Screening Family Planning Limited-Service Clients for Chlamydia & Gonorrhea in New Jersey

Family Planning & STDP Brainstorming Limited-Service Clients in Family Planning Agencies do not receive a full pelvic exam and wish to receive a pregnancy test only. It is believed that most women presenting at a Family Planning Agency for only a pregnancy test, against the clinician’s advise to undergo a full exam, are at greater risk for Sexually Transmitted Infections then the average Full-Service Family Planning cliental. Our brainstorming first began way back when, Chris Reynolds first brought up the need.

How Did We Do It! Money to screen Limited-Service Family Planning women was first supported by the CY2003 Supplemental IPP grant, but not received until very late in the calendar year. We presented the information to the Family Planning Agencies at their Clinic Coordinator’s Meeting. Screening this at-risk population began in CY2004 in Family Planning Agencies that agreed to participate. This supplemental grant became included in the base IPP grant which has continued to support this effort.

How Do We Prove That Our Brains Can Storm Examine number of Limited-Service women screened, screening coverage, and positivity rates at participating Family Planning Agencies since the beginning of the project in CY2004. Compare those rates to the rates of disease in Full-Service Clients. These are the things we are planning on looking at. However, since some of the information we need is not known, we have not completed looking at all aspects, yet. Debbie and I have decided that we need to visit each of the FP agencies for some basic education and information gathering. Since the Region is changing much of the Data Criteria, we felt that we could combine education on data elements and collection, along with some information gathering on these topics.

FAMILY PLANNING AGENCIES Limited Service Clients (Females Only) Total Screened/Percent Positive 2004 - 2005 - 2006 What we don’t know: Since the agencies did not code “reason for visit” in a correct and consistent way, we do not know if these urine screens are in fact Limited-Service Clients. Were the agencies truly screening all Limited-Service Clients or were they diagnostically testing only a select number of clients based on history, symptoms, risk factors, etc……. What we do know 1. The rates are higher than Full-Service clients demonstrating need.

FAMILY PLANNING Limited-Service Clients (Females) Age & Percent Positive 2004 – 2005 - 2006 Age trends mimic those in full-service clients. However, since so much is still unknown about who was screened and how consistent that screening was, it may explain why there was such a spike in 2005 and then a significant drop in 2006.

What You Think Is What You Get? Bat Question What You Think Is What You Get? You start these projects thinking “ this is pretty straight forward, no problem, this is a piece of cake.” Then you take a look at what you have and BAM, how could so much be unclear? Regardless of how unclear the data may be, this is still a high-risk population that has a great need for screening. BAM

The Rundown These rates are higher than Full-Service clients, demonstrating need. Age trends mimic those in full-service clients. Although, the women >25 had lower rates of disease, it was still high enough to warrant continued screening. Even though I did not talk about the GC data, it showed higher than average disease rates and mimicked the CT data except lower. Site-Visits are necessary for data coding education and information gathering. BEEP, BEEP I definitely feel like the coyote!

What Now? My Three Wishes Debbie, Margaret, and myself to set up Site-Visits with every Agency and for Cicatelli to accompany and assist us in training staff. To gather enough information from the participating agencies to have a clear & consistent project allowing us to look at screening coverage and population comparisons. Increase participation throughout the Family Planning Agencies.

Preview of What’s Coming in New Jersey Begin screening previously positive women, four months after their initial positive result. Starting in the Family Planning Agencies and expanding into STD Clinics and School-Based Programs. Begin a universal screening project in one high school district, modeled after the Philadelphia Project. 4/12/2019

4/12/2019