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"Isabel: Your Electronic Counselor"
Makes Sex Education Accessible to Young People in Perú
Project Dates: 1997-1999
Using Computers for Health Education
Within the past five years the use of computer technology for behavioral counseling and health education has become very popular. This rise is due, in part, to the increased availability of powerful yet low-cost computers that make it feasible to deliver computer-based health education materials to large numbers of people. The increased use of computer-delivered health education messages can also be attributed to numerous field studies which established the benefits of computer-based instruction (CBI) vis-a-vis traditional health education interventions.
Among these benefits is the capacity of CBI to function as a mass medium and disseminate standardized messages to a large audience, to personalize information personalized and allow the user to control the rate of learning, and to build confidence by providing a safe learning environment in which users can practice skills free of judgement. CBI can also provide a confidential and anonymous means of access to explicit information. This last benefit is particularly important to adolescent sex education projects that may otherwise be limited in the content they may offer.
High-Tech Sex Education for Adolescents
The Johns Hopkins University/Population Communication Services (JHU/PCS), Population Council in Peru (PCP), and IPPF affiliate INPPARES joined together in 1997 to evaluate the capability of interactive multimedia CD-ROM technology to deliver family planning, reproductive health, sex, and sexuality information to adolescents and young adults in Peru.
The partners in this project chose to use computer-based interactive multimedia to reach these audiences because it allows sensitive information to be disseminated while the user remains anonymous. This is attractive to adolescents who may not be comfortable speaking to adult counselors. In addition, interactive multimedia tends to be popular and appealing to urban youth, especially as schools and universities throughout Latin America are being equipped with state-of-the-art multimedia computer systems. JHU/PCS saw this project as a new opportunity to reach the intended audiences with existing print and video material produced in Peru, including art work from two Ministry of Health family planning/reproductive health (FP/RH) client-provider print packages and clips from the 1993-1995 National FP/RH Tromes campaign TV spots produced by APROPO, a USAID-funded project.
"Isabel: Your Electronic Counselor"
JHU/PCS designed, produced and beta tested Isabel: Your Electronic Counselor, a CD-ROM that increases levels of knowledge about sex, sexuality, unplanned pregnancy, contraception, and gender, in order to influence the intent to adopt a FP method and avoid risky behaviors. Isabel covers three main subject areas (reproductive health, sex education, and family planning) that encompass 25 subtopics. The information is presented by means of videos, animated cartoons, text, and audio. Isabel also contains an anonymous database capable of tracking user sex, age, educational level, and area of residence. The software is designed for use with touch screens so that it remains accessible to people with little or no previous computer experience.
"Isabel" in Action
In May of 1998, PCP began to evaluate Isabel. The software was installed on equipment provided by PCP and set up in the Patres INPPARES clinic. Isabel was available for use by clinic clients for a total of 455 hours over 14 weeks. During this time, it was used by a total of 670 people who accessed an average of 2.6 subtopics. The typical user was a woman (67%) between the ages of 13 and 24 (42.9%) with an education beyond high school (84%).
The five topics most frequently consulted were: benefits of family planning, first sexual relation, machismo, hygiene, and abortion prevention. There were, however, differences in use by age. Users under age 13 most often consulted information about female anatomy. For users ages 13 to 19, machismo was the most popular topic. Users aged 20 to 40 preferred information on the benefits of family planning. Those over age 40 were most interested in vasectomy information.
Evaluation
PCP also carried out a survey in July and August of 1998 with 232 clinic users. The purpose of this survey was to verify the accuracy of the anonymous database and to get feedback on Isabel's quality and ease of use. According to this survey, 96% of clinic clients liked Isabel. Specifically, users mentioned that the software is motivating, innovative, informative, and educational. Other users mentioned that they liked using Isabel because it was free of charge, always accessible, and it saved time during the clinic visit. Among the 4% of users who did not like Isabel, the primary reason was lack of in-depth information.
Seventy-three percent of clients said Isabel was very useful software because it allowed them to access new information that was easy to understand. Users also mentioned that Isabel helped them to avoid embarrassment during their clinic visit because they were able to get the information they needed without having to address issues of sex and sexuality with strangers. Close to 60% of clients found it easier to interact with Isabel than with a traditional counselor. The remaining clients felt that talking to the counselor was better because the counselor could provide more information than the software and the information was provided in a more confidential setting.
During the months of July and August of 1998, Isabel was also showcased in the Ministry of Health's booth at the "Home and Garden Fair" held in Lima. The software was available for 140 hours during the Fair and a total of 2,454 people accessed it. This was an average of 18 people per hour. As in the pretest in the Patres clinic, the software attracted a predominantly young, female audience. Fifty-nine percent of those who used the software were younger than 24 years of age and 59 percent were women. The three topics that were most often accessed were the benefits of reproductive health, machismo, and hygiene. This did not differ for men although women preferred to access information on Norplant more than information on hygiene. Contraceptive information was accessed by half of the users between the ages of 20 and 24.
"Isabel" Moves Forward
The results of the software evaluation will be used to modify Isabel so it can respond better to the needs of clients. Among the most important changes that will be made are increasing the level of interactivity and adding more information. In addition, the Ministry of Health has expressed a strong interest in using Isabel in its clinic waiting rooms. rooms. Finally, the versatility of creating a piece of software based on existing health communication materials will result in versions of Isabel tailored to Brazil, Bolivia, and Nicaragua. |
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