142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

301692
Enhancing Access to Clinical Services during a Syphilis Outbreak: Effective Use of Mobile Clinic Services

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 9:15 AM - 9:30 AM

Michael Thomas, BS Microbiology; MPH Public Health , Bureau of Nursing Services, Houston Department of Health and Human Services, Houston, TX
Algia Hickenbotham, MEd, RN-BC , Division Manager, Nursing and Health Center Operations, City of Houston, Department of Health and Human Services, Houston, TX
Carolyn Mitchell, RN, BSN, Chief Nurse , HDHHS Community Health Services, Houston Department of Health and Human Services, Houston, TX
Natur Brooks, MS, RN, WHNP-BC , HDHHS Community Health Services, Houston Department of Health and Human Services, Houston, TX
Lupita Thornton, STD Program Manager , Bureau of HIV/STD and Viral Hepatitis Prevention, Houston Department of Health and Human Services, Houston, TX
The Houston Department of Health and Human Services utilizes mobile STD clinics to provide STD services in non-traditional settings. The Department’s success in providing comprehensive Mobile STD services at venues where high risk populations frequent, resulted in a common phrase used by individuals seeking STD care, “Where Can I find The Mobile Clinic Today?”

The Mobile Clinic Team utilizes evidenced-based policies, including case-related screening, a CDC approved activity, to provide STD services for marginalized and underserved populations at risk for STDs- thus significantly reducing health disparities related to access to care. 

During a recent syphilis outbreak among Men Who Have Sex with Men (MSM) in Houston Texas, access to STD services and low service utilization presented a challenge as syphilis morbidity rates soared. The targeted population, MSM, demonstrated minimal interaction with traditional free-standing STD clinics.  

Mobile STD clinical services provided during the outbreak allowed the Health Department to develop and maintain infrastructure for accessible STD services. Management observed the following outcomes during the Syphilis Outbreak Response period (8/26/12 thru 6/30/13) and the post outbreak period (7/30/13 to 12/31/13):

Clinic attendance: Increased 22% during outbreak; 15% increase post outbreak. 

Syphilis test conducted: Increase 29% during outbreak; 11% increase post outbreak.

Positive syphilis tests identified: Increased 37% during outbreak; 135% increase post outbreak. 

Clients treated for early syphilis: Increased 85% during outbreak; 40% increase post outbreak.    

Mobile STD clinical services enabled health providers to address an increase in syphilis cases and to develop infrastructure that increased access to clinical care.

Learning Areas:

Administer health education strategies, interventions and programs
Administration, management, leadership
Clinical medicine applied in public health
Diversity and culture
Provision of health care to the public
Public health or related nursing

Learning Objectives:
Describe innovative strategies using Mobile Clinic operations to improve access to STD Clinical services. Discuss best practices for STD clinics, program leadership and evaluation. Explain best practices to provide STD clinical services in a mobile or field" setting". Identify STD policies and/or clinical practices that expedite, enhance, or otherwise improve delivery of STD services.

Keyword(s): Accessibility, Public Health Infrastructure

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have 30 years of experience as a Public Health Advisor working with the Centers for Disease Control and Prevention STD Prevention Program. During this time, I have been assigned to state and local health departments and provided technical expertise to program and clinical staff on routine and innovative STD interventions. I am responsible for developing, implementing, and monitoring/assessing STD/HIV intervention programs. I earned a B.S. in Microbiology and a MPH from Emory University.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.