LBd Performance Evaluation of a Community-Embedded Public Health Investigator Model Compared with a Traditional Public Health Investigator Model: The Los Angeles Experience

Wednesday, March 10, 2010: 4:45 PM
Grand Ballroom C (M4) (Omni Hotel)
Ellen Rudy, PhD1, John Cross, BA2, Frank Ramirez, BA1, Robert Bolan, MD2 and Peter Kerndt, MD, MPH1, 1STD Program, Los Angeles County Department of Public Health, Los Angeles, CA, 2Sexual Health Program, Los Angeles Gay & Lesbian Center, Los Angeles, CA

Background: In 2008 the Sexually Transmitted Disease Program (STDP) of Los Angeles County initiated the Community-Embedded Public Health Investigator (CEPHI) model at a sexually transmitted disease clinic that serves the MSM community as a comprehensive strategy to provide enhanced partner services for newly-diagnosed early syphilis (ES) cases.

Objectives: We evaluated the CEPHI model outcomes for 2009 with the traditional PHI model outcomes for 2007 (before initiation of the CEPHI model) with six performance measures. 

Methods: Performance measures include total number of cases interviewed, time to interview and the ratio of partners elicited per cases interviewed.  Data were extracted from the STD*CASEWATCH Surveillance database system. We present the performance measures and the percentage change in performance measures between the CEPHI model and the traditional PHI model and provide a summary of key strategies attributable to the success of the CEDIS program.

Results: We observed a 20-fold increase in ES cases interviewed within 7 days of diagnosis for the CEPHI compared with the traditional PHI. We observed a 3-fold increase in the ratio of the number of partners located and notified about possible syphilis exposure by the CEPHI (1.63) compared with the traditional PHI (0.56) and an almost 4-fold increase in the ratio of the number of partners preventively treated during the incubation period per new ES case by the CEPHI (0.83) compared with the traditional PHI (0.22). 

Conclusions: The CEPHI program highlights key elements to a successful partner notification program such as strong community collaboration and community trust. 

Implications for Programs, Policy, and/or Research:  Our data indicate we are interviewing cases sooner and eliciting and informing more partners about a possible syphilis exposure with the CEPHI model.  Implementation of the CEPHI program should be considered in settings with high volume STD morbidity.

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