the quality of Internet-based health
  promotion and HIV and STD prevention services
  provided by New York City-based organizations
  through the development and dissemination of
  resources, best practices and standards, a
  commitment to ethical service delivery, and the
  recommendation of these to the New York City
  Department of Health and Mental Hygiene.

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IIAG topics

• Identifying Promising Internet Models
• Internet Addiction
• Disclosing Professional Role and AffiliationIf,
  When and How
• Prevention Resources
• Partnerships between Commercial Internet Sites
  and Health Providers
• Structuring Positions and Ongoing Support and
  Supervision of Staff
• Ethics of Encouraging HIV Status Disclosure In
  Online Venues
• Staff Training
• Monitoring and Evaluation of Internet
  Interventions

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IIAG Participation

• Many of the first participants were
  early-adopters of Internet-based strategies
• As interest and the viability of these
  initiatives increases, so does interest in IIAG
  participation especially among those new to the
  field
• As new agencies come into the IIAG, they benefit
  from the experience in the room. Existing members
  assist themselves and late-adopters by preventing
  late-adopters from making mistakes that may
  damage the reputation of Internet-based service
  providers.

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What worked well

• Invited any and all agencies conducting
  Internet-based health promotion and/or prevention
  activities
• Co-chairs were community reps, not DOH reps
• Structure had a informal feel simple structure
  allowed for a great deal of sharing from
  participants
• Copious minutes were emailed to parts. that
  included any and all contributions,
  recommendations, concerns, etc., and
  participants names were used
• Assessments and feedback showed that topic
  oriented sessions were most popular and resulted
  in greater turnout

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Lessons learned

• Sub-committees
• Location of meetings
• Co-chairs
• Inviting community members

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Incentive for participation

• Assists in getting disparate agencies to the
  table to discuss important issues of ethics,
  liability prevention, etc.
• Agencies get to weigh-in and help set standards
• DOH gets insight (or much needed updating)
• Agencies learn from one another
• Misconceptions are discussed and dispelled
• New, innovative approaches are shared and
  examined
• Funding

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Participating organizations

• Organizations that have been members or
  participants in the IIAG include
• AIDS Center of Queens County
• Bronx AIDS Services
• Center for HIV Educational Studies and Training
  (CHEST)
• Connected Health Solutions
• Cicatelli Associates Inc.
• Gay Mens Health Crisis
• Harlem United
• Hispanic AIDS Forum
• Forging Ahead for Community Empowerment and
  Support (FACES, formerly the Minority Task Force
  on AIDS)
• New Jersey Department of Health and Senior
  Services, STD Program
• New York City Department of Health and Mental
  Hygiene
• New York State Department of Health, AIDS
  Institute
• MHRA-FITA
• People of Color in Crisis (POCC)
• New York City Department of Health and Mental
  Hygiene, Program Evaluation Training Unit

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Sub-committees

• Standards and Ethics Committee
• Areas of responsibility include
• Cultural competence of Internet-based
  interventions-Devising tenets of Internet
  cultural competency assessing the online
  communitys cultural values, language and norms
  and identifying ways in which providers can take
  these into consideration when designing an
  intervention.
• Staff training and standardization of outreach
  procedures-Creating curricula for training
  frontline Internet staff and specific policies
  and procedures for conducting such work.
• Political climate-Assessing and outlining the
  impact that more conservative funding and
  political climates may have on the viability of
  these types of initiatives.
• Cont.

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Sub-committees

• Standards and Ethics Committee, cont.
• Ethics of service delivery-Assessing and
  outlining ethical considerations associated with
  engaging Internet users under various
  circumstances such as in sex-seeking situations
  or by posing as another online chatter.
• Job descriptions for staff providing direct
  services online-Developing position descriptions
  for Internet-based staff that detail the work in
  accurate and updated detail.
• Confidentiality standards for agencies providing
  Internet-based interventions-Developing standards
  and model systems for delivering and documenting
  services without compromising client
  confidentiality.

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Sub-committees

• Research Committee
• Areas of responsibility include
• Literature searches to ascertain the latest
  scientific findings about Internet interventions
  and related topics.
• Identifying and conveying relevant research on
  Internet-based efforts to the larger group.
• Prevention Resources Committee
• Areas of responsibility include
• Communication between providers.
• Developing relationships with online venues such
  as AOL, Yahoo, and
• dating sites.
• Identifying or developing resource materials for
  members and participants to share and/or build
  upon.
• Development of tools for Internet service
  delivery such as documentation and data
  collection instruments.

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Sub-committees

• Evaluation Committee
• Areas of responsibility include
• Devising possible (collaborative) referral
  tracking system ideas for the group and funders
  to consider for use in measuring the
  effectiveness of Internet-based interventions.
• Discussing and developing outcomes monitoring
  systems for use with Internet-based initiatives.
• Promising Internet Models
• Documentation of models of promising
  Internet-based health promotion or prevention
  strategies.

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IIAG Report

• The history and formation of the advisory group
• Methods for replicating a similar effort
• Several critical issues and considerations
  explored by the IIAG with excerpts from minutes
• Can be accessed at http//www.nycsag.org/tech_conf
  erence.html