how can we approach chlamydia screening with girls & young women? preliminary findings from cdc...
TRANSCRIPT
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
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.
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
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
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
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
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
1. Diminishing Barriers: Overcoming Stigma
1. Diminishing Barriers:Ease of Testing
2. Empowerment
3. Women’s Health & Infertility (in context of broader Life Aspirations)
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.
Participant Demographics
Age
15–17 66
18–25 56
Race/EthnicityAfrican American 40
Hispanic 44
Caucasian 38
• Total of 122 women participated in focus groups
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
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
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
Suggested channels of dissemination
Health care facilities Schools Facebook Twitter Health websites Teen & health magazines TV (MTV, BET, VH1) Outdoor advertising Community events
Information Sources
CDC Planned Parenthood, health clinics Women’s health organizations Community-based organizations NIH
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
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
