Mary-Ann Shafer, MD Professor 3333 California Street STE 245 San Francisco, CA 94143-0503 Phone: (415) 476-4384 Email: email@example.com
Young Adulthood (19-21 years)
Chlamydia trachomatis (CT) remains epidemic among sexually young adult and adolescent females especially our ethnic minority women. Despite recommendations for at least annual screening of all sexually active women up to age 25, CT screening rates remain low. Most young women do not regularly attend primary care clinics where preventive care such as CT screening should be done; and clinicians lack time and comfort to address CT screening during the context of an urgent care visit. To address the CT epidemic, we need to interface with young adults wherever they utilize care and devise new paradigms of health delivery that address the unique needs and risks of this young population while living within reasonable constraints of the current health delivery system. This proposed study takes advantage of a "missed opportunity" for screening these at-risk young women for CT when they come in contact with the health care system during an urgent care visit. The purpose of this study is to develop an effective bilingual (English-Spanish) computer kiosk module to significantly increase CT screening among at risk English and Spanish speaking women (18-25 yo) attending urgent care clinics. This novel approach utilizes and applies computer technology to assess clients' CT risk and prompt the client and health care professionals for CT urine specimen collection with a pre-completed laboratory request form. We will also test the extent to which this computer kiosk module intervention use is acceptable and feasible among both English and Spanish speaking young women (on the kiosk itself after completion of the CT module of the kiosk module), and health care professionals who care for them in urgent care settings (via pen-paper survey). This type of intervention to improve CT screening is potentially translatable to a wide variety of health delivery settings as it is not dependent on staff time, motivation or skill to assess sexual history in the busy urgent care setting. This project also supports current recommendations of Healthy People 2010, the U.S. Preventive Services Task Force and othe professional organizations to screen all sexually active young adult females at least annually for CT to address this important public health problem especially among our young ethnic minority women who carry the largest STI disease burden.
This proposal addresses each of the four MCHB Strategic Research Issues (SRI). Because the interactive computer kiosk is designed to deliver a preventive service in the urgent care setting, it is redesigning the health care system and is, according to SRI # I, improving public health service systems and infrastructures to assure that all patients have access to quality care as outlined in SRI # III (services and systems to assure quality of care). By increasing CT screening among young with specific attention to racial/ethnic minorities, this proposal also addresses SRI # II in that it will help eliminate health disparities and barriers to health care access as it relates to CT screening. The kiosk will be developed with sensitivity to racial/ethnic minorities specifically those with high STI rates (African Americans and Hispanic young women) and will be developed in both English and Spanish. Ultimately, this projects promotes the healthy development of MCH populations as stated in SRI # IV in that CT infections are among the leading causes of PID with its serious long-term sequelae of ectopic pregnancy or tubal factor infertility. Early detection through routine CT screening coupled with appropriate treatment of CT infections can eliminate widespread infection and prevent such major reproductive morbidity.
Screening, Sexually Transmitted Diseases, Health Disparities, Access to Health Care, Telehealth & Health Information Technology, Cultural Competence