background: chlamydia burden
DESCRIPTION
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. - PowerPoint PPT PresentationTRANSCRIPT
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How can we approach chlamydia screening with girls
& young women? Preliminary findings from CDC
focus groups
Allison Friedman, MSDivision of STD Prevention
Centers for Disease Control & Prevention
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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.
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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
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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
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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
Barriers Benefits• Fear (testing, positive results, parents finding out)
• Knowing one’s STD status
• Privacy concerns; peer stigma • Ability to take action if positive
• Access • Confirm negative status (reassurance)
• Lack of symptoms/perceived susceptibility
• Being responsible
• Embarrassment
• Lack of awareness
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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
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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 women3. Emphasize women’s health and infertility, in relation to life
aspirations
Six posters developed to represent these concepts
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1. Diminishing Barriers: Overcoming Stigma
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1. Diminishing Barriers:Ease of Testing
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2. Empowerment
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3. Women’s Health & Infertility (in context of broader Life Aspirations)
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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.
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Participant Demographics
Age15–17 6618–25 56Race/EthnicityAfrican American 40Hispanic 44Caucasian 38
• Total of 122 women participated in focus groups
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Key Findings: Concept Preferences
1. Woman you want to be (Infertility) most liked & motivating emotional appeal, values positive message, empowering vibrant colors - attention getting
2. 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
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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
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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
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Suggested channels of dissemination
Health care facilities Schools Facebook Twitter Health websites Teen & health magazines TV (MTV, BET, VH1) Outdoor advertising Community events
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Information Sources
CDC Planned Parenthood, health clinics Women’s health organizations Community-based organizations NIH
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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
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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