Take Charge of Your Sexual Health: What You Need to Know About Preventive Services

Launch Report

Take Charge of Your Sexual Health: What you need to know about preventive services

April 1-July 31, 2014

Table of Contents Executive Summary...... 3

1. Introduction ...... 5 2. National Media Outreach and Results ...... 5 National Media Initiative...... 5 Media Results ...... 8 Editorial Highlights from Selected Outlets ...... 10 Press Release Results...... 11 Social Media Promotion by Media Outlets...... 12 Editorial Highlights from Selected Outlets ...... 12 Media Partnerships ...... 13 Challenges and Lessons Learned ...... 13 3. Promotional Campaign to NCSH Members and Results ...... 13 Promotional Efforts of Members ...... 14 Promotion Through Non-Media Channels ...... 14 Promotion by NCSH Members and Others Through Social Media ...... 16 4. Traffic to the Website ...... 17 Total Number of Visits and Pageviews ...... 17 Top Referral Sources ...... 17 Most Popular Pages ...... 18 Most Popular Downloads ...... 19 Website traffic by month ...... 19 5. Conclusion...... 21 6. Appendices...... 22 Appendix A- Message Strategy Appendix B- Press Release Appendix C- Pitch Letter Appendix D- Affordable Care Act Coverage of Preventive Sexual Health Services Appendix E- Full List of Syndicated Placements Appendix F- Promotional Package Appendix G- Website Referrals by Month

Executive Summary

Introduction. To provide a comprehensive source of information about preventive sexual health services to the public and increase uptake of recommended services, the National Coalition for Sexual Health (NCSH) developed and released a new guide and website, “Take Charge of Your Sexual Health: What you need to know about preventive services.” To promote the guide and website, the NCSH implemented a two-pronged campaign. The campaign’s goals were to secure media coverage of the new guide and website among leading national and local media that reach the general public, and to encourage NCSH members to promote the guide and website to their audiences.

National Media Outreach and Results. With support from Ogilvy Public Relations, NCSH created a national media initiative that included message development, trained spokespeople, personal outreach to national media, and materials (a press release, a pitch letter, and a chart of preventive sexual health services covered by the Affordable Care Act).

Overall, media outreach resulted in stories by 168 media outlets. Through personalized outreach, coverage was secured in 20 national media outlets alone, which resulted in nearly 176 million audience impressions (175,889,034). The press release, issued on May 6th, was syndicated through 148 sites, which had a combined reach of approximately 20 million visitors per day (20,412,000). Leading national outlets that featured the story and/or guide included Cosmopolitan (online), HuffPost Live (online broadcast), Women’s Health (online), SELF (online), Shape (online), Huffington Post Gay Voices (online), SiriusXM’s Doctor Radio/Sexual Health Show (radio), Kinsey Confidential (online), and POZ (online). A chart of placements can be found in the full report.

Four prominent media outlets (Cosmopolitan, HuffPost Live, Self, Women’s Health) also promoted their original stories about preventive sexual health services and the guide via social media, increasing the overall reach of their coverage. Cosmopolitan and Women’s Health were responsible for the vast majority of social media promotion, with a combined potential reach of approximately 3.3 million Twitter users.

Promotional Campaign to NCSH Members and Results. The NCSH’s 50 organizational and individual members have the ability to reach millions of Americans with important sexual health information. To encourage and equip our members to promote the guide and website through numerous channels, NCSH prepared and distributed a promotional package on April 1, 2014 and conducted follow-up during May.

Approximately 40% of NCSH members promoted the guide and website to their members, networks and audiences through a variety of channels, including webinars, e-mail blasts, newsletters, blogs, permanent resource lists, and social media. NCSH members alone accounted for 186 tweets, which were retweeted 337 times and favorited 115 times. Six members also shared the guide on Facebook, while two promoted the guide on Pinterest.

Traffic to the Website. The promotional efforts and media coverage throughout April, May, June, and July were successful in driving traffic to the www.ncshguide.org website. During May, when intensive media outreach and member promotion took place, website visits surged to seven times higher than in April. From April 1 – July 31st, there were 5,194 visits to the website and 10,797 pageviews.

The leading sources of referral to the website include Women’s Health, followed by direct traffic, Twitter, Huffington Post, and Cosmopolitan. Meanwhile, the Homepage and the Chart of Recommended Preventive Sexual Health Services for Women were the two most popular pages. The entire guide was the most popular download (362), followed by the Chart of Recommended Services for Women (42).

Conclusion. The NCSH reached millions of Americans with messages about the importance of preventive sexual health services and the availability of the guide and website to help them get the services they need. However, the campaign is ongoing, and the NCSH will continue to pitch media outlets, including those that reach teens, parents, heterosexual men, African Americans, and Latinos. The NCSH will also continue to conduct personal outreach to NCSH members and other national organizations to encourage their use and promotion of the guide and website. We hope these ongoing efforts will drive even more people to the website, and ultimately help increase the uptake of preventive sexual health services.

1. Introduction

Overview. More than half of Americans are not getting essential preventive sexual health services, including the HPV vaccine, HIV testing, and chlamydia screening, even though these potentially life- saving services are available at no cost through the Affordable Care Act. To provide the public with a comprehensive source of information about these services and to increase the low uptake, the National Coalition for Sexual Health (NCSH) developed and released a new guide and website, “Take Charge of Your Sexual Health: What you need to know about preventive services.”

To promote the guide and website to the public, we (the NCSH) implemented a two-pronged campaign: a media outreach initiative and a promotional initiative among NCSH members. The goals of this campaign were to:

• Secure media coverage of the new guide and website and related messages among leading national and local media that reach the general public, with special emphasis on those who reach young adults, teens, women, parents, and gay and heterosexual men.

• Encourage NCSH members to promote the guide and website to their audiences through a variety of channels, such as social media, websites, and e-mail.

Purpose and Contents of this Report. This report describes the results of this campaign, including coverage by traditional media, promotion through social media outlets, promotion by NCSH members, and traffic generated to the website. It also describes the campaign, including the message strategy, audiences, tactics, and monitoring, along with an appendix of promotional materials. The report captures results achieved from April 1 - July 31, 2014. However, this promotional campaign is still ongoing.

2. National Media Outreach and Results

National Media Initiative. With support from Ogilvy Public Relations, NCSH created a launch plan that defined the message strategy, audiences, tactics, and results monitoring. Highlights of the strategy are described below.

Message strategy: Even though our end goal was to create awareness of the new guide, we recognized that this new product—by itself—was not likely to be newsworthy and generate media coverage, particularly with leading national media. As a result, we created a message strategy that provided a news hook, featured compelling data, and tied into current events (see Appendix A). We also promoted highly credible spokespeople for interviews.

We led with our strongest asset: the Coalition and its members. We positioned the announcement as a call-to-action by the Coalition around the low uptake of sexual health services. Based on a data

analysis that revealed uptake rates of less than 50% for many recommended services, we created a compelling subhead for the press release. We also linked these services to the new Affordable Care Act, making the announcement timely and relevant.

Our Headline in the Press Release: “Coalition Issues Call-to-Action to Increase Shockingly Low Uptake of Sexual Health Services: Half of Americans are not Getting Recommended and Potentially Life-Saving Services, Despite ACA Coverage.”

Other Top Messages: We delivered the following messages through media materials and spokespeople.

1. Given the poor state of sexual health in America, widespread use of these services is critical. 2. There are more cases of STIs than cases of diabetes, heart disease, breast cancer, and asthma combined. 3. Increased use of recommended sexual health care services could prevent serious health problems, lifelong illnesses, and even death. 4. To address this gap, a new, easy-to-use guide and website are now available to help the public get the services they need. 5. Many preventive services are now available at no or low cost through the ACA, but check with your insurer or health care provider about your specific coverage. 6. Make sexual health part of your health care routine. It is one of the important steps you can take to protect and improve your health.

Audiences: The intended audience for this media initiative was broad, and included the general public, with special emphasis on young adults, teens, women, parents, and both gay and heterosexual men.

For personalized outreach, we focused primarily on leading, national media outlets that had the greatest reach and credibility with these audiences, and were likely to include coverage of sexual health. Prior to the launch, we conducted an audit of leading media outlets to assess their history of sexual health coverage, editorial policy, and reporters likely to cover the issue. This audit served as the foundation for the development of a media list. Targeted media were primarily national online and print publications; however, a few national television and radio outlets were also included. In addition, we targeted national and local media outlets through distribution of a press release nationwide.

Spokespeople: We leveraged one of our core strengths: the clout, credibility, and expertise of NCSH members. Our spokespeople attracted media attention, and brought the stories to life. To meet the needs of different media outlets and their audiences, we enlisted and briefed six spokespeople with relevant subject area and target audience expertise. They included:

• Edward W. Hook, III, M.D., Director, Division of Infectious Diseases and Professor of Medicine, University of Alabama at Birmingham. • E.W. Emanuel, M.D., a practicing Ob-Gyn and Associate Medical Director for health education/promotion and women’s health for the Mid-Atlantic Permanente Medical Group. • Gale Burstein, M.D., MPH, FAAP, Erie County Health Commissioner (New York), pediatrician and adolescent health specialist at Women and Children’s Hospital of Buffalo. • Dana Van Gorder, Executive Director, Project Inform (San Francisco). Project Inform is an HIV and Hepatitis C Advocacy organization. • Debra Hauser, MPH, President and Executive Director, Advocates for Youth (Washington, D.C.), which champions efforts to help young people make informed and responsible decisions about their reproductive and sexual health. • Michael Horberg, M.D., MAS, National Director for HIV/AIDS at Kaiser Permanente, Executive Director, Research and Community Benefits of Mid-Atlantic Permanente Medical.

Tactics: The NCSH conducted a variety of activities before, during, and after the launch to encourage media coverage.

Materials development: We created a series of materials, including: a press release that featured quotes from Dr. Hook and Susan Gilbert, along with compelling data (see Appendix B); a pitch letter that was tailored to different outlets based on audience demographics (see Appendix C); and a chart of preventive services that are covered by the ACA (see Appendix D). In addition, to prepare spokespeople, NCSH provided a message strategy and talking points tailored for each media interview. To help respond to potential media inquiries, NCSH prepared a question and answer document.

Distribution of Press Release: Through PR Newswire, the press release was distributed to 10,000+ media outlets. These outlets included local and national print, online, and broadcast media, along with news services like the Associated Press.

Personalized Media Outreach: Ogilvy Public Relations took the lead on personalized outreach to 130 key media outlets, with support from NCSH. During the embargoed phase two weeks prior to the media launch on May 6th, reporters were contacted through phone calls and e- mails using a customized pitch letter. We used an embargo to try to generate coverage by offering media the opportunity to be the first to break the story and/or to conduct interviews and write stories in advance of launch day. This helped us create a groundswell of coverage on or around May 6th.

When pitching, we included key data points relevant to the audience for each media outlet, such as teens, young adults, women, heterosexual men, parents of tweens/teens, and gay men. We also offered spokespeople who were most relevant to the media’s audience. In many cases, we made multiple contacts until a reporter was identified and reached. More aggressive efforts

were made to reach outlets in which we felt there was a better chance of generating coverage.

Responding to Individual Media Requests: We scheduled interviews and briefed spokespeople, as needed. We also created talking points and scripts for spokespeople. For example, NCSH developed a show outline and talking points for a HuffPost Live TV segment with Dr. Hook and Dr. Emanuel, and for Sirius XM’s Doctor Radio’s one-hour show with Dr. Emanuel. We also responded to media requests for background data and/or additional messages. For example, Cosmopolitan (online) asked NCSH to prepare the top ten surprising facts about sexual health, which then served as the foundation for an extensive sexual health story that also promoted the guide.

Monitoring of Media Placements: Limited resources were available to monitor media coverage. However, we used a few different mechanisms to capture as many placements as possible, including the NCSH media monitoring system that employs Google Alerts and daily monitoring of Facebook and Twitter, the report from PR Newswire on press release pick-up, and follow-up with reporters.

Monitoring of Social Media Promotion: Both the media and NCSH members used social media to promote the guide, key messages, and media stories. NCSH used available tools to track social media promotion of the guide.

Media Results. In this section, we describe the results of personalized media outreach and press release distribution nationwide, along with social media promotion by media outlets, media partnerships established, and lessons learned.

Overall, media outreach resulted in stories by 168 media outlets. Through personalized outreach, coverage was secured in 20 national media outlets alone, which resulted in approximately 176 million audience impressions (175,889,034). The press release was syndicated through 148 sites, which had a combined reach of approximately 20 million visitors per day (20,412,000). This is clear evidence that a personalized, one-on-one approach with media is more effective in generating meaningful coverage and significant reach to the public than mass distribution of a press release.

Personalized Media Outreach: Leading national outlets that featured the story and/or guide included Cosmopolitan (online), HuffPost Live (online broadcast), Women’s Health (online), SELF (online), Shape (online), Huffington Post Gay Voices (online), SiriusXM’s Doctor Radio/Sexual Health Show (radio), Kinsey Confidential (online), and POZ (online). A chart of placements can be found on page 7.

Several pieces were initially published on one outlet, and then syndicated elsewhere, including HuffPost Live piece on AOL (online), Cosmopolitan piece on Harper’s Bazaar (online) and Marie Claire (online), and POZ piece on Real Health (online) and Hep Mag (online), extending the reach of NCSH’s messages.

Stories featured several NCSH spokespeople, including Dr. Hook, Dr. Emanuel, Dr. Burstein, Dana Van Gorder, and Susan Gilbert. However, reporters, particularly from women’s magazines, frequently requested to speak with an OB-GYN, which is reflected in the heavy use of Dr. Emanuel as a quoted source within the articles. Dr. Hook was also frequently quoted, in part because articles pulled his quote from the press release. Most articles mentioned NCSH’s call-to-action, and linked to the guide. The articles tended to focus on the state of sexual health in America, facts about STIs, or mirror the press release.

National Media Coverage Outlet Audience Title Spokesperson Impressions Quoted AOL (online) 58,392,802 Taking Charge Of Your Hook; Emanuel Sexual Health Cosmopolitan (online) 1,980,801 9 Things Every Woman Emanuel Needs to Know About Sexual Health Everyone is Gay Not available SEXUAL HEALTH (website None (online) resource) Harper’s Bazaar 252,568 Empowering Info About Your Emanuel (online) Sexual Health Hep Mag (online) 24,024 Coalition Seeks Increase in None U.S. Sexual Health Care Services HIVandHepatitis.com Not available Coalition Calls for Wider Use Hook; Gilbert (online) of Sexual Health Care Services in U.S. Huffington Post Gay 48,587,527 How's Your (Sexual) Health Van Gorder Voices (online) HuffPost Live (online 60,000,000 How Preventive Services Can Hook; Emanuel broadcast) Protect Your Health Kinsey Confidential Not available Why Aren’t Americans Fontanella (online) Getting Vital Sexual Health Care Services? Lady Lux (online) Not available What You Need to Know None About STDs Marie Claire (online) 681,467 9 Things You Never Knew Emanuel About Your Sexual Health The Parents Project Not available Sex (website resource) None (online) POZ (online) 44,644 Coalition Seeks Increase in None U.S. Sexual Health Care Services Real Health (online) Not available Coalition Seeks Increase in None U.S. Sexual Health Care Services SELF (online) 1,025,194 Are You Keeping Your Sexual Hook Health in Check?

SHAPE (online) 1,125,738 The Sleeper STDs You’re at None Risk For SiriusXM’s Doctor Not available Emanuel Radio/Sexual Health Show (radio) Windy City Times Not available Michelle Obama recognized None (online) lesbian mother; marriage battles Women’s Health Not available A Shocking Number of Burstein (online) Women Aren't Taking Care of Their Sexual Health—Are You One of Them? Women's Health 1,574,269 Placement in the October None Magazine (print) Issue

Editorial Highlights from Selected Outlets

Cosmopolitan: Entitled “9 Things Every Woman Needs to Know About Sexual Health,” the article highlighted important information on STIs, covered services under the ACA, and the burden of poor sexual health on young women. It featured quotes from Dr. Emanuel. NCSH provided a list of 12 surprising sexual health facts that served as the foundation for this piece.

“Emanuel advised on a new guide launched by the National Coalition for Sexual Health last week, which tells ~*~MiLLeNniALs~*~* everything they need to know about having a healthy sex life. He says to check with your doctor or your local clinic to see how much the ACA covers for you, and assures me that just about everything is free or much cheaper, depending on your income and insurance situation.”

Huffington Post Gay Voices: Authored by NCSH member Dana Van Gorder of Project Inform, this piece entitled, “How’s Your (Sexual) Health?” promotes the NCSH definition of sexual health and open discussion with partners and health care providers about sexual health. It also encourages readers to visit the new guide/website to learn about services for gay men.

“The key goals of the …Coalition are to educate Americans about the elements of building good sexual health and to encourage them and their medical providers to form a relationship in which there is support for building good sexual health regardless of age, gender or sexual orientation. The first product of the Coalition was just launched, and it deserves a look from gay men.”

Kinsey Confidential: The piece, “Why Aren’t Americans Getting Vital Sexual Health Services?” was authored by Jaclyn Fontanella of NCSH/Partnership for Prevention and placed by the Kinsey Institute, one of our NCSH members.

“Personally, I have four nieces and nephews ages 11-12, and not one of them has been vaccinated (against HPV)…Recent studies reveal that at least 25% of parents don’t intend to get their children vaccinated for HPV at the recommended ages. We, as a society, need to do a better job of educating Americans about sexual health and the services that are available…”

SHAPE: Entitled “Sleeper STDs You Are At Risk For,” the article features the NCSH call-to-action, and opens with the fact that many women are at risk but not taking advantage of services available under the ACA.

“Politics aside, there has been one undeniable upside to the Affordable Care Act: no-cost screenings for STDs (like chlamydia, gonorrhea, and HPV) for women with an increased risk of infection. (Usually this means sexually active woman age 25 or younger.) The downside: More than half of Americans still aren’t getting these critical sexual health services, according to the National Coalition for Sexual Health.”

Women’s Health: Entitled “A Shocking Number of Women Aren’t Taking Care of Their Sexual Health – Are you one of them?”, this story featured our spokesperson, Dr. Gale Burstein, Erie County Health Commissioner (NY). The positive piece focused on the need for services and linked women directly to the chart of recommended services on the guide’s website.

“NCSH just released a new website that makes it super simple to see which sexual health services are recommended for your age and risk level. These are the services that you should talk to your doctor about at your next visit—especially now that they're covered under most health plans, says Burstein. ‘We don't blow off our heart or lungs or kidneys,’ says Burstein. ‘We can't blow off our reproductive health either.’”

Press Release Results: Through PR Press Release Views by Audience Type NewsWire, NCSH delivered its messages to media nationwide, as well as 75 directly to people searching for this information online. The release, which was distributed at 8 a.m. on May 6, was viewed a total of 1,018 times.

Top syndicated network postings included: MarketWatch (758,000 visitors per day), Reuters (617,000 943 visitors per day), Boston.com (561,000 visitors per day), Bloomberg Business Online & Search Media Week (407,000 visitors per day), and Cincinnati Business Courier (389,000 visitors per day). See Appendix E.

Social Media Promotion by Media Outlets: Four prominent media outlets (Cosmopolitan, HuffPost Live, Self, Women’s Health) actively promoted their stories about the call-to-action and guide via social media, increasing the overall reach of their coverage. Cosmopolitan and Women’s Health were responsible for the vast majority of social media promotion. Three original tweets from these two outlets were retweeted 101 times and favorited 95 times. Cosmpolitan and Women’s Health have such a large following that these three tweets had the potential to reach approximately 3.3 million Twitter users. Meanwhile, two Facebook posts by these media accumulated 1,103 shares, 3,106 likes and 734 comments.

However, it’s important to keep in mind that these social media numbers represent a snapshot in time. Retweets, favorites, and likes may have increased in the months since initial monitoring was completed, and many of these outlets’ posts were subsequently reposted; as a result, all social media promotion is unlikely to be captured.

Editorial Highlights from Selected Outlets

• SELF (@SELFmagazine) o Listen up ladies - are you keeping your sexual health in check? http://on.self.com/1rZiP1l

• Women’s Health (@WomensHealthMag) o A shocking number of women aren’t taking care of their sexual health—are you one of them? http://ow.ly/wyu61

• Cosmo (@Cosmopolitan) o Is your vagina healthy? The surprising STI fact every woman should know: http://www.cosmopolitan.com/sex-love/advice/womens-sexual-health …

Media Partnerships. During proactive media outreach, NCSH was able to form new relationships and partnerships with prominent media outlets and websites, such as your YourTango.com, a leading website for love and relationship advice, and Girl Zone, a lifestyle site for teen girls ages 13-18. These outlets were chosen because they reach NCSH’s target audiences and are willing to work with NCSH to promote topics that satisfy a mutual agenda.

We also formed a partnership with Amber Madison, a trained therapist/relationship expert who is a nationally recognized sex columnist, lecturer, and author. Amber is now serving as a spokesperson for the NCSH, and recently joined the Coalition.

Challenges and Lessons Learned. While implementing the media initiative, NCSH encountered several challenges. We cultivated a number of relationships in advance of the announcement by fielding queries from key reporters about other sexual health topics. Unfortunately, directly prior to the announcement, several changes occurred among media outlets and reporters that NCSH had to contend with: Ladies Home Journal folded after 113 years; the key contact at Prevention left; and the key contact at EverydayHealth changed beats, and EverydayHealth shifted its focus to women over 40, rather than younger women.

In terms of content, many media outlets tend to be focused, almost exclusively, on stories relating to sexual pleasure, rather than other aspects of sexual health, such as the use of sexual health care services. Using a strong pitch and audience-specific statistics, NCSH was able to convince many editors that the story was important and relevant. However, some types of outlets were more amenable to focusing on sexual health and preventive services than others, and this is reflected in the outcomes. Outlets reaching heterosexual men were particularly resistant.

Additionally, some outlets—in particular those reaching teens or parents—were not likely to address the topic of teen sexual health, and thus, securing coverage was challenging. For these reasons, despite outreach efforts strongly focusing on a range of outlets, efforts tended to be more successful in reaching the general population, women and gay men. We are addressing these challenges by working with Coalition members who have relationships with media outlets and reporters that reach teens, parents, and heterosexual men.

3. Promotional Campaign to NCSH Members and Results

Currently, the NCSH has over 50 organizational and individual members. Our members, in turn, have the ability to reach millions of Americans with important information about sexual health. To encourage and equip our members to promote the guide/website through numerous channels, an e- mail and promotional package was prepared and distributed on April 1, 2014. The promotional package included sample text for newsletters and email blasts, seven posts for Facebook, and seven posts for Twitter. See Appendix F for the e-mail and promotional package. This “soft launch” of the guide was

conducted in advance of the media push so that NCSH members would be aware of the new guide/website and could conduct activities in support of the media launch on May 6th.

Promotional Efforts of Members. Coalition members promoted the guide through a wide variety of channels, including non-media and social media channels. Overall, approximately 40% of NCSH members promoted the guide through one or more channels, and several have done so on an ongoing basis. Promotion by NCSH members made it possible for the Coalition to reach priority audiences, including youth, which can be challenging to reach through traditional media outlets. This summary of promotional activities is drawn from our monitoring system and reports from NCSH members; thus, it may not be exhaustive.

Promotion Through Non-Media Channels: Eleven NCSH members promoted the guide/website to their members, networks, and audiences through channels, including webinars, e-mail blasts, newsletters, blogs, and permanent resource lists.

Member Action Link (if available) Advocates for • Listed the guide as a resource for teen http://www.advocatesforyouth.org/tee Youth pregnancy prevention professionals n-pregnancy-prevention-resources- for-professionals

American Sexual • Linked to the guide on their resources page http://www.ashasexualhealth.org/links. Health html Association (ASHA) California • Posted the guide on their blog on April 1 for http://www.preventconnect.org/2014/ Coalition Against Sexual Assault Awareness Month 04/national-coalition-for-sexual- Sexual Assault- • Blogged about the NCSH Call-to-Action health-take-charge-of-your-sexual- Prevent Connect • Included the guide as a resource (#1) in health/ (CALCASA) blog post about key sexual health resources http://www.preventconnect.org/2014/ 05/national-coalition-against-sexual- health-a-call-to-action/

http://www.preventconnect.org/2014/ 06/12-key-sexual-health-resources/

Centers for • Included in list of fact sheets/brochures on http://www.cdcnpin.org/stdawareness/ Disease Control CDC NPIN “STD Awareness Resources” Brochures.aspx and Prevention • Added as a publication in the CDC Stacks (CDC) • Promoted the NCSH and guide as the http://stacks.cdc.gov/view/cdc/22461 NPIN Featured Partner listing on their homepage http://content.govdelivery.com/accou • Promoted via the CDC Connects internal nts/USCDCNPIN/bulletins/bc348f blog post • Sent out link to the guide in the DSTDP’s GovD partner email

Department of • Included the guide in a webinar on http://www.med.navy.mil/sites/nmcph the Navy promoting sexual health c/health-promotion/Pages/hp- • Added the guide to the Health Promotion toolbox-april.aspx toolbox web page for April • Featured in SHARPNews email alert • Listed as a resource on their website

National • Included the guide in its HIV/STI weekly http://www.ncsddc.org/resources/take Association of update for Feb 6, 2014 -charge-your-sexual-health-what- County and City • Included the guide and website in its you-need-know-about-preventive- Health Officials HIV/STI weekly update for May 8, 2014 services (NACCHO) • Included the guide in their July 31 HIV/STI Weekly Update about customizable supporting materials

National • Flagged guide as highlighted resource http://www.ncsddc.org/resources/take Coalition of STD • Included in weekly Friday emails to the STD -charge-your-sexual-health-what- Directors field you-need-know-about-preventive- (NCSD) • Posted guide to website, listing it in services resource database

Nurse • Linked to the guide and website on their http://www.npwh.org/i4a/pages/index. Practitioners in Consumer Information webpage cfm?pageid=1 Women’s Health (NPWH) http://www.npwh.org/files/SexualHealt hGuide-03-26-14.pdf

Project Inform • Sent out through organization’s constituent http://www.projectinform.org/news/na database (about 5,000 individuals) tional-coalition-for-sexual-health- • Sent out through program services provider launches-new-booklet-take-charge- database (about 1,000 providers) of-your-sexual-health/ • Posted a notice about the guide on their homepage

The STD Project • Posted guide to the website in two different http://www.thestdproject.com/std- locations prevention-your-ultimate-reference- guide/ http://www.thestdproject.com/safer- sex-std-prevention/

Variance LLC • Used the STD testing information in the Pending (Sexual Health guide in their Penthouse Magazine column, Rankings) which will appear in the October issue of the magazine

Promotion by NCSH Members and Others Through Social Media: Overall, 95 unique Twitter users actively promoted the guide and its messages, including 16 NCSH members. The guide was tweeted about 287 times, retweeted 490 times, and favorited 224 times. Notable retweeters include: WebMD, Womenshealth.gov, Reddit Health, and USA Today Health. These users have such a large following that a single tweet about the NCSH guide reached approximately 1,945,000 Twitter users through their networks.

NCSH members alone accounted for 186 tweets, which were retweeted 337 times and favorited 115 times. Six members also shared the guide on Facebook, while two promoted the guide on Pinterest. Members who promoted the guide via social media channels include: Amber Madison; ASHA; CALCASA; Cardea; CDC; Department of the Navy; Dr. E.W. Emanuel, MD; Kinsey Institute; NACCHO; NCSD; National Sexual Violence Resource Center; Planned Parenthood Federation of America; Program in Human Sexuality at the University of Minnesota; Project Inform; The STD Project; Variance LLC (Sexual Health Rankings); and YTH. Many members used the sample copy provided in the promotional package, and others created their own original content.

However, it’s important to keep in mind that these numbers represent a snapshot in time. Retweets, favorites, and likes may have increased in the months since initial monitoring was completed, and many of these outlets’ posts were subsequently reposted; as a result, all social media promotion is unlikely to be captured.

Editorial Highlights from Selected Members

• Planned Parenthood (@PPFA) o Everything you need to know about taking care of your sexual health in one handy guide: http://p.ppfa.org/1lhE4hy #wellness

• Amber Madison (@AmberMadi) o Hey @seventeenmag readers, have sexual health Q's? Check out #NCSHguide http://bit.ly/ObEqX7

• NACCHO (@NACCHOalerts) o 1 in 5 sexually active teens were tested for both STIs and HIV. Learn more about making sexual health a priority: http://bit.ly/ObEqX7

• The STD Project (@TheSTDProject) o Check out this phenomenal guide from the folks at the National Coalition for Sexual Health! http://www.ncshguide.org

• Cardea (@CardeaServices) o Talking with your doctor about #sexualhealth can be awkward. Here are some key tips/questions for your next visit. http://bit.ly/ObEqX7

The Department of the Navy Pinterest Board

4. Traffic to the Website

The promotional efforts and media coverage throughout April, May, June, and July were successful in driving traffic to the www.ncshguide.org website. During May, when intensive media outreach and member promotion took place, there was a notable surge in website visits, with the number of visits seven times higher than in April.

Total Number of Visits and Pageviews. From April 1 – July 31st, there were 5,194 visits to the website and 10,797 pageviews. See chart below for a breakdown by month.

Month Number of Visits Number of Pageviews April 518 1,387 May 3,602 7,060 June 607 1,468 July 467 882 Total: 5,194 Total: 10,797

Top Referral Sources. The leading sources of referral to the website include Women’s Health, followed by Direct, Twitter, Huffington Post, and Cosmopolitan. [Note: direct refers to visitors who visited the site by typing the URL directly into their browser. 'Direct' can also refer to the visitors who clicked on the links from their bookmarks/favorites, untagged links within emails, or links from documents that don't include tracking variables (such as PDFs or Word documents)].

Referral Source Website Visits Women’s Health 1,577 Direct 1,056 Twitter 377 Huffington Post 346 Cosmopolitan 291 Partner 272 Flipboard 160 NCC Newsletter – May 2014 147 Harper’s Bazaar 111 Partnership Special 103 Announcement

Most Popular Pages. The five most popular pages were the Homepage, Recommended Preventive Sexual Health Services for Women (chart), What is sexual health and how do I achieve it?, Preventive Sexual Health Services for Women, and Preventive Sexual Health Services for Men.

Page Page Views Homepage 3,344 Recommended Preventive Sexual Health Services for 2,077 Women (chart) What is sexual health and how 607 do I achieve it? Preventive Sexual Health 606 Services for Women Preventive Sexual Health 583 Services for Men How do I prepare for a visit to 489 my health care provider? What are preventive sexual 426 health services? What kinds of questions should 358 I ask? Recommended Preventive Sexual Health Services for Men 273 (chart) What to look for in a sexual 253 health care provider

Most Popular Downloads. In total there were 449 downloads. The entire guide was the most popular download (362), followed by Recommended Services for Women (42).

Document Downloaded Total Downloads Sexual Health Guide 362 Recommended Services- 42 Women (chart) Sexual Health Questions 13 ACA Chart 11 Recommended Services- Men 10 (chart) How Can I Talk with My Health Care Provider About Sexual 10 Health

Website traffic by month: When the website went live on April 1st, we began to promote the guide to NCSH members and engaged in limited outreach with other partners such as the National Chlamydia Coalition and the California Department of Public Health. As part of this promotion, we created a “partner campaign” to monitor referrals to the website. This campaign was the second most popular referral for the month of April and resulted in increased traffic overall.

Traffic also surged in May as a result of media placements. On May 6th, Partnership for Prevention sent out a “Special Announcement” to all of their network subscribers. On May 7th, Women’s Health released their article, “A Shocking Number of Women Aren’t Taking Care of Their Sexual Health – Are You One of Them?”, which linked directly to the chart of recommended preventive sexual health services for women. This article drove unprecedented traffic to the website. The referral visits from Women’s Health accounted for 42% of all visits for the month of May. Other significant media placements in May that drove traffic to the site included Cosmopolitan and Huffington Post.

In June and July, website traffic returned to similar levels as seen in April. In both of these months, Twitter was one of the primary referrals to the site, which can mostly be attributed to the Centers for Disease Control and Prevention’s tweets. For a more comprehensive breakdown of the top website referrals by month, see Appendix G.

Website Traffic May 2nd-May 9th

May 6, 2014 212 total visits:

-60 visits via Partnership Special Announcement

-38 visits from Women’s May 7, 2014 Health 1,341 total visits: -1,168 visits from Women’s Health Visits -88 direct visits -50 visits from Flipboard 1600 1400 1200 1000 800 Visits 600 400 200 0 2-May 3-May 4-May 5-May 6-May 7-May 8-May 9-May

Other Peaks in Traffic During the Month of May (10th-31st)

May 14, 2014 – Cosmopolitan piece 218 total visits: May 24, 2014 –Gay Voices -131 visits from Cosmopolitan 222 total visits: -25 visits from Harper’s Bazaar -90 direct visits -18 direct visits -87 visits from Huffington Post

-13 visits from Women’s Health -26 visits from Huffington Post Facebook

May 10 – 31, 2014

Traffic

5. Conclusion

Through the NCSH’s promotional campaign, millions of Americans learned about the importance of preventive sexual health services and the availability of a new guide and website to help them get the services they need. The keys to our success were a compelling and newsworthy message strategy; highly credible spokespeople; intensive, personalized outreach to the media; and promotion by NCSH members.

However, our campaign is not over, and we will continue to promote the guide and related messages to a variety of media outlets, with special emphasis on those that reach teens, parents of teens, heterosexual men, African Americans and Latinos. Despite facing some barriers – such as the trend among some outlets to focus only on sexual pleasure and a reluctance to cover teens and sexual health – we are building relationships with these outlets and hope to secure future coverage. To increase our likelihood of success, NCSH members can help us identify reporters at these outlets, and when possible, make introductions on our behalf. This approach has already yielded some positive results, including pending stories on a teen radio program and an online teen news service.

Our fifty NCSH members have extensive reach to the public through numerous communication channels, including websites and social media. To support their efforts to promote the guide and website, the NCSH recently released national and customizable versions of the guide, a postcard that promotes the guide/website, and a short brochure, “What is Sexual Health: Five Key Action Steps to Help You Achieve It” that members can print or make available electronically. To extend the reach of these materials, NCSH plans to conduct personalized outreach to its members and other national organizations to discuss tailored options for promoting the guide and website. Through these ongoing efforts we hope to reach even more Americans with vital messages, drive more traffic to the website, and ultimately increase the uptake of preventive sexual health services.

Appendix A

Message Strategy/Talking Points: Launch of NCSH Guide

Core Message Strategy/Media Pitch

1. The National Coalition for Sexual Health, consisting of nearly 40 leading health and medical organizations, has issued a call-to-action to increase the shockingly low uptake of essential preventive sexual health services in America.

More than half of all Americans are not getting recommended preventive sexual health services, including HPV vaccination, chlamydia screening, and HIV testing, even though these potentially life-saving services are now available at no cost through the Affordable Care Act.

• For example, only 34% of adolescent girls and 7% of adolescent boys are getting three-dose HPV vaccine series, only 49% of sexually active young women (ages 16-24) were screened for chlamydia, and only 45% have ever been tested for HIV. • Twenty-two percent of sexually active teens (ages 15-19) and 20% of sexually active young adults (ages 20-24) did not use contraception during first sex.

2. Given the poor state of sexual health in America, widespread use of these services is critical.

• Each year there are an estimated 20 million new cases of STIs, and a total of 110 million cases overall. There are more cases of STIs than many other leading health conditions combined: diabetes, heart disease, breast cancer, and asthma. STIs often don’t have symptoms but can have serious and irreversible consequences. • And, each year there are 3.2 million unintended pregnancies, primarily among young adults and teens. • The financial costs of poor sexual health are high. The medical cost of the eight leading STIs alone is about $16 billion annually (chlamydia, gonorrhea, hepatitis B, HIV, HPV, herpes simplex virus type 2, syphilis, trichomoniasis). And, the cost of unintended pregnancies is an estimated $12 billion annually. The total cost of STIs and pregnancies combined is $28 billion. The physical and emotional costs are also significant.

3. Increased use of recommended preventive sexual health services could prevent serious health problems, lifelong illnesses, and even death.

• Services include vaccines (HPV and hepatitis), screenings (for STIs and other illnesses), and counseling (STI prevention and contraceptives). • These services can help prevent male and female cancers, infertility and sterility, pelvic pain, unintended and ectopic pregnancies, liver disease, fetal illnesses, and other health conditions. • They are recommended by CDC and the U.S. Preventive Services Task Force. • To ensure greatest effectiveness, it’s important that people receive the services at the recommended ages and intervals (e.g. HPV vaccine at 11 or 12).

Appendix A

4. To address this need, a new, easy-to-use guide and website are now available to help the public get the sexual health care services they need.

• The guide, “Take Charge of our Sexual Health: what you need to know about preventive services,” includes information and practical tools. It is designed for men and women of all ages. It features action steps for good sexual health, charts of recommended services for men and women based on age, questions you can ask your provider, and other sexual health resources. • You can easily access the guide through the website, www.ncshguide.org, which is Smartphone compatible. It was created by the National Coalition for Sexual Health. • You can print out the tools and take them to your next appointment with a health care provider, or access them on your phone, if you’re on the go.

5. Many services are now available at no cost through the Affordable Care Act (health reform), but check with your insurer or health care provider about your specific coverage.

• Many health plans must cover specific preventive services without charging you a fee, copayment or coinsurance. This is true even if you haven’t met your yearly deductible. • However, keep in mind that this coverage only applies when an in-network provider delivers these services. • If you don’t have health insurance, free or low cost services might be available through a local health center or clinic. To learn more, go to ncshguide.org or healthcare.gov.

6. The National Coalition for Sexual Health is working to improve sexual health and well- being across the lifespan.

• The coalition believes that the benefits of good sexual health go well beyond disease prevention. Being sexually healthy means being able to enjoy a healthier body, a satisfying sexual life, positive relationships, and peace of mind.

Additional Messages: Tips and Advice for the Public

1. Make sexual health part of your health care routine.

• This is one of the most important steps you can take to protect and improve your health. • Make sure you know which services you need, and make sure you get them. Don’t assume that you are automatically receiving them as part of a health care visit. • These services can prevent serious problems, and detect illnesses early so that they can be treated and managed effectively. • Learn about the services recommended for you in the new guide and website.

Appendix A

2. Find a health care provider who is right for you and have open and honest conversations.

• Find a provider who you makes you feel comfortable and respects you. • Talking about sexual health might make you feel uncomfortable or embarrassed. But, it’s important to talk openly and honestly with your provider. Then, he or she can give you better care and advice. • In the new guide, you will find tips on how to start the conversation, and a list of questions you can ask.

3. There are other steps you can also take to protect and improve your sexual health.

• Just like other aspects of our health – from keeping fit to managing your weight to preventing heart disease—there are steps you can take to protect and improve your sexual health. • These include valuing yourself and deciding what’s right for you; getting smart about your body and protecting it; treating your partners well and expecting them to treat you well; and building positive relationships. Check out the guide to learn more. • It’s time to give our sexual health the attention it deserves, and to take charge of our sexual health.

Appendix B

May 6, 2014, 9 a.m. ET

Contacts: Susan Gilbert 202-375-7810 [email protected]

Lisa Guiterman 301-217-9353 [email protected]

Coalition Issues Call-to-Action to Increase Shockingly Low Uptake of Sexual Health Services

Half of Americans are Not Getting Recommended and Potentially Life-Saving Services, Despite ACA Coverage

Washington, DC – Today, the National Coalition for Sexual Health (NCSH), which consists of nearly 40 leading health and medical organizations, issued a call-to-action to increase the shockingly low uptake of essential sexual health care services in America, and launched a new guide and website to help Americans get the services they need.

More than half of all Americans are not getting recommended sexual health care services, including HPV vaccination, chlamydia screening, and HIV testing, even though these potentially life-saving services are now available at no cost through the Affordable Care Act (ACA). For example, in 2012, only 34% of adolescent girls and 7% of adolescent boys received all three doses of the HPV vaccine, and less than half of sexually active young women ages 16- 24 were screened for chlamydia.

The consequences of America’s poor sexual health are significant. Each year, there are an estimated 20 million new cases of sexually transmitted infections (STIs) and a total of 110 million cases overall. There also are an estimated 3.2 million unintended pregnancies in the U.S. each year, one of the highest rates in the developed world. The eight leading STIs, along with unintended pregnancies, cost the nation $28 billion annually in medical costs alone.

“There are more cases of STIs than diabetes, heart disease, breast cancer, and asthma combined. Despite the fact that we live in a hyper-sexualized world, we are not taking our sexual health as seriously as other health conditions,” said Edward W. Hook III, M.D., Director, Division of Infectious Diseases and Professor of Medicine and Epidemiology at the University of Alabama, Birmingham. “It’s time to give our sexual health the attention it deserves. Widespread use of these recommended sexual health services is critical since they can prevent serious health problems, lifelong illnesses, and even death.”

-more-

Sexual health services include HPV and hepatitis vaccines, screenings for STIs and other illnesses, counseling for STI prevention and contraceptive use, and contraceptives. Recommended by the CDC and the U.S. Preventive Services Task Force, these important services can help prevent male and female cancers, infertility and sterility, pelvic pain, unintended and ectopic pregnancies, liver disease, fetal illnesses, and other health conditions.

Under the ACA, health plans must now cover specific preventive services without charging a fee, copayment or coinsurance. Individuals should check with their insurer about specific coverage. If they are uninsured, free or low cost services might be available through a local health center or clinic.

“We need to make sexual health part of our health care routine and recognize that good sexual health is essential to our overall health and well-being,” said Susan Gilbert, NCSH co- director. “Get informed about the services that are recommended for you, and make sure that you get them. Don’t wait for your provider to bring it up or assume you’re automatically getting what you need. Take charge of your health and ask your provider about testing and other preventive options.”

To help Americans get the critical sexual health care services they need, NCSH has released a new, easy-to-use guide and website that features action steps for good sexual health, charts of recommended services for men and women based on age, questions to ask health care providers, and other resources. The guide, “Take Charge of Your Sexual Health: What you need to know about preventive services,” is accessible at: http://www.ncshguide.org/. Tips and tools can be downloaded, and the site is mobile-friendly for easy access on the go.

###

About the National Coalition for Sexual Health

The National Coalition for Sexual Health (NCSH) is a group of nearly 40 leading national health, medical, and consumer organizations working together to improve sexual health and well-being across the lifespan. The Coalition also includes individuals who are dedicated to improving the state of sexual health in America. NCSH is managed by Partnership for Prevention, a non-profit public health organization that is dedicated to making disease prevention and health promotion a national priority. NCSH member organizations include:

• Adolescent AIDS Program • Advocates for Youth • AIDS Institute-New York State Department of Health • AIDS Community Research Initiative of America, ACRIA Center on HIV & Aging • American Academy of Physician Assistants • American Association of Nurse Practitioners • American College Health Association

-more-

• American College of Nurse-Midwives • American Sexual Health Association • Answer • Association of Reproductive Health Professionals • California Coalition Against Sexual Assault-Prevent Connect • Cardea Services • Center for Research and Education on Gender and Sexuality at San Francisco State University • Center of Excellence for Sexual Health at Morehouse School of Medicine • Department of the Navy, Sexual Health and Responsibility Program (SHARP) • The Female Health Company • Gay, Lesbian & Straight Education Network • Howard University Student Health Center • JSI Research & Training Institute, Inc. • The Kinsey Institute for Research in Sex, Gender and Reproduction • National Association of Community Health Centers, Inc. • National Association of County & City Health Officials • National Association of Nurse Practitioners in Women’s Health • The National Campaign to Prevent Teen and Unplanned Pregnancy • National Coalition of STD Directors • National Institute for Health Care Management Foundation • National Network of STD/HIV Prevention Training Centers • National Sexual Violence Resource Center • National Viral Hepatitis Roundtable • Ogilvy Public Relations Washington, DC • Partnership for Prevention • Planned Parenthood Federation of America, Inc. • Program in Human Sexuality at the University of Minnesota • Project Inform • Sexuality Information and Education Council of the United States • Variance, LLC • Youth+Tech+Health (YTH)

NCSH individual members include: • Edward W. Hook III, MD • Michael Horberg, MD, MAS • Arik Marcell, MD, MPH • Amy Schalet, PhD • Beverly Whipple, PhD, RN, FAAN

For more information: www.nationalcoalitionforsexualhealth.org.

Appendix C

Hi [NAME]. I hope you are well. As someone who routinely covers sexual health, I wanted to give you the “heads up” under embargo (embargoed until 5/6/14) that the National Coalition for Sexual Health, which consists of nearly 40 leading health and medical organizations, will be issuing a call-to-action to increase the shockingly low uptake of essential sexual health care services in America on Tuesday, May 6th. • More than half of all Americans are not getting critical recommended sexual health care services, including HPV vaccination, HIV testing, and chlamydia screening, even though these potentially life-saving services are now available at no cost through the Affordable Care Act. • For example, [INSERT TBD TARGET SPECIFIC STAT].

America is Not a Sexually Healthy Nation and the Cost of Poor Sexual Health is High • Each year, there are an estimated 20 million new cases of sexually transmitted infections (STIs) and a total of 110 million cases overall. That’s more than the total number of cases of diabetes, heart disease, breast cancer, and asthma combined. • There are 3.2 million unintended pregnancies annually, primarily among young adults and teens. The U.S. still has the highest rate of unintended pregnancy in the developed world. • STIs and unintended pregnancies combined cost our nation approximately $28 billion annually in medical costs alone—that’s double the amount of direct health care costs of childhood obesity every year!

Utilization of Recommended Sexual Health Services is Critical Increased use of recommended sexual health care services—including vaccines, screenings, and counseling— could prevent serious health problems, lifelong illnesses, and even death. Recommended by CDC and the U.S. Preventive Services Task Force, these services can prevent male and female cancers, infertility and sterility, pelvic pain, unintended and ectopic pregnancies, liver disease, fetal illnesses, and other health conditions.

EMBARGOED PRESS RELEASE/INTERVIEW OPPORTUNITY: To help Americans get the critical sexual health care services they need, NCSH on May 6th is officially launching a new, easy-to-use sexual health guide and website. The guide and website: • provide action steps for achieving good sexual health; • outline recommended sexual health services for men and women based on age; • offer tips on how to talk with a health care provider, and other resources on sexual health topics.

Attached for your reference is a copy of “Take Charge of Your Sexual Health: What you need to know about preventive services,” which is accessible at www.NCSHguide.org.

If interested, I’m happy to share a copy of the embargoed press release and/or connect you via phone with a spokesperson: • [insert spokesperson names and what they can speak to] Thanks in advance. We greatly appreciate your support in urging Americans to make good sexual health part of their overall health care routine.

Best,

Lisa Guiterman Office: (301) 217-9353 Cell: (202) 330-3431 [email protected] AFFORDABLE CARE ACT COVERAGE OF PREVENTIVE SEXUAL HEALTH SERVICES All plans purchased through the ACA (Marketplace plans) and many other plans must cover the following list of preventive services without charging you a copayment or coinsurance. This is true even if you haven’t met your yearly deductible. This applies only when these services are delivered by a network provider. For more information go to www.healthcare.gov.

Sexual Health Service Affordable Care Act Coverage

• For women ages 21 to 29, get a Pap test every 3 years. Cervical cancer screening • For women ages 30 to 65, get screened every 3 to 5 years based on your provider’s recommendation.

• Annual screening for sexually active women ages 24 and younger, including those who are pregnant. Chlamydia screening • Annually for women ages 25 and over who are at risk, including those who are pregnant.

Contraceptive counseling • For women of reproductive capacity. Includes patient education and counseling, FDA-approved and methods contraceptive methods and sterilization procedures.

Counseling to prevent • For all sexually active adolescents. sexually transmitted infections • For adults at risk.

Gonorrhea screening • For all women at risk, including those who are pregnant.

• For all children ages 12 months and older. Hepatitis A vaccine • For other recommended populations.

• For all infants, starting with the first dose at birth. Hepatitis B vaccine • For all children and adolescents younger than 19 years of age who were not vaccinated at birth. • For other recommended populations.

Hepatitis B screening • For pregnant women at their first prenatal visit.

• One-time screening for adults born between 1945 and 1965. Hepatitis C screening • For other recommended populations.

• For everyone ages 15 to 65 get tested at least once. HIV screening • For those at risk get tested more frequently. • For pregnant women.

• A three-dose series for girls 11-12, and for females ages 13 to 26 not vaccinated when younger. HPV vaccine • A three-dose series for boys 11-12 and for males ages 13 to 21 not vaccinated when younger. It may also be given to males ages 22 to 26; check with your provider.

• For all pregnant women. Syphilis screening • For adults at risk.

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Older Not Dead.com http://www.oldernotdead.com/health/index.asp?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 NorthStar News http://northstarnews.com/news/prnewswire.php?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Washington CityRoom [Washington, DC] http://cityroom.com/city-guides/washington/?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Trauma News Blog http://traumanews.blogspot.com/p/medical-news-from-prnewswire.html?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Contra Costa Times http://markets.financialcontent.com/mng-ba.contracostatimes/news/read/27122343/Coalition_Issues_Call Daily Breeze (Torrance, CA) http://markets.financialcontent.com/mng-lang.dailybreeze/news/read/27122343/Coalition_Issues_Call Cincinnati Enquirer http://finance.cincinnati.com/gannett.theenquirer/news/read/27122343/Coalition_Issues_Call Columbus Ledger-Enquirer (Columbus, GA) http://markets.financialcontent.com/mi.ledgerenquirer/news/read/27122343/Coalition_Issues_Call Carlsbad Current-Argus (Carlsbad, NM) http://markets.financialcontent.com/mng-elpaso.currentargus/news/read/27122343/Coalition_Issues_Call CPhI-Online http://www.en-cphi.cn/news/prnewswire.html?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 DallasNews.com http://www.mediawebsite.net/danews/story/?catSetID=7007&catID=290897&nrid=258092511&page=1 Denton Record-Chronicle http://www.mediawebsite.net/dentonrc/story/?catSetID=7007&catID=290897&nrid=258092511&page=1 Farmington Daily Times (Farmington, NM) http://markets.financialcontent.com/mng-elpaso.dailytimes/news/read/27122343/Coalition_Issues_Call FDA Reg Watch http://www.fdaregwatch.com/press-releases/?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Triangle Business Journal http://www.bizjournals.com/triangle/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews El Nuevo Herald (Miami, FL) http://markets.financialcontent.com/mi.elnuevo/news/read/27122343/Coalition_Issues_Call eMoneyDaily http://markets.emoneydaily.com/emoneydaily/news/read/27122343/Coalition_Issues_Call Tampa Bay Business Journal http://www.bizjournals.com/tampabay/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Daily Herald http://finance.dailyherald.com/dailyherald/news/read/27122343/Coalition_Issues_Call Dealbreaker http://markets.dealbreaker.com/breakingmedia.dealbreaker/news/read/27122343/Coalition_Issues_Call Healthcare Times http://healthcaretimes.com/pr-news.asp?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 San Francisco Business Times http://www.bizjournals.com/sanfrancisco/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews San Jose Business Journal http://www.bizjournals.com/sanjose/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Hire Life Science http://www.hirelifescience.com/prnewswire.aspx?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 South Florida Business Journal http://www.bizjournals.com/southflorida/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews

Healthlinks http://www.healthlinks.net/prnewswire.html?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 St. Louis Business Journal http://www.bizjournals.com/stlouis/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Intern Daily http://www.interndaily.com/reports/prnewswire-interndaily- news.html?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Portland Business Journal http://www.bizjournals.com/portland/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Info4Disasters.org http://info4disasters.org/tentblogger/prnewswire/?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Puget Sound Business Journal http://www.bizjournals.com/seattle/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Life Sciences Industry News http://www.lifesciencesindustry.com/prnewswire.php?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Sacramento Business Journal http://www.bizjournals.com/sacramento/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Las Vegas Business Press http://www.mediawebsite.net/lvbp/story/?catSetID=&catID=&nrid=258092511&page=1 San Antonio Business Journal http://www.bizjournals.com/sanantonio/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Anchorage Daily News http://markets.financialcontent.com/mi.adn/news/read/27122343/Coalition_Issues_Call Worth http://markets.financialcontent.com/worth/news/read/27122343/Coalition_Issues_Call WRAL-TV CBS-5 (Raleigh, NC) http://markets.financialcontent.com/wral/news/read/27122343/Coalition_Issues_Call Belleville News-Democrat http://markets.financialcontent.com/mi.belleville/news/read/27122343/Coalition_Issues_Call Wichita Eagle (Wichita, KS) http://markets.financialcontent.com/mi.kansas/news/read/27122343/Coalition_Issues_Call WorldNetDaily http://markets.wnd.com/worldnetdaily?Page=MEDIAVIEWER&GUID=27122343 Arizona Republic http://finance.azcentral.com/azcentral?Page=MEDIAVIEWER&GUID=27122343 Wall Street Select http://investor.wallstreetselect.com/wss?Page=MEDIAVIEWER&GUID=27122343 Buffalo News (Buffalo, NY) http://markets.financialcontent.com/buffnews/news/read/27122343/Coalition_Issues_Call Beyond The Dow http://markets.financialcontent.com/beyondthedow/news/read/27122343/Coalition_Issues_Call Whittier Daily News (Whittier, CA) http://markets.financialcontent.com/mng-lang.whittier/news/read/27122343/Coalition_Issues_Call ProfitQuotes http://www.profitquotes.com/cgi/?a=news&ticker=a&w=&story=201405201405060800PR_NEWS_USPR_____DC20287 Value Investing News http://markets.financialcontent.com/fatpitch.valueinvestingnews?Page=MEDIAVIEWER&GUID=27122343 Washington Business Journal http://www.bizjournals.com/washington/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Wichita Business Journal http://www.bizjournals.com/wichita/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews HealthTechnologyNet http://www.healthtechnologynet.com/articles/viewarticle.jsp?id=3235200&type=home Austin American-Statesman (Austin, TX) http://www.mediawebsite.net/ausas/story/?catSetID=&catID=&nrid=258092511&page=1 Benchmark Imaging Group http://www.benchmark-imaging.com/News/MedNews.html?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 BioDevicesBiz http://www.biodevicesbiz.com/news.asp?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 Boston Globe http://finance.boston.com/boston/news/read/27122343/coalition_issues_call Chronicle Union News http://chronicleunion.com/prnewswire/?doc=201405060800PR_NEWS_USPR_____DC20287&dir=0 ClinicaSpace.com http://www.mediawebsite.net/clinicaspace/story/?catSetID=7007&catID=290917&nrid=258092511&page=1 ITBusinessNet.com http://www.itbusinessnet.com/article/Coalition-Issues-Call-to-Action-to-Increase-Shockingly-Low-Uptake-of-Sexual-Health- Services-3235200 Asian Hospital & Healthcare Management http://www.asianhhm.com/news/news_archives.asp?NewsID=71435&title=Coalition-Issues-CalltoAction-to-Increase- Shockingly-Low-Uptake-of-Sexual-Health-Services AD HOC NEWS http://www.ad-hoc-news.de/coalition-issues-call-to-action-to-increase-shockingly-low--/de/News/36748263 AlipesNews https://www.alipesnews.com/Public/ArchiveStory.aspx?id=4526928235288764&languageId=4000 PR Newswire http://www.prnewswire.com/news-releases/coalition-issues-call-to-action-to-increase-shockingly-low-uptake-of-sexual- health-services-258092511.html Business Journal of the Greater Triad Area http://www.bizjournals.com/triad/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Business Journal of Greater Milwaukee http://www.bizjournals.com/milwaukee/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Business Journal of Phoenix http://www.bizjournals.com/phoenix/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Business First of Columbus http://www.bizjournals.com/columbus/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Business First of Louisville http://www.bizjournals.com/louisville/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Reuters http://www.reuters.com/article/2014/05/06/ncsh-call-to-action-idUSnPn1jQpjf+88+PRN20140506 Press-Enterprise http://markets.pe.com/pe/news/read/27122343/coalition_issues_call MarketWatch http://www.marketwatch.com/story/coalition-issues-call-to-action-to-increase-shockingly-low-uptake-of-sexual-health- services-2014-05-06 FinancialContent - PR Newswire http://markets.financialcontent.com/prnews.pressrelease/news/read?GUID=27122343 Digital Journal http://www.digitaljournal.com/pr/1897434 BioPortfolio http://www.bioportfolio.com/news/article/1915724/Coalition-Issues-Call-to-Action-to-Increase-Shockingly-Low-Uptake-of- Sexual.html Business First of Buffalo http://www.bizjournals.com/buffalo/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Boston Business Journal http://www.bizjournals.com/boston/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Birmingham Business Journal http://www.bizjournals.com/birmingham/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Baltimore Business Journal http://www.bizjournals.com/baltimore/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Austin Business Journal http://www.bizjournals.com/austin/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews Atlanta Business Chronicle http://www.bizjournals.com/atlanta/prnewswire/press_releases/Georgia/2014/05/06/DC20287?ana=prnews BusinessWeek http://investing.businessweek.com/research/markets/news/article.asp?docKey=600- 201405060800PR_NEWS_USPRX____DC20287-1 Provident Healthcare Partners http://ww2.providenthp.com/healthcare-expertise/healthcarenews/view?article_id=154201

Appendix F

Dear NCSH Members,

We are pleased to announce the official launch of Take Charge of Your Sexual Health: What you need to know about preventive services and its associated, smartphone-compatible website, www.ncshguide.org. We encourage you to promote this guide to your colleagues and partners. Developed by the Health Care Action Group of the NCSH, the guide includes action steps for achieving good sexual health, information about recommended sexual health care services, tips on how to find and talk with a health care provider, and a list of additional sexual health resources.

Attached you can find the full PDF of the guide, as well as a promotional package. This promotional copy includes sample newsletter/email text and social media copy for Facebook and Twitter. Please help to share this great sexual health resource through your networks.

In addition to promoting the guide through our members and their networks, we have been working with colleagues at Ogilvy Public Relations to plan a proactive media push around the guide, including targeted media outreach to specific online and print publications. This media promotion will launch on May 6th, and we will keep you updated on our progress.

Thank you to all the NCSH members who have helped brainstorm, advise, draft, edit and review this document. If you are able to share, please let us know when and how you’ve promoted the guide. As always, if you have any questions, please feel free to call or email Susan Gilbert or Alana Ward.

All the best,

Alana, Susan, Alyson, and Jacky NCSH staff at Partnership for Prevention

Appendix F

PROMOTIONAL PACKAGE “Take Charge of Your Sexual Health: What you need to know about preventive services”

For Newsletters and Email Blasts:

The National Coalition for Sexual Health (NCSH) is pleased to announce the release of a new, easy-to-use guide and website, Take Charge of Your Sexual Health: What you need to know about preventive services. This guide informs men and women of all ages about recommended preventive services, such as screenings, vaccines, and counseling, to help protect and improve sexual health. The guide, which was audience-tested with members of the public, includes action steps for achieving good sexual health, information about recommended sexual health services, tips on how to find and talk with a health care provider, and a list of additional sexual health resources.

Take Charge of your Sexual Health can be easily accessed online and is available for download and print in full PDF format or in short chapters. It is smartphone compatible so patients may access the full guide, including questions to ask your provider and charts of recommended services, while on the go or at the doctor’s office. Please feel free to promote and share the guide with your colleagues and the public.

The majority of Americans are not getting recommended sexual health care services, including HPV vaccination, HIV testing, and chlamydia screening, even though these vital services are now available at no cost under the Affordable Care Act. These services can help prevent male and female cancers, infertility/sterility, unintended pregnancies, fetal illnesses, and other health conditions. The NCSH encourages all Americans to make sexual health part of their health care routine and to make sure they are getting the preventive services they need. For more information about the NCSH, please see the coalition website.

For Facebook:

Do you know what sexual health services are recommended for you? It’s time to take charge of your health! Check out this new resource to find out what you need. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

HPV is associated with multiple cancers for both men and women. Have you been vaccinated? Learn more about the HPV vaccine and other recommended preventive sexual health services. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

Talking with your doctor about sexual health can be awkward. Have you had a conversation with your provider recently? Tell us how it went in the comments, and check out this guide for some key tips and questions for your next visit. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

Appendix F

April is STD Awareness Month! In addition to STD testing, find out what other preventive sexual health services are recommended for you with this handy new guide. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

All sexually active women ages 25 and younger should be tested for chlamydia every year. When was the last time you were tested? Check out this new guide to learn more about the preventive sexual health services that are recommended for you. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

Did you know that HIV testing is recommended for all sexually active men and women? Unfortunately, 55% of Americans have never been tested. Share this post to spread the word. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

Did you know that STIs are one of the leading causes of infertility? Check out this guide and learn more about how you can protect yourself. http://www.ncshguide.org/?utm_source=partner&utm_medium=promotion&utm_campaign=ncshguide

For Twitter:

Do you know what sexual health services are recommended for you? It’s time to take charge of your health! http://bit.ly/ObEqX7

Talking with your doctor about #sexualhealth can be awkward. Here are some key tips/questions for your next visit. http://bit.ly/ObEqX7

Everyone who is sexually active should be tested for HIV at least once. When was the last time you were tested? http://bit.ly/ObEqX7

There are an estimated 20 million new cases of STIs every year. Do you know what you should be tested for? #NCSHguide http://bit.ly/ObEqX7

57% of women ages 16-25 were NOT screened for chlamydia last year. When were you last tested? #NCSHguide http://bit.ly/ObEqX7

Did you know that there is an HPV vaccine that can prevent certain cancers & other diseases? #NCSHguide http://bit.ly/ObEqX7

< 1 in 5 sexually active teens were tested for both STIs & HIV. Learn more about how to make sexual health a priority http://bit.ly/ObEqX7

**The shortened link included above directs to http://www.ncshguide.org/. Whenever possible, we would also like to include the #NCSHguide hashtag to get the conversation started.

Appendix G Website Referral Traffic by Month

April 15, 2014 40 total visits: April 4, 2014 -18 visits from Twitter April 21, 2014 47 total visits: -10 direct visits 24 total visits: -40 direct visits April 8, 2014 -7 visits from Partner -13 visits from Twitter -3 visits from 30 total visits: -2 visits from Facebook -7 direct visits med.navy.mil -20 visits from Partner -1 visit from Google -2 visits from Facebook -2 visits from Google -8 direct visits -1 visit from med.navy.mil -1 visits from Flipboard -2 visits from Partner -2 visits from Facebook -1 visit from npwh.org -1 visit from Partner

April 2014

May 7, 2014 – Women’s Health piece 1341 total visits: -1,168 visits from Women’s Health Please note that the scale of the visits -88 direct visits spans from 1 to 2,000 which makes it -50 visits from Flipboard -5 visits from SELF, 3 from SELF Facebook difficult to accurately represent the th -4 visits from Facebook website on days other than May 7 . -4 visits via Partnership Sp. Announcement For example, even though, May 10th -3 visits from POZ looks like it has zero visits, there in -3 visits via Press release fact, 23.

May 6-13, 2014 May 14, 2014 – Cosmopolitan piece 218 total visits: -131 visits from Cosmopolitan -25 visits from Harper’s Bazaar -18 direct visits -13 visits from Women’s Health -9 visits from Flipboard -9 visits from Twitter -3 visits from Partner -2 visits from Marie Claire -2 visits from NCSH website -2 visits via Press release May 14-21, 2014

May 24, 2014 – Gay Voices piece May 30, 2014 – NCC Newsletter 222 total visits: 55 total visits: -90 direct visits -26 visits via NCC Newsletter -87 visits from Huffington Post -8 direct visits -26 visits from HuffPost Facebook -5 visits from Facebook -4 visits from Flipboard -3 visits from NCSH website -4 visits from Women’s Health -2 visits from Life Out -3 visits from Twitter -2 visits from Partner -2 visits from Google -1 visit from Advocates for Youth -2 visits from Facebook -1 visit from Cosmopolitan -1 visit from Bing -1 visit from Harper’s Bazaar

May 22-31, 2014

June 2, 2014 – NCC Newsletter 74 total visits: June 9, 2014 June 17, 2014 -48 visits from NCC Newsletter 25 total visits: 37 total visits: -6 direct visits -5 direct visits -14 visits from Twitter -3 visits from Cosmopolitan -4 visits from Cosmopolitan -13 direct visits -3 visits from Partner -4 visits via NCC Newsletter -2 visits from Cosmopolitan

-3 visits from Women’s Health -2 visits from Flipboard -2 visits from Partner -2 visits from Huffington Post -2 visits from Huffington Post -1 visit from CDC -2 visits from Partnership Sp. -2 visits from Facebook -1 visit from health.ny.gov Announcement -1 visit from Harper’s Bazaar -1 visit from Huffington Post -1 visit from Advocates for Youth -1 visit from HuffPost Facebook -1 visit from NCSH website -1 visit from Facebook -1 visit from Partnership Sp. -1 visit from NCC Newsletter -1 visit from Harper’s Bazaar Announcement -1 visit from Project Inform

June 2014

July 16, 2014 – CDC twitter activity July 7, 2014 July 21, 2014 18 total visits: 64 total visits: -42 visits from Twitter 39 total visits: -6 visits from Twitter -16 visits from Twitter -5 direct visits -7 visits from Women’s Health -4 visits from Partner -8 direct visits -2 visits from Partner -8 visits from Marie Claire -1 visit from CDC -3 direct visits -2 visits via Press release -2 visits via semalt.semalt.com -1 visit from Huffington Post -1 visit from Flipboard -1 visit via NCC Newsletter -2 visits via semalt.semalt.com -1 visit from Advocates for Youth -1 visit from Harper’s Bazaar -1 visit via semalt.semalt.com -1 visit from NCSH website -1 visit from Women’s Health -1 visit via Constant Contact -1 visit from Facebook -1 visit via NCC Newsletter -1 visit via Partnership Sp. July 10, 2014 -1 visit via Partnership Sp. Announcement 18 total visits: Announcement -10 visits from Partner -4 direct visits -3 visits via semalt.semalt.com -1 visits from Pinterest