Building on What Works:Building on What Works:A Statewide Local Capacity-Building A Statewide Local Capacity-Building

Approach for the Primary Prevention of STDsApproach for the Primary Prevention of STDs Amy Smith, Paul Gibson, Jasmin Delgado, Sandra Rose,

Jennifer Rudy, Sharla Smith, Alice Gandelman & Gail Bolan

STD Control Branch

California Department of Health Services

CDC National STD Prevention ConferenceJacksonville, Florida

May 8-11, 2006

STD Community STD Community Interventions Program (SCIP)Interventions Program (SCIP)

Established by California in 2000 Established by California in 2000 to enhance to enhance the the capacitycapacity of local of local health jurisdictionshealth jurisdictions to plan and to plan and conduct Chlamydia and other STD conduct Chlamydia and other STD primary prevention activities.primary prevention activities.

SCIP BackgroundSCIP Background

First time funds from State of CA for First time funds from State of CA for STD STD primaryprimary prevention prevention

Total SCIP budget Total SCIP budget ≈≈ $1 million a year $1 million a year

80% of funds given to most of CA’s 61 80% of funds given to most of CA’s 61 local health jurisdictions (LHJs): local health jurisdictions (LHJs): ~ ~ $7,000 a year for lower STD morbidity $7,000 a year for lower STD morbidity ~~ $35,000 for higher STD morbidity $35,000 for higher STD morbidity

SCIP Focus & PhilosophySCIP Focus & Philosophy

Focus on programs that serve youth and Focus on programs that serve youth and young adults due to high STD rates.young adults due to high STD rates.

Support Local Health Departments to Support Local Health Departments to build build capacitycapacity of schools and community programs of schools and community programs to reach youth before they get STDs. to reach youth before they get STDs.

Youth development, violence prevention and Youth development, violence prevention and alcohol & drug prevention alcohol & drug prevention ISIS STD primary STD primary prevention – linking antecedent factors.prevention – linking antecedent factors.

SCIP State Director

Northern

Central

Southern

SCIP ProgramSCIP ProgramStructureStructure

Three Regional Health Educators:

Local SCIP Coordinator

The Local SCIP Coordinator is a county or city employee

who partners with local youth-serving organizations to integrate STD prevention

messages into existing programs and services

SCIP Activities:SCIP Activities:

1.1. Conduct Conduct LocalLocal Assessments of… Assessments of… Community Youth Resources (topics & venues): Community Youth Resources (topics & venues): 2,550 2,550

total CA assessments and many local databases.total CA assessments and many local databases.

Staff Training & TA Needs: Staff Training & TA Needs: 600 surveys in CA600 surveys in CA

2.2. Provide Local Trainings & TA to integrate STDs Provide Local Trainings & TA to integrate STDs into existing services: into existing services: ~ 3,000 providers trained~ 3,000 providers trained

3.3. Developed Youth Sexual Behavior Survey: Developed Youth Sexual Behavior Survey: Piloted Piloted 290 youth surveys for one county290 youth surveys for one county

4. Created FREE 8-lesson STD curriculum…4. Created FREE 8-lesson STD curriculum…

Distributed to over 1,150 California Distributed to over 1,150 California educators in schools & youth agencieseducators in schools & youth agencies

Making the Connection Between HIV and STDs:

A Supplemental Guide to STD Education1st Edition 2004

STD Control BranchCalifornia Department of Health Services

Program ChallengesProgram Challenges

Paradigm shift from 2Paradigm shift from 2ºº to 1 to 1ºº STD prevention STD prevention

No SCIP budget for schools and community No SCIP budget for schools and community partners to integrate STD messages into partners to integrate STD messages into current programscurrent programs

Limited State & local staff for all training & TALimited State & local staff for all training & TA

Difficult to assess the impact of prevention Difficult to assess the impact of prevention on STD rateson STD rates

Long-term capacity building and community Long-term capacity building and community collaboration takes time and dedicationcollaboration takes time and dedication

Program AchievementsProgram Achievements

““Our relationship with community agencies Our relationship with community agencies has improved since we have been a part of has improved since we have been a part of SCIP…(it) opened up doors of communication SCIP…(it) opened up doors of communication and helped staff identify community programs and helped staff identify community programs that they didn’t even know existed…(it) that they didn’t even know existed…(it) contributed to the perception of the health contributed to the perception of the health department as a resource for information department as a resource for information related to adolescent reproductive health and related to adolescent reproductive health and STD education and prevention.” STD education and prevention.”

- Nevada County SCIP Coordinator- Nevada County SCIP Coordinator

Impact on Health Department- Impact on Health Department- Community CollaborationCommunity Collaboration

91%91% of SCIP Coordinators reported meeting of SCIP Coordinators reported meeting at least at least quarterlyquarterly with a community with a community coalition or collaborative – coalition or collaborative – compared to compared to 49%49% before SCIP. before SCIP.

53%53% of SCIP Coordinators currently meet of SCIP Coordinators currently meet monthlymonthly with a coalition or collaborative – with a coalition or collaborative – compared to 20%compared to 20% before SCIP before SCIP

N=45 in retrospective survey of SCIP Coordinators in 45 local health jurisdictions (LHJs)

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Much More orSomewhat MoreConfident

N=41. Note: Six of seventeen skills assessed are listed here.Four response categories were: No change, Slightly More, Somewhat More & Much More

Impact on SCIP Coordinators’ self-efficacyImpact on SCIP Coordinators’ self-efficacy

Impact on Local Program ChangesImpact on Local Program Changes

School & Community Program ChangesSchool & Community Program Changes % of % of LHJsLHJs

SCIP STD curriculum now in school lessonsSCIP STD curriculum now in school lessons 31%31%

New STD/HIV prevention education or STD New STD/HIV prevention education or STD data added to community youth programs data added to community youth programs

51%51%

Increased program staff knowledge of STDsIncreased program staff knowledge of STDs 64%64%

New STD screening services on campus or New STD screening services on campus or in collaboration with schoolsin collaboration with schools

13%13%

N=43. Note: 4 out of 21 program changes assessed are listed here.

““Honestly, SCIP has put STD primary Honestly, SCIP has put STD primary prevention on the map…(and) it has prevention on the map…(and) it has facilitated other STD control activities in facilitated other STD control activities in the county (related to screening)…if SCIP the county (related to screening)…if SCIP funds were ever eliminated it would funds were ever eliminated it would impact other STD activities and primary impact other STD activities and primary prevention as well.” prevention as well.”

- Santa Clara County SCIP Coordinator- Santa Clara County SCIP Coordinator

AcknowledgementsAcknowledgements

Denise GilsonDenise Gilson

Carol KongCarol Kong

Rafiki RamRafiki Ramāā Franklin Franklin

Erin TousleeErin Touslee

Staff from the CA STD/HIV Prevention Training CenterStaff from the CA STD/HIV Prevention Training Center

Jas Nihalani & the California Chlamydia Action CoalitionJas Nihalani & the California Chlamydia Action Coalition

Planned Parenthood Six Rivers and Mar Monte Planned Parenthood Six Rivers and Mar Monte

California STD Controllers AssociationCalifornia STD Controllers Association

Local SCIP Partners in MCAH, Offices of Education, etc.Local SCIP Partners in MCAH, Offices of Education, etc.

Local SCIP Partners in community-based agenciesLocal SCIP Partners in community-based agencies

AcknowledgementsAcknowledgementsSCIP Coordinators from the 45 local health jurisdictions:SCIP Coordinators from the 45 local health jurisdictions:

Alameda CountyAlameda County Monterey County Monterey County Santa Barbara County Santa Barbara CountyCity of BerkeleyCity of Berkeley Nevada County Nevada County Santa Clara County Santa Clara CountyButte CountyButte County Orange County Orange County Santa Cruz County Santa Cruz CountyContra Costa CountyContra Costa County City of Pasadena City of Pasadena Shasta County Shasta CountyFresno CountyFresno County Placer County Placer County Siskiyou County Siskiyou CountyHumboldt CountyHumboldt County Plumas County Plumas County Solano County Solano CountyImperial CountyImperial County Riverside CountyRiverside County Sonoma County Sonoma CountyKern CountyKern County Sacramento County Sacramento County Stanislaus County Stanislaus CountyCity of Long BeachCity of Long Beach San Benito County San Benito County Sutter County Sutter CountyLos Angeles CountyLos Angeles County San Bernardino County Tehama CountySan Bernardino County Tehama CountyMadera CountyMadera County San Diego CountySan Diego County Tulare County Tulare CountyMarin CountyMarin County San Francisco CountySan Francisco County Tuolumne County Tuolumne CountyMendocino CountyMendocino County San Joaquin CountySan Joaquin County Ventura County Ventura CountyMerced CountyMerced County San Luis Obispo CountySan Luis Obispo County Yolo County Yolo CountyModoc CountyModoc County San Mateo CountySan Mateo County Yuba County Yuba County

Contact InformationContact Information

Amy V. Smith, MPHCalifornia STD Control Branch

300 Frank H. Ogawa Plaza, Suite 520Oakland, CA 94710

asmith2@dhs.ca.gov510-625-6000 ph; 510-836-0239 fax

www.dhs.ca.gov/ps/dcdc/STD/stdindex.htmwww.stdhivtraining.org