 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
|
| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Kwa Abakah Sey, MPH, School of Public Health. Department of Community Health Sciences, UCLA, 600 S. Commonwealth, Suite 1920, Los Angeles, CA 90005, 213 351 8199, esey@dhs.co.la.ca.us and Donald Morisky, ScD, Department of Community Health Sciences, School of Public Health, University of California, Los Angeles, 650 Charles E. Young Drive South, CHS 26-070, Los Angeles, CA 90095-1772.
Background/Objectives: Although the goal of STD interventions is to reduce STD incidence, their evaluation is often limited to behavior change. This analysis evaluates the effect of four risk-reduction interventions in terms of the number of potential chlamydial infections averted.
Methods: Commercial sex establishments in four Philippines cities were randomly assigned to one of four intervention groups. Self- reported STD risk behavior among 2 cross-sections of 1383 and 1484 commercial sex workers employed in these establishments was assessed at baseline and post-intervention for significant changes in STD risk behavior. A Bernoulli mathematical model was used to translate self-reported STD risk behavior change into potential chlamydial infections averted. Sensitivity analyses were conducted to assess how changes in chlamydia prevalence, affected the estimates of chlamydial infections averted.
Results: Significant reductions in STD risk behavior were observed in the manager support and combined peer and manager support groups. Based on a chlamydia prevalence estimate of 5.6%, and an intervention group size of 1000, the changes in STD risk behavior among the control, peer education, manager support, combined peer education and manager support groups represented -37, -0.07, 35 and 65 averted infections respectively. Sensitivity analysis demonstrated that for any given behavior change, the prevalence of chlamydia significantly impacted the number of potential infections averted.
Conclusions: Evaluations based exclusively on behavior change are inadequate representations of intervention impact. Evaluations must include impact indicators, such as potential averted infections, that account for influential population parameters like STD prevalence.
Learning Objectives:
Keywords: Evaluation, Interventions
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.