ahrq.gov/clinic/uspstfix.htm, through the National Guideline Clearinghouse at http://www.guideline.gov. Evidence-based findings concerning chlamydia screening and treatment of PID contained in the peer-reviewed and scholarly literature.

The additional resources cited at Appendix a will also be consulted.

3. Identify a specific group of people that are being affected by the disease/condition. The screening guidelines published by the USPSTF recommend that the following specific groups of women should be routinely screened, whether or not they are pregnant, if they:

Are sexually active and aged 25 or younger;

Have more than one sexual partner, regardless of age;

Have had an STD in the past, regardless of age; and Do not use condoms consistently and correctly, regardless of age (Screening for Chlamydial infection) a. Explain any unhealthy behaviors that may be contributing to the disease/condition. Some of the unhealthy behaviors that may contribute to the incidence of PID include (1) having multiple sex partners and (2) not using condoms consistently and correctly; I addition, having had an STD in the past also increases the risk of contracting chlamydia which may result in PID (Screening for Chlamydial Infection 2001:1).

b. Explore why this group is experiencing the disease/condition, or why the disease/condition has a higher prevalence rate among the population that you have selected. Given the serious health care outcomes that can result from failing to use a condom correctly and consistently, it remains unclear why so many young unmarried people fail to use condoms. The growing body of research in this area suggests that just a small minority of adolescent females consistently use condoms (Christ, Raszka and Dillon 1998:735). These authors report that just 22%-47% of adolescent females used condoms during their first intercourse, and only 21%-33% currently used them (Christ et al.). Other studies have shown that just one in ten females had actually bought a condom, while other researchers have determined that just over one-quarter (28%) of women used condoms during their most recent intercourse, and only 17% used them more than 90% of the time (Christ et al.). A number of studies have identified reasons why adolescent females may not use condoms correctly or routinely, with the identified factors including:

Negative experience with condoms decreases the likelihood of using condoms again in the future.

There is an association between risk-taking behaviors and inconsistent condom use;

Self-efficacy theory is also relevant to effective condom use, with low self-efficacy among college students contributing to inconsistent condom use (Christ et al.).

c. Specifically, consider the 5 dimensions of access to health care (from BHS-450).

d. Tell me if there is a barrier to access that is preventing the clients from accessing health education/health promotion activities that would mitigate the problem you have identified. There are some interesting and perplexing aspects to the provision of timely and effective preventive care information to the targeted group. On the one hand, it is reasonable to suggest that lower socioeconomic members of this group would be at higher risk of contracting chlamydia or gonorrhea and their associated complications in PID. On the other hand, though, a number of studies have suggested that female college students regardless of socioeconomic status are at high risk as well, making the formulation of a "one-size-fits-all" approach inappropriate. In addition, the provision of heath promotion activities will be facilitated in the case of high school and college students where the audience and appropriate educational support services are already in place compared to community-based educational initiatives.

MODULE 2 - as evidence of progress on your final assignment submit a paper that contains the following:

1. Consider any specific factors that may influence learning in the group you have selected for your health education program. As noted above, infection rates vary from community to community, as well as from group to group, with sexually active girls under the age of 16 years representing one of the groups at highest risk. Therefore, the educational initiatives envisioned herein must be relevant and able to be comprehended by the target audience. Depending on the audience, then, the specific factors that should be addressed would include the need to openly discuss safe sex practices to emphasize the dangers involved in failing to use condoms correctly and consistently. According to Klein and Knauper (2003), "The tendency to avoid thoughts related to sexually transmitted infections (STIs) is associated with communication about safer sex practices and condom use consistency. Many STIs are more easily transmitted from male to female than vice versa. Infection rates for common STIs, such as chlamydia and herpes simplex virus, are higher among women than men" (137). Besides being biologically more susceptible to contracting...

Studies have also shown that young people may be reluctant to discuss safer sex issues because they believe discussion of the topic implies mistrust, infidelity and a lack of commitment to the relationship (Klein and Knauper 138).
In addition, Klein and Knauper note that the tendency to ignore the issue altogether carries some potentially serious consequences: "Individuals may also unconsciously avoid asking questions that are too detailed because they may fear an answer that indicates their partner could pose an STI risk. Becoming aware of partner STI risk may induce individuals to worry that they have already contracted an STI and consequently need to be tested and need to suggest that their partner be tested" (138). These all-too-human reactions to what may be a clear and present danger is perhaps reflective of the extent to which these young people feel they are immortal and are somehow immune from such public health threats. In addition, broaching the subject of condom use and STI transmission might involve changes in behavior that many young people are hesitant to make. As Klein and Knauper point out, discussions of safer sex might "require refraining from unsafe sexual practices. Consequently, individuals are motivated not to discuss issues regarding safer sex practices" (138).

a. Explore whether or not there are any physical/mental / developmental considerations that must be taken into consideration when planning your program.

b. Consider such factors as age, socioeconomic status, or cultural considerations that may influence learning.

c. Address any health literacy concerns that may exist in the group you have selected. According to Mackay (2006), "Increased educational efforts are required to improve physician compliance with STD screening and treatment guidelines, as well as ensure the appropriate use of STD drugs provided. Opportunities are being missed for screening for C. trachomatis among young people, the majority of whom are seen regularly by a physician" (2). The studies to date clearly indicate that many physicians may lack basic, up-to-date factual information necessary to motivate increased chlamydia testing. Such information includes the prevalence of asymptomatic chlamydia infection among young people, its association with PID, screening procedures, and awareness of pertinent chlamydia screening guidelines. There is good reason to conclude that providing physicians with informational packages that fill important gaps in their knowledge is a perquisite to increasing physician testing (Mackay 2006:2).

2. Identify the setting in which your proposed health education/health promotion program will be implemented and supporting rationale.

The educational component of the initiative envisioned herein would take place in the schools, throughout the community and workplaces, and the screening component would take place in community-based health care settings. As noted above, the costs of treating PID each year are staggering, and there are some cost-effective educational programs available as well as low-cost screening techniques that are particularly appropriate for women who are not pregnant and who are at risk for chlamydial infection. In fact, these initiatives, including the cost of the screening, may be less than the cost of treating chlamydia and its complications such as PID in the first place (Screening for Chlamydial Infection, 2001).

3. Identify organizations, groups and/or individuals who may assist in planning, implementation or administration of your proposed health education program.

4. Consider how you would incorporate principles of community organization in the planning of your program.

a. Consider how you would communicate the need for this health education program to whose who will be involved.

5. Select an appropriate health planning model which will serve as the framework for your health education/health promotion program.

a. Explain why this model is appropriate for your health education/health promotion program.

MODULE 3 - as evidence of progress on your final assignment submit a paper that contains the following:

1. Identify the program goals and measurable objectives (remember that your objectives should be behaviorally stated).

2. Identify specific strategies that you will implement in your health education/health promotion program.

It would appear reasonable to conclude that because resources are by definition scarce, it is important to wring every bit of public health good from every available dollar. While abstinence represents the absolute best way to…