Background:
In 2001, The Philadelphia Department of Public Health (PDPH) in partnership with The School District of Philadelphia, established a citywide High School STD Screening Program (HSSSP) in an effort to reduce STD infections among adolescents. Data from this program can provide public-health officials with descriptive process information for the planning and implementation of a large-scale, high school STD screening program.

Objective:
To describe the processes and resources associated with the implementation of a HSSSP in public high schools.


Method:
Direct observations, interviews of key program staff, and positive test rates for chlamydia and gonorrhea were collected for process evaluation. Descriptions of input resources include: personnel time, clerical support, materials, equipment, laboratory testing, transportation, treatment and follow-up, and partner notification. Additionally, school characteristics, and staffing interaction and structure will be included as indicators in process evaluation.

Result:
Two staff teams of four were utilized for school visits and STD education presentations. Each year the teams visited over 50 high schools and presented to approximately 30,000 students, with approximately 60 students per presentation. Preliminary observations indicated the process was most efficient and participation rates highest in schools with greater cooperation and organization of faculty, as well as schools having a minimum of 3-4 restroom stalls available in each restroom.

Conclusion:
Implementation of this extensive program requires substantial programmatic commitment, investment, and support from schools, health department staff, and other stakeholders. However, when effectively coordinated and implemented, the program can identify and efficiently treat large numbers of infected adolescents.

Implications:
Important implications of this large-scale, high school based STD screening program are its feasibility and overwhelming acceptance, as demonstrated through the active participation of the students. The information presented can help maximize efficiency and participation rates when planning for similar screening programs.