CDC National STD Prevention Conference Jacksonville, Florida May 8-11, 2006

1. 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

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

3. 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

4. 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.

5. SCIP Program Structure  SCIP State Director   Technical Assistance Three Regional Health Educators: Consultation  Northern Training Central  Southern

6.  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  

7. SCIP Activities: 1. Conduct Local Assessments of… • Community Youth Resources (topics & venues): 2,550 total CA assessments and many local databases. • 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

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

9. 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

10. 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

11. 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. • 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)

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

13. Impact on Local Program Changes N=43. Note: 4 out of 21 program changes assessed are listed here.

14. “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

15. 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

16. Acknowledgements SCIP Coordinators from the 45 local health jurisdictions: Alameda County Monterey County Santa Barbara County City of Berkeley Nevada County Santa Clara County Butte County Orange County Santa Cruz County Contra Costa County City of Pasadena Shasta County Fresno County Placer County Siskiyou County Humboldt County Plumas County Solano County Imperial County Riverside County Sonoma County Kern County Sacramento County Stanislaus County City of Long Beach San Benito County Sutter County Los Angeles County San Bernardino County Tehama County Madera County San Diego County Tulare County Marin County San Francisco County Tuolumne County Mendocino County San Joaquin County Ventura County Merced County San Luis Obispo County Yolo County Modoc County San Mateo County Yuba County

17. Contact Information Amy V. Smith, MPH California STD Control Branch 300 Frank H. Ogawa Plaza, Suite 520 Oakland, CA 94710 asmith2@dhs.ca.gov 510-625-6000 ph; 510-836-0239 fax www.dhs.ca.gov/ps/dcdc/STD/stdindex.htm www.stdhivtraining.org