1. Michelle Jasczynski, Ed.M.
Reality Check: Community Consultative Process to Develop a Targeted Youth Sexual Health Intervention
Michelle Jasczynski, Ed.M.
Public Health Associate
Office for State, Tribal, Local and Territorial Support
Centers for Disease Control and Prevention
PHAP 2014 Class Summer Training
June 2nd, 2015
Centers for Disease Control and Prevention
Office for State, Tribal, Local and Territorial Support

2. Framing the Problem: DC Adolescents and STDs
The adolescent population of the District presently experiences rates of chlamydia and gonorrhea that are correspondingly double and triple the national adolescent average.
Data and Graphic Source: Reportable STDs in Young People Years of Age, 2013 courtesy of National Electronic Telecommunications System for Surveillance, Centers for Disease Control and Prevention. CDC/NCHS 2012 bridged population estimates, derived from US Census data, used for rate denominators.

3. Framing the Problem: DC Adolescents and STDs
Graphic Source: Reportable STDs in Young People Years of Age, 2013 courtesy of National Electronic Telecommunications System for Surveillance, Centers for Disease Control and Prevention. CDC/NCHS 2012 bridged population estimates, derived from US Census data, used for rate denominators.

4. Framing the Problem: DC Adolescents and STDs
In response to the high rates of both chlamydia and gonorrhea, the DC Department of Health was tasked to develop a cost-effective, youth-acceptable intervention that would reduce barriers to sexual health information and care.
In reviewing prior strategies and best practices for youth sexual health programs, it was determined that a text-message based program the best programmatic approach.
For this program, the DOH collaborated with a technical partner, YTH to assist with programmatic design and manage the technical infrastructure.

5. Scope of Intervention
Goals and Objectives of the Text Message Program:
Health Goal: Reduction in Chlamydia and Gonorrhea incidence and prevalence in Washington DC residents ages
Behavioral Goal: Reduction in unsafe sexual behaviors among Washington DC adolescents after the design and implementation of an intervention based on risk and protective factors gathered from this focus group.
Program Goal: Recommended intervention strategies, based on the findings of qualitative research, to increase knowledge and comprehension of sexual health risks and linkage to resources among Washington DC adolescents regarding STD prevention.

6. Methods - Design
Qualitative design with information gathered through one pre-activity questionnaire and focus group.
Formative research to gain in-depth information from participants so that the subsequent content for the text-message information reflects the realities of DC adolescent experiences and opinions.
Planned as a semi-structured conversation so that participants respond to promote debate and discussion among participants on issues related to sexual health, relationships and intimacy, alcohol and drug use, and
* Citations, references, and credits – Calibri, 11pt

7. Methods – Participants and Procedures
One focus group: 13 participants (n=13) ages living in the District of Columbia.
Recruitment: Participants were requested and referred through DC community-based organizations
Protocol: a set of pre-group questionnaires followed by a 2 hour discussion group led by DOH facilitators. Discussion was guided by an agenda. Questions were asked open-endedly, with the opportunity for participants and facilitators to respond, probe, and follow-up. All activities were recorded using a tape recorder.

8. Methods – Data Collection Procedures
Focus group occurred on February 5, 2015
Research staff: two facilitators and one assistant
Location: DOH Conference Room
Data Collection Tools: Questionnaires, audio recorder and facilitator notes
Confidentiality: Confidential data storage and record keeping
Informed Consent: Verbally given by facilitator at the start of the focus group

9. Methods – Data Analysis
2 focus group facilitators for audio recording .
Simplified, emic coding schema. Facilitators focused on the themes and interests of the groups than bring an etic approach to the data.
The pre-group survey questionnaires were likewise coded with a simplified ranking system to again determine the topics adolescents found most engaging and/or important.
After listening and noting overarching themes in the the audio recording of the session, the facilitators compared findings to create categories for text-message content development.

10. Results & Implications for Practice
The coding process yielded six categories for content development:
Symptoms/Not Getting Tested
Discussing Sexual Health
Sex and Drugs
LGBTQ
Condoms
Confidentiality/Privacy/Insurance
The emic coding of the data align with established best practices for youth interventions. A community consultative process as a method may be replicated to develop further youth-focused programmatic strategies.

11. Limitations Small sample size (n=13) of focus group
Gender imbalance in sample size (11 female to 2 male)
As focus group was designed specifically for District of Columbia adolescents, the results may lack external validity.
+ Sample size = 13 students aged 14-18; missed older age bracket between 18-24
+ (11 female to 2 male)
Image courtesy of Dave Gandy, Wikimedia Commons

12. Acknowledgements District of Columbia Department of Health – HAHSTA
Robert Bangert, MSW
Bhupendra Sheoran, MD
Jaime Labrija, MA
Veronica Urquilla, MSW
Yasir Shah, MPH

13. Contact Information:
Michelle Jasczynski
Centers for Disease Control and Prevention
Office for State, Tribal, Local and Territorial Support