In order to increase access to chlamydia screening for young women, CFHC developed the Educational Partnerships to Increase Chlamydia Screening (EPICS) Program in 2007. The program provides funding, training and technical assistance to Title X agencies that operate school based health centers (SBHCs).

SBHCs provide an optimal setting to provide
chlamydia services.

They have direct access to the student population, can provide confidential and low to no-cost services as well as youth-focused prevention counseling, and they allow for easy integration of chlamydia services with other reproductive health care.

During the most recent grant cycle in 2008, the EPICS program expanded to include nine Title X agencies that partnered with a total of nineteen SBHCs, located in high schools and community colleges. Over the course of the year, these agencies provided reproductive health services to almost 4,500 students, 80% of whom were female.

Overall, 88% of students who received services were screened, and chlamydia was diagnosed in 6.3% of females and 6.1% of males screened. The U.S. Department of Health and Human Services’ Healthy People 2010 goal is to reduce positive chlamydia tests for youth to 3 percent. These rates are more than double that. Chlamydia positivity was highest among youth of color, particularly those identifying as Black, Asian, and mixed race, consistent with trends seen in national STD data.

SBHCs have been successful in California.

In order to increase access to chlamydia screening for youth in California, clinic staff at participating SBHCs have implemented innovative clinical, outreach and education programs. The following stories from current EPICS grantees illustrate several of these successful strategies:

Marla Joy, Six Rivers Planned Parenthood

The EPICS grant has proven invaluable to the Humboldt County community. The most significant impact has been our introduction to the tribal reservation in Hoopa, California. It isn’t easy for young men and women to have access to confidential reproductive health care. The local health center isn’t easy to get to and once you’re there you may run into a relative or a neighbor.

Being able to go where the young people are makes all the difference. We serve both the local university and the community college. We arrive with suitcases and brochures every time we visit. We provide small incentives such as condom keychains, glow-in-dark condoms, tote bags with our logo, and popcorn. With music playing in the background, the goal is to create a welcoming and comfortable atmosphere. We offer urine chlamydia and gonorrhea testing, rapid HIV testing, and pregnancy testing and education.

What is wonderful is that young women are not only seeking birth control methods while they are sexually active, but are seeking methods to start before their first sexual debut. Boys are coming in for condoms and testing. Students who are familiar with our services are bringing their peers, so the word is getting out that we are a confidential and trusted agency.

Without the support from the EPICS grant, this service would be virtually impossible. We are building a clientele and a trust that we hope will sustain our services even after the grant expires.

Kathy Mittleider, Kings County Department of Public Health

EPICS is the "bridge" between many students and our clinic. Through EPICS we are able to reach out to a population not able to attend traditional family planning services because they are in school or at work. Through EPICS we provide outreach at the community college and we are able to schedule the students who walk in to our mobile unit for more comprehensive services at our clinic.

Mary Peifer Moore, La Clinica de la Raza

Working to meet the objectives of the EPICS program has opened avenues to improve STI testing as a whole and that includes all of the procedures and protocols that go with it. It became apparent that those clients who fit all the criteria to be tested for gonnorhea and chlamydia also met the criteria for testing for HIV, syphilis, pregnancy in females and in some cases HPV. Our team has developed protocols over the course of the EPIC S grant period to increase all screening, and we have experienced a marked increase in screening over previous years in direct relationship to the expectations of the EPICS program.

Deanna Staags, Delta Health Care

Outreach to males has been one of our most creative EPICS activities. We have sponsored a handball tournament where a session on reproductive health care was the "price of admission" into the draw. We have reached out to athletes during sports physicals and provided them with STI handouts. Our health educator provides one-to-one outreach and counseling to males on chlamydia and STIs. Our male testing numbers have increased significantly this year. We are excited that our male students are taking responsibility and becoming educated about chlamydia.

These stories demonstrate that access to chlamydia screening does not have to happen within a traditional health center, but that alternate settings such as a library or a mobile testing van can be utilized to increase access to services. Furthermore, they demonstrate the importance of implementing creative clinic, outreach and educational strategies that meet youth where they’re at! The models of reproductive health care delivery developed by EPICS sites to ensure access to reproductive health services for youth have been recognized as successful models locally, regionally, and nationally. Given the success of this program in reaching youth, other SBHCs may want to consider implementing confidential school-based chlamydia testing and treatment programs as a part of their comprehensive reproductive health care services.

For more information, please contact Rebecca Braun at braunr@cfhc.org or 510.486.0412 x2327.

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