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Frequently Asked Questions
What is PalmPal?
PalmPal (or PalmIT, as it is called by the SF DPH) is an electronic data collection system that is designed to replace the paper Counselor Information Form that test counselors in California are required to complete for each test client. The system could eventually replace other forms such as STD or HERR LEO forms as well.
PalmPal was developed based on research by Nicolas Sheon and colleagues at CAPS demonstrating that the CIF impedes counseling by - focusing the session on paperwork rather than the client
- placing clients on the defensive by interrogating them about past risks;
- focusing on topics because they are on the form, not because they are relevant to the client
- limiting eye contact since counselor is focused on the paperwork
and not the client
The goal of PalmPal is to remove the form from the session to improve the quality
of client data and allow a more client-centered counseling discussion to flourish.
How does PalmPal affect the clinic work flow?
 PalmPal is a computer assisted survey that is
self-admininstered by the client before they see the counselor. Counselors do not have access to individual client data. This forces counselors to get to know the client's situation using open-ended questions instead of relying on the CIF. The client arrives at the test site 10 minutes before their
scheduled session and completes the PalmPal survey in the waiting room. By having
clients complete the CIF questions in the waiting room, the site has more time and space to provide individual counseling. The SF DPH has developed a Magnet PalmIT Protocol that describes the process of using PalmIT in detail.
Is the PalmPal interface difficult for visually impaired or low-literacy populations?
The PalmPal interface is built with Nova Research Questionnaire Development System (QDS) version 2.5.
The questionnaire can be administered on a Pocket PC, or can be used with a larger screen and audio assistance when on a Tablet PC or Touchscreen Kiosk.
How does PalmPal affect the counseling session?
 The PART Study used several methods to assess the impact of PalmPal on the test experience.
We compared data collected at the same clinic using PalmPal with the previous year's data using the paper CIF. Clients reported five times as many partners on PalmPal than they did to the counselor. This finding reflects those of other studies that have deomonstrated that interviewees are more honest when completing survey questions on a computer than with a counselor. This honesty leads clients to
reflect on their behavior right before seeing the counselor. We conducted focus groups with counselors before and after implementing PalmPal and follow-up interviews with test clients who allowed us to record their test session for the PART study.
Clients and counselors both report being more honest and talkative about a wide range of issues related to risk behavior in the counseling session after PalmPal.
Other than the CIF, can other paperwork also be streamlined using PalmPal?
Yes. We have created electronic versions of the State Lab Slip, an STD chart, and positive referrals. PalmPal streamlines the paperwork because questions common to many forms, such as the client's
zip code, race, age, etc. only need to be entered once and PalmPal populates all the necessary fields across multiple forms.
To avoid data entry error, bar code scanners are used to input the lab slip number.
Is PalmPal more expensive than using paper?
Surprisingly, the PalmPal system costs only about 30% of the current cost of using paper forms.
Most the expense of using paper forms is from the cost of data entry personnel at the DPH, printing
and storage of the paperwork. We estimate that, over ten years, PalmPal could save the county of San
Francisco about 6 million dollars just on data management.
Is PalmPal only available in English?
PalmPal is currently available in Spanish and English. This CAPS Conference presentation describes how we adapted the language of the pilot version used at Magnet into Spanish and English for the Forensic AIDS Project.
What platforms is PalmPal built with?
When we started developing PalmPal in 2005, the best handheld computer device available to us was the Dell Axim V running Windows Mobile (Pocket PC) platform and the QDS HAPI interface. Since 2007, with the advent of the Apple iPhone and iOS, the field of mobile technology has changed dramatically and Pocket PC is no longer a viable platform. An iOS alternative to QDS is iFormbuilder by Zerion software which works on the iPhone, iPod touch or iPad.
If wifi is available in the place where PalmPal will be used, Survey Gizmo is a good option as it works with any browser and can be adapted to work with iOS and Android tablets as well. Both iForm and Survey Gizmo are less expensive and easier to use than QDS.
Contact us if you have other questions.
last updated 2/1/11
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