Mobile technology and the Washington, DC, School-based STD Screening Project

Objectives: In response to disproportionately high adolescent Chlamydia trachomatis (CT) and gonorrhea rates in Washington, DC, the DC Department of Health (DOH) and DC Public Schools developed a comprehensive School-based STD Screening Project (SBSP) to increase ease and access, and reduce barriers to STD testing and treatment for District adolescents. Methods: The program included short STD education sessions; voluntary confidential urine tests; free treatment; and optional notification cards to help inform parents or partners. DOH engaged in an iterative process with area youth to produce communications materials, including text messages Pilot year surveying indicated student preference for text message results. All students received promotional print materials; those providing mobile phone numbers opted-in to the text message system. Results: SBSP showed a statistically significant reduced positivity rate, from 9% in the pilot year to 6% (z = 4.11, p<0.0001) in 2009-10. During the 2009-10 academic year, 4,549 students out of 7,013 present at education sessions (65%) submitted urine specimens; 262 STD cases were diagnosed. One-third of students tested (1,524) received text message reminders to call for results. Of the 262 cases, 241 were documented as treated at the time of writing. DOH employees reported high student enthusiasm for the text messaging component. Direct program costs totaled $61,663.82 ($13.55/person, excluding DOH human time-cost). Conclusions: A synthesis of outreach, community involvement, and technology proves successful in reducing CT and gonorrhea prevalence among Washington, DC, adolescents. Future SBSP efforts can leverage partnerships with established area youth text message campaigns and outreach to improve cost-efficiency.

As an intern at the DC Department of Health HIV/AIDS, Hepatitis, STD & Tuberculosis Administration during the course of the SBSP, Megan Jacobs was involved with designing and developing the suite of communications materials, including coordinating the text message component of the program. She also performed the quantitative analysis as part of her Culminating Experience, fulfilling graduation requirements of The George Washington University School of Public Health and Health Services Master's of Public Health degree.