Logic Model for Chlamydia Interventions at the State and Local Level

Background:
The current STD intervention policy in Illinois is largely developed at the local level. The state health department (SHD) provides testing and data resources, but community outreaches and interventions are driven by local health departments (LHD). Varying levels of training, technical skill and resource availability create opportunities for ineffective/inefficient interventions.

Objective:
The purpose of this study is to create a logic model, including Inputs, Processes and Outputs sections, of the current intervention development, implementation and review process and offer an alternative. The objective is the development of a more cost-effective intervention strategy by comparing the existing policy and its limitations to a new policy and its potential benefits.

Method:
Case studies of the STD sections of the state and thirteen LHDs were performed. The logic model for the current policy was created and compared to a comparison model of the proposed policy.

Result:
The proposed model was tested in 2006. An element of geographic information system analysis and Census Bureau data from the state health department was added to the Inputs section. An intervention evaluation for effectiveness was added to the Process (not tested). A cost-effectiveness analysis (CEA) was added to Outputs. LHDs were enthusiastic to utilize the additional Input, and the CEA showed an annual decrease of <2% would make tested interventions cost-effective at most ranges of disease progression and cost.

Conclusion:
The proposed model provides an experimental input for STD intervention and the means to evaluate its effectiveness and worth. This model may also be utilized for other infectious disease intervention development, and as an aid in conserving limited resources.

Implications:
The use of a logic model to create and evaluate an intervention can assist in identifying proper partners, conducting evaluations as needed, and using feedback to alter practices to make them more effective.