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Background: Chlamydia burden

How can we approach chlamydia screening with girls & young women? Preliminary findings from CDC focus groups Allison Friedman, MS Division of STD Prevention Centers for Disease Control & Prevention. Background: Chlamydia burden.

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Background: Chlamydia burden

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  1. How can we approach chlamydia screening with girls & young women? Preliminary findings from CDC focus groupsAllison Friedman, MSDivision of STD PreventionCenters for Disease Control & Prevention

  2. Background: Chlamydia burden • Estimated 2.8 million new cases of Chlamydia (CT) in the U.S. each year. [1] • Highest rate among 15-to-24 year-old females • CT is treatable w/antibiotics, but usually asymptomatic. • Most of those infected do not know or seek testing • CT is a leading cause of pelvic inflammatory disease (PID), which can lead to ectopic pregnancy, chronic pelvic pain & infertility. • Annual CT screening recommended for sexually active women <26 yrs. • Yet only ~40% of eligible young women get screened annually. [2] [1] Weinstock et al., 2004 [2] NCQA.(2009). The State of Health Care Quality 2009.

  3. To address low rates of CT screening, CDC’s Division of STD Prevention is developing a national social marketing campaign to promote CT screening among sexually active young women , ages 15-25yrs. • African American • Caucasian • Hispanic

  4. Project Background Project Activities • Literature Review (2007)   • Exploratory Research (2007-2008) • Phone interviews (n=80) • In-person interviews (n=45) • Concept & Message Testing (Nov-Dec 2009) • 18 Focus Groups in 4 cities

  5. Summary of Exploratory Research Findings • Very few young women had substantial knowledge of CT. • Most were unaware of: • CT’s asymptomatic nature, potential to cause infertility • Recommendation for routine CT testing • Urine test for CT Perceived Barriers & Benefits to Screening

  6. Exploratory Research Findings (cont’d) • Young women were motivated by info that increased awareness and perceived susceptibility, severity & risk of disease, while offering simple, actionable solutions: • CT is common & often asymptomatic • CT can cause infertility • A simple test and cure are available for CT

  7. Concept & Message Development • Guided by exploratory research findings & 2 theoretical frameworks • Health Belief Model • Theory of Planned Behavior • Three main concepts designed to: 1. Diminish identified barriers: • Overcome stigma • Emphasize ease of testing 2. Empower women 3. Emphasize women’s health and infertility, in relation to life aspirations • Six posters developed to represent these concepts

  8. 1. Diminishing Barriers: Overcoming Stigma

  9. 1. Diminishing Barriers:Ease of Testing

  10. 2. Empowerment

  11. 3. Women’s Health & Infertility (in context of broader Life Aspirations)

  12. Concept/Message Testing Focus Groups Methods • 18 focus groups conducted in 4 cities. • Participant inclusion criteria: • Young women, ages 15-25yrs • African American, Caucasian or Hispanic • Working & in school • English speaking • Sexually active or had sought reproductive health services • Mix of income/SES • Segmented by age, race/ethnicity, and school/work status (adults) • Groups also explored dissemination preferences • Interviews were transcribed & coded using NVivo2.

  13. Participant Demographics • Total of 122 women participated in focus groups

  14. Key Findings: Concept Preferences • Woman you want to be (Infertility) • most liked & motivating • emotional appeal, values • positive message, empowering • vibrant colors - attention getting • Few people talk about it, lots of people do it (Stigma) • 2nd most liked • everyone is at risk • relatable situation • focus on female and male

  15. General vs. Specific Approach • STD vs. CT: • CT slightly preferred: novel, relevant • STD brand more recognized • Female vs. Male/Female • F focus for infertility, but imagery/messaging should include M • Relationships, partner support = well received • If focus is STD testing, important to include both M & F

  16. Key Findings (cont’d) • Audiences want: • Relatable people, relationships, contexts, conversations, testimonials • Diversity • Alarming statistics (prevalence) w/easy, actionable solutions • Direct, upfront messaging & logos • Audiences do not want: • Messaging or tone that minimizes seriousness of STDs or testing • Messages suggesting that girls need STD testing & boys do not

  17. Suggested channels of dissemination • Health care facilities • Schools • Facebook • Twitter • Health websites • Teen & health magazines • TV (MTV, BET, VH1) • Outdoor advertising • Community events

  18. Information Sources • CDC • Planned Parenthood, health clinics • Women’s health organizations • Community-based organizations • NIH

  19. Campaign Website Components • Clinic locator tool • Frequently asked questions (FAQs) • Personal testimonies, Inspirational quotes • Blogs, chat rooms • Opportunities to chat w/ or submit a Q to a health professional • Quizzes, polls • Public service announcements/videos • Hotline for more information • Website should NOT include games

  20. Conclusions & Implications • Messages should inspire/empower women and normalize testing • For young women to pay attention to CT & consider behavior change, messaging must: • take CT (STD testing) seriously • be thought-provoking, tapping into deeper values • Messaging for STD testing should be ‘equal opportunity’ to avoid stigmatizing a particular group • Design: use of bright colors, diverse models, relatable situations/settings • Traditional & new/interactive media tools needed to reach young audiences, but source should be credible/respected

  21. Contact Me! Allison Friedman alf8@cdc.gov (404) 639-8537

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