Innovative advertising strategies can help increase demand for vasectomy in communities generally considered to be uninterested in the procedure, according to a recent evaluation.

The evaluation, which examined a two-year no-scalpel vasectomy (NSV) training program for publicly funded clinics, found that demand for vasectomy in low-income and minority communities in the U.S. increased after innovative advertising strategies were implemented.

The NSV Training Program
The program, funded in part by the David and Lucile Packard Foundation and the Huber Foundation, provided on-site, hands-on training for physicians working in 43 publicly funded health centers in 17 states.

The program also provided sites with surgical instruments, training materials, a press kit, and some assistance with public information activities.

The clinics used a variety of formal and informal advertising strategies to inform potential clients about vasectomy services.

Advertising Strategies
Clinics, some of which had not provided vasectomy at all before staff received training, had no trouble finding clients who wanted the procedure once they informed the public of its availability.

After airing 40 radio spots on two Kansas City rock stations and after a press release was picked up by the local news media, one Kansas clinic increased its caseload from one vasectomy per month to between seven and eight per month.

A county health department in Florida that used to refer one vasectomy client per month now provides five in-house vasectomies per month. A provider there attributed this success to the informal advertising of services: "All three nurses doing health education are enthusiastic...They mention NSV during all discussions with tubal ligation clients, as well as with mothers coming in for maternity and prenatal services."

A family planning clinic in California that had not provided any vasectomies before the program began providing 6&endash;10 vasectomies per month after posting signs, placing advertisements in the local paper, and mailing out flyers with Medicaid checks (thus reaching 67,000 people two to three times per year).

A clinic in Georgia went from providing no vasectomies to providing five per month after placing advertisements in the local yellow pages directory and the nearby army base directory.

Cost Factors
According to some of the clinics, low- or no-cost procedures were a factor in attracting new clients.

A Florida hospital began providing 50 vasectomies per year after posting neon-colored flyers at county health department clinics. The nurse in charge explained that women who see the announcement for free vasectomies ask about the service and refer their husbands for it.

The increase in caseload in these health centers is particularly striking because the clinics are in low-income and minority communities usually considered to be less interested in this service.

Because vasectomy is primarily used by white, well-educated men in their mid-to-late thirties, some believe that minority and low-income men are not interested in vasectomy.

On the contrary, findings from this evaluation suggest that this underutilization may be due to a lack of information and services in low-income and minority communities.

Providers attributed their increased caseloads to availability, publicity, and affordability of the service. In fact, several providers surveyed said that advertising created demand that exceeded their capacity to meet it. Clearly, increasing access to vasectomy in low-income and minority communities will increase vasectomy utilization.

Manisha Mehta is a research assistant in AVSC's Evaluation Department. Maureen McKenzie is the training program officer for AVSC's programs in the U.S.