Building on What Works: A Statewide Local Capacity-Building Approach for the Primary Prevention of STDs Amy Smith, Paul Gibson, Jasmin Delgado, Sandra Rose, Jennifer Rudy, Sharla Smith, Alice Gandelman & Gail Bolan STD Control Branch California Department of Health Services CDC National STD Prevention Conference Jacksonville, Florida May 8-11, 2006

STD Community Interventions Program (SCIP) Established by California in 2000 to enhance the capacity of local health jurisdictions to plan and conduct Chlamydia and other STD primary prevention activities. Established by California in 2000 to enhance the capacity of local health jurisdictions to plan and conduct Chlamydia and other STD primary prevention activities.

SCIP Background  First time funds from State of CA for STD primary prevention  Total SCIP budget ≈ $1 million a year  80% of funds given to most of CA’s 61 local health jurisdictions (LHJs): ~ $7,000 a year for lower STD morbidity ~ $35,000 for higher STD morbidity

SCIP Focus & Philosophy  Focus on programs that serve youth and young adults due to high STD rates.  Support Local Health Departments to build capacity of schools and community programs to reach youth before they get STDs.  Youth development, violence prevention and alcohol & drug prevention IS STD primary prevention – linking antecedent factors.

SCIP State Director Northern Central Southern              SCIP Program Structure Three Regional Health Educators:

             Local SCIP Coordinator  The Local SCIP Coordinator is a county or city employee who partners with local youth- serving organizations to integrate STD prevention messages into existing programs and services

SCIP Activities: 1.Conduct Local Assessments of… Community Youth Resources (topics & venues): 2,550 total CA assessments and many local databases. Community Youth Resources (topics & venues): 2,550 total CA assessments and many local databases. Staff Training & TA Needs: 600 surveys in CA Staff Training & TA Needs: 600 surveys in CA 2.Provide Local Trainings & TA to integrate STDs into existing services: ~ 3,000 providers trained 3.Developed Youth Sexual Behavior Survey: Piloted 290 youth surveys for one county

4. Created FREE 8-lesson STD curriculum… Distributed to over 1,150 California educators in schools & youth agencies

Program Challenges  Paradigm shift from 2º to 1º STD prevention  No SCIP budget for schools and community partners to integrate STD messages into current programs  Limited State & local staff for all training & TA  Difficult to assess the impact of prevention on STD rates  Long-term capacity building and community collaboration takes time and dedication

Program Achievements “Our relationship with community agencies has improved since we have been a part of SCIP…(it) opened up doors of communication and helped staff identify community programs that they didn’t even know existed…(it) contributed to the perception of the health department as a resource for information related to adolescent reproductive health and STD education and prevention.” - Nevada County SCIP Coordinator

Impact on Health Department- Community Collaboration 91% of SCIP Coordinators reported meeting at least quarterly with a community coalition or collaborative – compared to 49% before SCIP. 91% of SCIP Coordinators reported meeting at least quarterly with a community coalition or collaborative – compared to 49% before SCIP. 53% of SCIP Coordinators currently meet monthly with a coalition or collaborative – compared to 20% before SCIP 53% of SCIP Coordinators currently meet monthly with a coalition or collaborative – compared to 20% before SCIP N=45 in retrospective survey of SCIP Coordinators in 45 local health jurisdictions (LHJs)

N=41. Note: Six of seventeen skills assessed are listed here. Four response categories were: No change, Slightly More, Somewhat More & Much More Impact on SCIP Coordinators’ self-efficacy

Impact on Local Program Changes School & Community Program Changes % of LHJs SCIP STD curriculum now in school lessons 31% New STD/HIV prevention education or STD data added to community youth programs 51% Increased program staff knowledge of STDs 64% New STD screening services on campus or in collaboration with schools 13% N=43. Note: 4 out of 21 program changes assessed are listed here.

“Honestly, SCIP has put STD primary prevention on the map…(and) it has facilitated other STD control activities in the county (related to screening)…if SCIP funds were ever eliminated it would impact other STD activities and primary prevention as well.” - Santa Clara County SCIP Coordinator

Acknowledgements Denise Gilson Carol Kong Rafiki Ramā Franklin Erin Touslee Staff from the CA STD/HIV Prevention Training Center Jas Nihalani & the California Chlamydia Action Coalition Planned Parenthood Six Rivers and Mar Monte California STD Controllers Association Local SCIP Partners in MCAH, Offices of Education, etc. Local SCIP Partners in community-based agencies

Acknowledgements SCIP Coordinators from the 45 local health jurisdictions: Alameda CountyMonterey County Santa Barbara County City of BerkeleyNevada County Santa Clara County Butte CountyOrange County Santa Cruz County Contra Costa CountyCity of Pasadena Shasta County Fresno CountyPlacer County Siskiyou County Humboldt CountyPlumas County Solano County Imperial CountyRiverside County Sonoma County Kern CountySacramento County Stanislaus County City of Long BeachSan Benito County Sutter County Los Angeles CountySan Bernardino County Tehama County Madera CountySan Diego County Tulare County Marin CountySan Francisco County Tuolumne County Mendocino CountySan Joaquin County Ventura County Merced CountySan Luis Obispo County Yolo County Modoc CountySan Mateo County Yuba County

Contact Information Amy V. Smith, MPH California STD Control Branch 300 Frank H. Ogawa Plaza, Suite 520 Oakland, CA ph; fax