A COMMUNITY NEEDS ASSESSMENT OF CHLAMYDIA PREVENTION EFFORTS IN THE MONTGOMERY COUNTY, TENNESSEE AREA 公开

Newby, Christina Swann (2015)

Permanent URL: https://etd.library.emory.edu/concern/etds/bg257f91j?locale=zh
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Abstract

According to the Centers for Disease Control and Prevention, one of the most commonly reported sexually transmitted diseases in the United States is chlamydia. It is one of the major causes of tubal infertility, ectopic pregnancy, pelvic inflammatory disease, and chronic pelvic pain. Screening for this infection is vital for its prevention and control. Chlamydia is of great public health importance in Montgomery County, Tennessee. Chlamydia rates have increased drastically over the past several years. In 2011, there were 1,337 cases reported. By 2014, this number grew to 1,834 cases. The case incidence was 758 per 100,000 in 2011 but has increased 20% since then. Currently, Montgomery County ranks among the worst in the state for STDs (91st out of Tennessee's 95 counties).

Through an in-depth study using interviews with key informants and secondary data, this chlamydia infection prevention needs assessment will seek to 1) catalog existing chlamydia infection prevention efforts and resources in the Montgomery County, Tennessee area; 2) Investigate Montgomery County and surrounding area public health professionals' knowledge of, perspectives on, beliefs about, and barriers to use of chlamydia infection prevention measures; and 3) recommend and suggest additional measures to prevent, as well as reduce, chlamydia rates in the Montgomery County community using a social ecological approach. The aim of answering these specific questions is to provide chlamydia prevention practitioners at multiple levels of influence with a full scope and context of existing chlamydia prevention efforts in the community to further create a comprehensive framework for reducing the rates of chlamydia infections throughout the area.

Given the range of chlamydia infection challenges at all levels of influence, evidence-based recommendations for reducing the rate, as well as the burden of disease in the Montgomery County community are outlined. Where appropriate, recommendations are tailored to more specially address challenges to provide local chlamydia control practitioners with a comprehensive framework for reducing chlamydia infections in their area.

Table of Contents

TABLE OF CONTENTS

EXECUTIVE SUMMARY………………………………………………………………………i

CHAPTER 1: INTRODUCTION……………………………………………………………….1

Rationale for Community Needs Assessment……………………………………………..1

Purpose Statement…………………………………………………………………………5

Statement of Significance……………………………………………………………...….6

Montgomery County, Tennessee………………………………………………......7

Community Needs Assessment………………………………………………….....8

Social Ecological Approach………………………………………………………8

Summary…………………………………………………………………………………..9

CHAPTER 2: REVIEW OF THE LITERATURE…………………………………………..10

Chlamydia in Montgomery County……………………………………………………,..10

Chlamydia Prevention…………………………………………………………………...21

Chlamydia Treatment……………………………………………………………………23

Current Chlamydia Control Efforts………………………………………………….…..24

Barriers and Related Risk Factors……………………………………………………….33

Summary…………………………………………………………………………………36

CHAPTER 3: METHODOLOGY…………………………………………………………….37

Research Design…………………………………………………………………………37

Key Informant Interview Methodology…………………………………………..37

Secondary Data Sources…………………………………………………………38

Limitations……………………………………………………………………………….38

Summary…………………………………………………………………………………39

CHAPTER 4: RESULTS……………………………………………………………………....40

Key Informant Interview Findings………………………………………………………40

Secondary Data Findings………………………………………………………….……..48

Summary…………………………………………………………………………………51

CHAPTER 5: CONCLUSIONS, IMPLICATIONS, AND RECOMMENDATIONS……..52

Recommendations……………………………………………………………………….53

General Limitations………………………………………………………………...……58

Continued Improvements………………………………………………………………...59

REFERENCES……………………………………………………………………………….....60

APPENDIX A: CONSENT FORM………………………………………………………...….66

APPENDIX B: KEY INFORMANT INTERVIEW GUIDE……………………………...…69

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