MCH Student:
Sara Bowman
Date of Defense:
April 28, 2017
Abstract:
Read more about Sara Bowman in our Student Spotlight feature.
Introduction:
Chlamydia is a public health concern because there were more than 21,000 cases reported in Minnesota in 2015 (2). Chlamydia is a bacterial sexually transmitted infection (STI) that can cause pelvic inflammatory disease, infertility, ectopic pregnancy, and can increase the chances of acquiring HIV (Human Immunodeficiency Virus). It can also cause eye infections or pneumonia in newborns who acquire chlamydia during delivery (3).
Chlamydia can be cured with as little as one dose of antibiotic, but in most cases, infections are asymptomatic. Therefore, screening all females (and select populations of men) at risk is essential to finding and curing cases (3).
The Minnesota Chlamydia Partnership (MCP) has a unique, community-based approach to reducing rates of this STI by promoting connections between community organizations and promoting awareness of chlamydia (3). The MCP Action Plan outlines essential background information about chlamydia, chlamydia screening and treatment, goals for the partnership, and statistics about chlamydia and adolescent sexual activity (3). Community organizations can use this information to take action and stop chlamydia from spreading in their communities.
Experience:
I worked with the Minnesota Chlamydia Partnership. My main goal was updating and revising the Action Plan to Reduce Chlamydia in Minnesota which was written in 2010.
The learning objectives for this field experience were as follows:
- Learn about trends and statistics in chlamydia rates including health disparities
- Learn about how social and cultural determinants of health impact health outcomes
- Learn how to work with stakeholders, community members, and community group; learn how these groups can be involved in the implementation and development of community health programs and prevention programs
- Understand the administrative and organizational framework for MCH programs and services at state and local level
- Learn about the successful and best practices for promotion of sexual/reproductive health
The learning activities for this field experience were as follows:
- Research chlamydia rates and trends; use this knowledge to make updates to the MN Chlamydia Partnership Action Plan so it reflects current data and trends
- Conduct a literature review on social determinants of health; synthesize information into the “Minnesota Chlamydia Partnership Action Plan” document
- Attend meetings with stakeholders and community groups to talk about what can be done about the high rates of chlamydia in our community
- Observe colleagues, attend meetings at the Department of Health
- Conduct a literature review on the topic of sexual health promotion; synthesize main ideas and add to the MN Chlamydia Partnership Action Plan as appropriate
I was able to achieve all of these learning objectives and complete all of my learning activities for this field experience. One weak point was that schedules did not work out so I was not able to observe anyone from family planning or MCH (Learning Objective #4); I mostly observed people in the STD/HIV/TB Unit. However, I did review literature to get a grasp on how MCH programs operate in Minnesota and I feel this reading provided similar information to what I would gain from observing someone in those units.
Organization:
The Minnesota Department of Health (MDH) serves as a backbone organization for the MCP, which meets 4 times per year (3). The MCP aims to promote awareness of chlamydia while engaging community organizations and community members statewide to mobilize and take action to stop the spread of chlamydia in their communities (3). The MCP began in 2010 after the Minnesota Chlamydia Summit, which was put on by MDH, where community members brainstormed ideas on how to take action about chlamydia (1). These ideas, along with a wealth of background information on chlamydia and goals for the new partnership were compiled into a document called the Minnesota Chlamydia Partnership Action Plan, which is available on the MDH website (3).
I was tasked with updating this action plan, since many of the statistics and other information had become outdated. I was also asked to expand the content about expedited partner therapy and add information about confidential care and social determinants of health. I also added citations so that all the information was attributed in an academically responsible manner.
The updated action plan provided the latest information as of August 2016. To avoid the need to update this document every year, I provided links to websites where readers can look up the absolute latest information on statistics, screening recommendations, and treatment options. This updated document fits in with the organization’s overall mission because it provides community members with up to date information in an easy to navigate format. At the current time, the updated strategy is still going through the communications team at MDH and is unfortunately not available on the website at this time but the 2010 version is still available (3).
Lessons Learned:
This field experience provided me with valuable insight into the inner workings and complexity of a state health department. I was also able to promote awareness of chlamydia and other STIs by tabling at community events such as Juneteenth. I was nervous talking to people at the fairs about this topic, especially adolescents. I feared that parents would be mad at me for talking to them about sex, so this was a challenge that I had to work through and ultimately overcome. My comfort level in talking about sexual health with teens definitely improved over time.
Recommendations:
One recommendation for my host organization is to have a partnership and/or impact evaluation done. This could help leadership improve recruitment and retain members as well as provide a way of knowing if goals are being worked on in a way that everyone agrees upon. Community building is a unique approach to combating STIs, but there is not much literature about the impact of this approach. Either of these evaluation projects could be done by a public health student for a field or culminating experience.
The traditional control of infectious disease model of screen-diagnose-treat is not sufficient to fight chlamydia in some of the hardest hit communities in Minnesota. Education and awareness are still needed, as is universal screening for all females under age 25. Therefore, novel approaches such as community building and raising community awareness should be implemented at least on a trial basis to see if they have an impact on this public health issue.
Conclusion:
I was able to apply my skills in public health writing and literature review to update and expand the Minnesota Chlamydia Partnership Action Plan. I also learned more about the practice of community building for public health and was able to promote awareness of the public health problem of chlamydia while overcoming some anxiety about talking to adolescents about sex.
References:
(1) Minnesota Department of Health. The Minnesota Chlamydia Partnership (MCP). No Date; Available at: http://www.health.state.mn.us/mcp. Accessed April, 2017.
(2) Minnesota Department of Health. Annual Summary: 2015 Minnesota Sexually Transmitted Disease Statistics. No Date; Available at: http://www.health.state.mn.us/divs/idepc/dtopics/stds/stats/2015/stdstats2015.html. Accessed April, 2017.
(3) Minnesota Department of Health. The Minnesota Chlamydia Strategy: Action Plan to Reduce and Prevent Chlamydia in Minnesota. No Date; Available at: http://www.health.state.mn.us/divs/idepc/diseases/chlamydia/mcp/strategy/index.html. Accessed April, 2017.