Resources to Improve Private-Sector Providers Chlamydia Screening Practices

1. Resources to Improve Private-Sector Providers Chlamydia Screening Practices Gale R Burstein, MD, MPH, FAAP Erie County Department of Health Buffalo, NY

2. Outreach Strategy “If the people do not come to you, go to the people.”

3. How to find “the people”? • Professional medical specialty organizations • State and local chapters • Medical institutions specialty departments • i.e. General Hospital pediatrics department • Academic institutions specialty departments • i.e. University of Florida pediatrics department

4. What to do when you find them? • Continuing medical educational programs • Medical specialty organization and office-based presentations • Consider train-the-trainer • Hospital-based, grand rounds may not reach target groups • Provide technical assistance, including providing tools, information, and resources

5. www.stdhivtraining.org/educ/training_module/index.html

6. www.stdhivtraining.org/educ/training_module/tools.html

7. www.mass.gov/dph/cdc/std/guidelines/chlamydia_toolkit.pdf

8. The Massachusetts Experience: Chlamydia Toolkit and Training Contents of Tool Kit: • Background Chlamydia trachomatis • Confidentiality/HIPAA • Making your Office Teen Friendly • Cultural Issues • Sexual History Taking • Providing Prevention Counseling • Screening and Treatment • Partner Management • Referral resources and practice • management tools www.mass.gov/dph/cdc/std/guidelines/chlamydia_toolkit.pdf

9. Toolkit: User Friendly!

10. Toolkit Content • Confidentiality and the teen friendly office • Office atmosphere, plans for contact information, charting, • HIPAA, billing

11. Toolkit Content • Sexual history taking • How to take a history, how to interview alone, reinforcing • confidentiality

12. Toolkit Content • Screening and treatment guidelines • Preferred testing and treatment approaches

13. Professional Medical Organizations • American Academy of Pediatrics • www.aap.org • Society for Adolescent Medicine • www.adolescenthealth.org • American Medical Association • www.ama-assn.org • American College of Obstetricians and Gynecologists • www.acog.org

14. American Academy of Pediatricswww.aap.org • National pediatricians professional medical organization • 60,000 members (45% <40 years old) • 59 chapters in US and 7 chapters in Canada* • Provide educational, advocacy, research, and networking opportunities • Publish clinical guidelines and policy statements *See handouts for chapter contacts

16. AAP Policy Statements • Adolescent Assault Victim Needs: A Review of Issues and a Model Protocol. Pediatrics 1996;98:991-1001. • Adolescents and HIV Infection: The Role of the Pediatrician in Prevention and Intervention. Pediatrics 2001;107:188-90. • Care of the Adolescent Sexual Assault Victim. Pediatrics 2001;107:1476-1479. • Condom Use by Adolescents. Pediatrics 2001;107:1463-9. • Contraception and Adolescents. Pediatrics 1999;104:1161-6. • HIV Screening. Pediatrics 1999;104:128. www.aappolicy.aappublications.org

17. AAP Section on Adolescent HealthTools in Development • AAP Reproductive health coding/billing fact sheet • AAP Brochure explaining and endorsing confidential adolescent health care • Brochure and script for offices to download and modify to explain their confidentiality policies • Hutchinson, et al. Changing parental opinions about teen privacy through education. Pediatrics. 2005;116:966-71. www.aap.org/sections/adol AAP Contact: Karen Smith Email: ksmith@aap.org Phone: 1-847-434-4000

19. www.ama-assn.org/ama/pub/category/1980.html

21. Parent Package www.ama-assn.org/ama/pub/category/7833.html

22. American College of Obstetricians and Gynecologistswww.acog.org • National OBGYN professional medical organization • 49,000 members • 20 districts divided into 83 sections • Provide educational, advocacy, research, and networking opportunities • Publish clinical guidelines and policy statements

28. More Tools

29. Adolescent and Sexual Health Specialty Organizations • Guttmacher Institute • www.guttmacher.org • Adolescent Health Work Group • www.ahwg.net • American Social Health Association • http://www.ashastd.org

30. The Guttmacher Institute www.guttmacher.org

31. http://www.guttmacher.org/statecenter/spibs/spib_MASS.pdf

33. Adolescent Health Work GroupAdolescent Provider ToolkitA GUIDE FOR TREATING TEEN PATIENTS • The Adolescent Provider Toolkit is a collection of resources for health care providers who work with adolescents. The Toolkit incorporates adolescent health care best practices and includes resources for providers, parents, and teens. • The Toolkit modules contain screening tools, brief office interventions and counseling guidelines, community resources and referrals, tip sheets for teens and parents, health education materials for teens and their adult caregivers, and literature and internet resources. www.ahwg.net

34. Adolescent Health Work GroupAvailable Toolkits • Adolescent Health Care 101: The Basics • Update to Website Links in Adolescent Health Care 101 • Sexual Health • Body Basics • Understanding Confidentiality and Minor Consent in California: An Adolescent Provider Toolkit First Revised Edition

35. www.ahwg.net/resources/toolkit.htm

41. NYSDOH Adolescent Health Questionnaire and Provider Response Guide • Provide a standardized mechanism to • identify adolescents engaging in risk behaviors • promote discussions between adolescents and health professionals • Available in English or Spanish • Lower reading level and brief (16 questions) • Available at: www.urmc.rochester.edu/gchas/div/adol/leah/resources.HTM

44. Conclusion • Many available strategies, tools and resources for health departments to use to interface with private-sector providers • Get the foot in the door • Let’s get started!!!

45. Questions