Project aims to improve education concerning sexually transmitted infections (STIs) in the teenage patient population of Springfield Health Center Family Practice.  Teenage patients were found to only cite pregnancy prevention, and not STI prevention, when asked by medical providers why they should use condoms.https://scholarworks.uvm.edu/fmclerk/1239/thumbnail.jp

Kostick, Talia

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University of VermontScholarWorks @ UVMFamily Medicine Clerkship Student Projects College of Medicine2016Test Your Knowledge: STI Questionnaire andEducationTalia KostickUVM College of MedicineFollow this and additional works at: http://scholarworks.uvm.edu/fmclerkPart of the Medical Education Commons, and the Primary Care CommonsThis Book is brought to you for free and open access by the College of Medicine at ScholarWorks @ UVM. It has been accepted for inclusion in FamilyMedicine Clerkship Student Projects by an authorized administrator of ScholarWorks @ UVM. For more information, please contactdonna.omalley@uvm.edu.Recommended CitationKostick, Talia, "Test Your Knowledge: STI Questionnaire and Education" (2016). Family Medicine Clerkship Student Projects. Book195.http://scholarworks.uvm.edu/fmclerk/195STI QUESTIONNAIRE AND EDUCATION  Test Your Knowledge Talia Kostick September 2016 Springfield Health Center Family Practice, Springfield VT Family Medicine Rotation (R4) Project Mentor: Dr. Barbara Dalton Problem Identification !  425 teenagers (13 to 19 years old) are currently patients at Springfield Health Center Family Practice !  Teenagers attend various middle and high schools in Windsor County, VT !  The various schools do not have a coordinated sexual health education program !  Some students get exposure to sexual health education starting in middle school, others not until high school !  Dr. Barbara Dalton reports that the majority of her teen patients only cite pregnancy prevention, and not STI prevention, when asked during annual exams why they should use condoms Community Cost !  According the the CDC’s Vermont State Health Profile from 2015: !  Reported rates of Chlamydia in women were 415.8 per 100,000 "  Rate of reported Chlamydia were 2.5 greater than those in men !  In 2013 "  Nearly 500 cases of Chlamydia in women ages 15-19 "  Nearly 600 cases of Chlamydia in women ages 20-24 !  Chlamydia infection can lead to pelvic inflammatory disease, chronic pelvic pain and infertility  Community Perspective !  “We have much more effective methods of birth control than condom usage.  Therefore, the real reason to use condoms is to prevent the spread of Sexually Transmitted Infections.  It is concerning that all these teens I see only reference pregnancy prevention when I ask them them why they should use condoms.”  -Dr. Barbara Dalton !  “If you tell a potential sexual partner that you are on birth control, the likelihood is that you will not use condoms during intercourse.” -Dr. Dolores Barbeau Intervention !  Two page STI questionnaire designed to test patient’s baseline knowledge and stimulate curiosity  !  Answer guide to questionnaire created with current statistics and recommendations !  Samples from questionnaire: " The majority of American teenagers use condoms the first time they have sex.   [!] True   [ ] False   In the US, 68% of females and 82% of males use a condom the first time they have sex . Intervention "  Which of the following STIs are CURABLE with medications?    [!] Chlamydia                [ ] Herpes    [!] Gonorrhea     [!] Genital Crabs   [!] Syphilis     [ ] Hepatitis B   [*] Molluscum Contagiosum   [!] Chancroid   [ ] HPV      [!] Trichomoniasis   [ ] HIV (the virus that causes AIDS)  Chlamydia, Gonorrhea, Syphilis and Chancroid are all bacterial infections and can be eliminated with a course of antibiotics.  However, if treatment is delayed or incomplete, these bacterial infections can cause serious complications such as infertility or neurologic damage.  Genital Crabs are a parasite and can be killed with over the counter lice treatments.  While Trichomoniasis is a parasitic infection, taking a course of antibiotics cures it.  Molluscum Contagiosum is a viral infection that can spontaneously resolve when one’s body clears or fights off the virus.  The lesions from this infection can be treated with laser, freezing, scraping, or chemical removal. Methodology !  All patients ages 13 to 19 are given the questionnaire to fill out when they are taken to the exam room by a nurse !  Patients given answer guide by nurse at end of appointment !  Can be given to patients being seen for an annual exam, birth control, or possible STI !  Patients are reassured that the questionnaire is for their eyes only !  Ideally, patients will compare their answers to those on the answer guide to assess their own knowledge Results !  Quantitative results were difficult to obtain due additional IRB approval necessary to collect data from patients under the age of 18 !  Community response: "  Project met with great enthusiasm from office staff and medical providers "  While teen patients did not appear to fill out the initial questionnaire, they were willing to take the answer guide home with them Evaluation and Limitations !  Evaluation of effectiveness of intervention is nearly impossible given time restraint of project !  Office staff intend to continue distribution of questionnaire and answer guide !  Effectiveness of intervention would be best measured by patients repeating questionnaire at a subsequent visit and a comparison of number of correct answers between first attempt and repeat completion of questionnaire !  Limitations include IRB approval for data collection and short duration of project Future Project !  Time is needed to obtain IRB approval for data collection on project’s target population "  With approval, all patient questionnaires could be collected and data compiled on baseline STI knowledge of the given population !  With an extension of project’s duration "  Effectiveness of intervention could be measured via subsequent questionnaire completion by same patients "  Change in individual knowledge, as well as population knowledge, could be evaluated "  Rates of STI infection in patient population could be tracked and compared to rates prior to intervention References !  Association of Reproductive Health Professionals.  “Health Matters Fact Sheets-Female Condoms.” 2009. http://www.arhp.org/Publications-and-Resources/Patient-Resources/Fact-Sheets/Female-Condom !  Centers for Disease Control and Prevention. “Human Papillomavirus (HPV).” 2016. http://www.cdc.gov/hpv/parents/vaccine.html !  Centers for Disease Control and Prevention.  “Molluscum Contagiosum.” 2015. http://www.cdc.gov/poxvirus/molluscum-contagiosum/treatment.html !  Centers for Disease Control and Prevention. “Parasites-Lice-Pubic “Crab” Lice.” 2013. http://www.cdc.gov/parasites/lice/pubic/gen_info/faqs.html !  Centers for Disease Control and Prevention.  “Vermont-2015 State Health Profile.” 2015. https://www.cdc.gov/nchhstp/stateprofiles/pdf/vermont_profile.pdf !  Centers for Disease Control and Prevention.  “Viral Hepatitis-Hepatitis B Information.” 2016. https://www.cdc.gov/hepatitis/hbv/hbvfaq.htm#D4 !  Holmes, King , Ruth Levine and Marcia Weaver.  “Effectiveness of condoms in preventing sexually transmitted infections.” Bulletin of the World Health Organization.  June 2004; 82 (6): 454-464. Accessed via PubMed.gov. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622864/pdf/15356939.pdf References Continued !  Pinkerton, Steven and Paul Abramson. “Effectiveness of condoms in preventing HIV infections.”  Soc Sci Med.  May 1997; 44 (9): 1303-12.  Accessed via PubMed.gov. https://www.ncbi.nlm.nih.gov/pubmed/9141163 !  Planned Parenthood Federation of America Inc.. “How effective are condoms?” 2016. https://www.plannedparenthood.org/learn/birth-control/condom/how-effective-are-condoms  !  Planned Parenthood Federation of America Inc.. “Ten Little-Known Facts About Condoms from Planned Parenthood.” 2016. https://www.plannedparenthood.org/about-us/newsroom/press-releases/ten-little-known-facts-about-condoms-planned-parenthood !  San Francisco City Clinic.  “All About Condoms.” 2008. http://www.sfcityclinic.org/stdbasics/condoms.asp  !  Sir Richard’s Condom Company.  “Condoms Sizes and How to Choose, Because Size Does Matter.” 2016. http://www.sirrichards.com/about/condoms-101/condom-sizes 

Test Your Knowledge: STI Questionnaire and Education

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