It Takes a Village—Maximizing Opportunities to Screen Adolescents for Chlamydia in School-Based Settings

Background

The highest rates of chlamydia in the United States are among adolescent females. Increasing access to screening for this population is a promising chlamydia control strategy. School-based health centers (SBHCs) may be an effective setting to reach adolescents who may not otherwise present for care at traditional screening venues.

Objective

To increase access to chlamydia screening for adolescent females through comprehensive reproductive services in school-based settings.

Methods

From January to December 2007, eleven SBHCs in California participated in the Educational Partnerships to Increase Chlamydia Screening (EPICS) program, a CDC-funded chlamydia screening program administered by the California Family Health Council, Inc. Clinical, outreach and educational strategies implemented by participating health centers varied, including:

• Routine chlamydia screening for all sexually active students visiting the health center

• Provider training on risk reduction counseling and best practices in chlamydia testing and treatment

• Peer health education programs that include training on chlamydia prevention, testing and treatment

• Participation in classroom and parent presentations, campus health fairs and testing drives

Results

Participating SBHCs provided family planning services to 2671 unduplicated adolescent females. Of these, 2151 females were tested for Chlamydia – a screening coverage of 80.5% (range 43.9% - 100%). Chlamydia infections were detected among 145 of these females, resulting in overall positivity of 6.7% (range 1.9% - 11.3%).

Conclusion

Participating SBHCs were able to establish high screening coverage and detect significant disease prevalence. Targeted clinical, outreach and educational strategies in the SBHC setting are effective in capturing this difficult to reach population.