Using DIS to Gain a Neighborhood Perspective for Syphilis Elimination Activities

Background:  Marion County, Indiana is currently experiencing a syphilis outbreak.  Syphilis elimination principles stress the importance of working with the community to plan and implement interventions.  It is sometimes difficult to identify and engage persons who represent affected communities.  Marion County Public Health Department lacked a true neighborhood perspective with which to plan interventions.

Objectives:  To utilize the unique skills and knowledge of the Disease Intervention Specialists (DIS) to conduct a street-level assessment of neighborhoods with the highest density of syphilis cases in Indianapolis.  To search for new ways to gain access to and build working relationships with gatekeepers and persons at highest risk for syphilis.

Methods:  DIS were given hot zones in various sections of Indianapolis and worked in teams in their assigned areas.  For a two-week period, DIS canvassed the areas on foot and spoke with community members about their neighborhoods and how to better serve those in the hot zone.  Venues for screening or outreach, key providers and gatekeepers were identified by residents.

Results:  The DIS prepared findings of their neighborhood assessments, chose their highest priority intervention, and made presentations to all clinic staff.  Previously unknown information was given to DIS by community members that would not have been shared without this neighborhood assessment. 

Conclusions:  Using the DIS at a local STD program to gain a street level perspective by engaging residents in identified neighborhoods can identify unknown gatekeepers, community partnerships, and venues for potential testing.  Additionally, this activity can engage the DIS in syphilis elimination program planning.

Implications for Programs, Policy, and Research:  Community engagement is vital to the success of public health interventions.  STD programs may find it beneficial to utilize DIS to obtain a better understanding of the communities they serve.  This also may build skills among DIS by giving them an opportunity to participate in planning, implementation and evaluation of interventions.