Evaluating and Improving STD Prevention Program Performance

Program Science goes beyond translating research findings into program implementation (Implementation Science) through the continuous monitoring and evaluation of the appropriateness and efficiency of interventions. This assures that limited resources are optimized through changes and improvements in the intervention or intervention mix. On-going evaluation allows programs to identify when interventions are not working, and to adapt or discontinue interventions as the epidemiology changes or as there are shifts in the social, cultural or economic context. This helps ensure that prevention efforts are appropriately targeted, successful and continuously improving. For example, chlamydia screening of high school girls has identified a high prevalence of infection and successfully treated a substantial number of infections in a number of communities in the United States. When implemented in San Francisco, however, few infections were identified for the number and proportion of students screened. Quick analysis of basic demographic and test data highlighted what would be required to make the intervention more successful, which was not feasible in San Francisco. Thus, an effective intervention successfully implemented in another setting might not be effective in the new setting. Evaluation and monitoring need not be complex to be useful. The collection of basic data and simple, descriptive, routine analysis of it, can aid programs in directing their limited resources most effectively.