Lessons from Electronic Data Collection with Inmates in a County Jail Setting

1. Lessons from Electronic Data Collection with Inmates in a County Jail Setting National HIV Prevention conference Atlanta, ga August, 2009 Noah Carraher, MA San Francisco Dept. of Public Health HIV Prevention Section San Francisco, CA Shelley Facente, MPH Facente Consulting Richmond, CA

2. Background • “PalmIT”: self-administered, computerized survey system • Currently, copious paperwork is required for CTR • We wanted to create a way for clients to reclaim their testing experience. • Clients now have a way to assess their own risk, privately, before seeing a counselor. Then they can discuss with the counselor whatever topics they think are most important.

3. Background • Questions include demographics, sexual and drug use history, and other HIV risk information. • Pop-up prompts alert clients to available services or highlight key educational information when applicable. • The data are uploaded at the end of each day and entered into a main database for later analysis.

4. Background • PalmIT began as part of an NIH R-01 • The UCSF Center for AIDS Prevention Studies collaborated with Magnet and the San Francisco Department of Public Health • Magnet requested we go site-wide • The rest is history

5. PalmIT has been availablein many forms at Magnet

6. Background • Magnet was easy – the question was, could it be done elsewhere? • If it could be done in the county jails, it could be done anywhere.

7. 1,728 HIV tests were conducted in 2008 using the PalmIT system in the jails.

8. Factors Affecting Feasibility and Implementation • Security in the jail • Safety of deputies and inmates • Jail subpopulations • Multilingual, multicultural population • Technological limitations • HIV counseling and testing staff

9. Factors Affecting Use • Language and translation • Audio recording • Digital divide • Staff training • Workflow

10. Language • Initially, the questions that HIV test clients answered were written using a vocabulary geared specifically to the Castro population of gay men. • Example #1: How frequently have you used condoms while topping with men in the last two years? • One of our hurdles to implementing the survey in the jails was finding language that would be easy to understand for inmates filling out the survey on their own. • Example #2: In the past 12 months, did you have anal sex with a man, when you put your penis in his butt?

11. How to create your own system • Avoid imposing a system from the outside • Start small from the inside • Organize your system around its users • Don’t be afraid to admit mistakes along the way • Be ready to change when necessary • The ultimate goal is the end user’s experience • Develop client-centered technology

12. Thank you! Shelley Facente Consultant Facente Consulting Richmond, CA shelley@facenteconsulting.com 415-999-1310 Noah Carraher PalmIT Coordinator HIV Prevention Section SF Dept. of Public Health San Francisco, CA Noah.Carraher@sfdph.org 415-703-7274