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A GONORRH EA INTERVENTION PROGRAM BY:
Sam M agl in ao
Paige H u ffm an
Dal e Tu r n er
Pau l M el ch ior r e
Al exis Lin dsey

HPEB 300-Sect ions 003 & H10

Winningham

ACKNOW LEDGEMENTS
We at Check Yourself Before You Wreck Yourself would like to thank and
acknowledge the following people and organizations without whom we could not
and would not have a successful program. Thank you for all of your donations, time,
energy and care for our mission to raise the rates of STI testing throughout the
campus of the University of South Carolina.
First we would like to thank all of the lab technicians and professionals from
The South Carolina HIV/ AIDS Council who came to support our event. Our program
would not be possible without the mobile lab and the skilled technicians
administering STI tests to our students. Thank you for showing as much care and
consideration for our students as we do.
We would also like to recognize Bedsiders for their donation of 3,000 condoms
and partnering with us,to ensure our program is both efficient and successful. We are
so humbled to have a national organization aimed at reducing STI and pregnancy
rates working with us and not only educating our students but us at Check Yourself
Before You Wreck Yourself (CYBYWY) as well.
A special thank you to National Pan-Hellenic Council Sororities (Alpha Kappa
Alpha Inc., Delta Sigma Theta Inc., Sigma Gamma Rho Inc., Zeta Phi Beta Inc.) for
allowing us to speak at your chapter meetings and help encourage young African
American women to practice better STI screening habits. Additionally, we would like
to thank Savvy and the Association of African American Students for acting as our
gatekeeper and their support through the planning process. Without the support
from your organizations we would not have been able to reach nearly as many
students.
Thank you to the University of South Carolina Thompson Student Health Center
Sexual Health Office and the Office of Multicultural Student Affairs (OMSA) for your
great help with education and promotion (respectively). We would also like to give
an honorable mention to the University of South Carolina Student Government for
approving and allowing us to implement our program
For financial support we would like to especially thank the Centers for Disease
Control and Prevention and Tell Them South Carolina. Both organizations have long
been committed to the reduction and prevention of the spread of diseases and
increasing quality of life for all.
Thank you too, to all our student volunteers for their time and hard work,
Russell House for providing us with a venue, all the members of CYBYWY and all
others who have donated their time and energy to our program.

TABLE OF CONTENTS
PROGRAM RATIONALE

NEEDS ASSESSM ENT

M ISSION STATEM ENT,GOALS,

AND OBJECTIVES

10

IM PLEM ENTATION

11

PROGRAM RESOURCES

14

PROGRAM M ARKETING

16

FLYER ON PAGE 17

PROGRAM BUDGET

18

PROGRAM EVALUATION

20

REFERENCES

21

PROGRAM RATIONALE
H EALTH OVERVIEW :
Neisseria gonorrhoeae, more commonly known as gonorrhea, is the
second most common sexually transmitted infection (STI) in the United
States. Gonorrhea can be transmitted through unprotected sex and can
cause infections in the genitals, mouth, and rectum (Centers for Disease
Control and Prevention [CDC], 2015a). Although gonorrhea is curable, it is
becoming increasingly resistant to typical antimicrobial treatments,
making gonorrhea treatments increasingly more difficult.
The national rate of gonorrhea cases has been steadily increasing. In
2013 the CDC reported that there were 105.3 cases per 100,000 people.
In 2014 that number increased to 110.7 cases per 100,000 people. The
CDC also found that the greatest number of cases were in the age group of
18-24 and among African Americans (CDC, 2015b).

Figure 20. Gonorrhea ? Rat es of Report ed Cases by Race/ Et hnicit y, Unit ed St at es, 2010?2014

Our home state of South Carolina also sees an increase in cases

among young adults and African Americans as well. African Americans
made up 57% of the total number of reported cases in South Carolina in
2014. Those aged 18-24 accounted for 57% of reported cases in 2014 as
well. Richland County, which includes the University of South Carolina, has
the highest rate of gonorrhea cases in the state (South Carolina
Department of Health and Environmental Control [SCDHEC], 2014) .
4

PROGRAM OVERVIEW :
Check Yourself Before You Wreck Yourself is an STI screening intervention program
that specifically targets African American women at The University of South Carolina
between the ages of 18 and 24. If left untreated, especially in women, gonorrhea can lead
to Pelvic Inflammatory Disease (PID) and increase the risk of tubal infertility and ectopic
pregnancy (CDC, 2015a). The goal of Check Yourself Before You Wreck Yourself (CYBYWY),
is to educate students about the importance of getting screened for STIs, increase the rates
of students getting screened, and to reduce the stigma associated with getting screened.
Our intervention aims to provide students a safe environment where they can feel
comfortable getting tested for STIs. In addition to the safe environment, we also strive to
keep this event fun and educational for the students while they?re getting screened by:
providing educational booths, food, prizes, condoms and much more. Through our program,
CYBYWY, we will allow USC students the opportunity to get screened for gonorrhea for
absolutely no cost. Although our primary population is African American women ages
18-24, we will open our program to all of USC?s student population; however, we will
primarily be marketing to our target group. Our program's marketing strategies will
include:
-

Partnering and promoting with on-campus offices, relevant to our population (e.g.
Office of Multicultural Student Affairs (OMSA), National Pan-Hellenic Council (NPHC)
Sororities, Association of African American Students, Savvy, etc.) .
Having a day of tabling on Greene Street during OMSA?s Hip Hop Wednesday to
continue marketing specifically to our priority population.
Advertising the event over the University?s radio station.
Grassroots mobilization through handing out flyers at on and off campus student
housing facilities.

PROPOSAL:
In order to carry out our goals, Check Yourself Before You Wreck Yourself is requesting
financial support from the Winningham Foundation. In total, our intervention is projected
to cost approximately $56,000, however, we are not asking the foundation to support in
full. Over the previous months our program has received grants and donations from various
foundations. Tell Them SC, a state-run program advocating for safe reproductive access and
habits, has granted us $20,000 towards our initiative. We have also been given a $2,000
grant from Bedsiders, an organization that actively promotes safe sex through education,
along with a donation of 3,000 Trojan Condoms. Lastly, as a reward for competing and
winning an intervention program planning contest, we were rewarded $5,000 from the
Centers for Disease Control and Prevention. We are asking for a grant of $30,000 from the
Winningham Foundation to further assist us in implementing our program.
According to the CDC (2013), gonorrhea accounts for about $574,000 a year spent
on health care. By making a donation to CYBYWY, The Winningham Foundation can help
make a substantial impact in both the rate of incidence and cost of gonorrhea annually. We
have learned from the Winningham Foundation, ?Knowledge is important, but not
sufficient for behavior change.? However, with proper support, we can provide the
resources to instill permanent behavior changes in our priority population that will carry
5
on to future generations.

NEEDS ASSESSMENT
OVERVIEW OF TH E H EALTH PROBLEM
Gonorrhea is the second most common sexually transmitted infection (STI) in the
United States. Gonorrhea can be transmitted through unprotected sex and can cause
infections in the genitals, mouth, and rectum. If left untreated, gonorrhea can lead to Pelvic
Inflammatory Disease (PID) and increase the risk of tubal infertility and ectopic pregnancy in
women. From 2013 to 2014, the national rate of gonorrhea (per 100,000) has increased from
105.3 to 110.7. The most commonly reported cases of gonorrhea are in African American
men and women aged 15-24 years (CDC, 2015b).

POPULATION AFFECTED
In 2014, the CDC noted that people aged 20-24 had the greatest number of
gonorrhea cases among one age group (CDC, 2015c). In regards to race, gonorrhea is most
prevalent among African Americans. The rate of African American cases is 405.4 per
100,000 people (CDC, 2015b). In the state of South Carolina, African Americans accounted
for 57% of reported gonorrhea cases in 2014. Richland County, which includes the
University of South Carolina, has the highest number of reported gonorrhea cases in the
state (SCDHEC, 2014).

TARGET GROUP
Our program will target young adult, African American women at the University of
South Carolina between the ages of 18 and 24.

Figure 18. Gonorrhea ? Rat es of Report ed Cases Among Women Aged 15?44 Years by Age, Unit ed
St at es, 2005?2014

RISK FACTORS
BEHAVIORAL
-

According to Manhart et al. (2004), common risk factors for gonorrhea are
"young age, African American race, low socioeconomic status, early onset
of sexual activity, single marital status, [and] a history of prior gonococcal
infection" (p. 394).
Manharet et al. (2004) also found that prevalence of gonorrhea among
African Americans may be attributed to choosing partners of the same
race, which would cause more exposure to the STI (p. 395).
Being sexually active
Having multiple sexual partners
Having unprotected sex
Neglecting to get tested regularly
ENVIRONMENTAL

In the Voisin, Salazar, Crosby, & DiClemente (2013) study, "a significant
portion of [the] participants lived in low income communities" (p. 360).
College culture normalizes promiscuous sexual behavior.
It also promotes a negative stigma towards getting tested for STIs.

PRIORITIZATION M ATRIX

PREDISPOSING, ENABLING, AND

REINFORCING FACTORS

STEERING COM M ITTEE:

1. A student who has or has had gonorrhea would have valuable
input due to their experience with the infection.
2. Director of the Sexual Health Office would be a sponsor to the
program and a resource for information.
3. Members from each NPHC sorority.
4. University of South Carolina Student Government officer, would
have access to all of USC?s student organizations, as well as
planning the budgets allocated to each.
5. USC students, specifically ones that are African American,
women, and between ages of 18-24.
6. Representative from Association of African American Students
(AAAS) as a gatekeeper to the African American community at
USC.
7. Representative from the Office of Multicultural Student Affairs
(OMSA) to help provide input about reducing stigma of getting
tested.
8. Ourselves. We have a vested interest in seeing this program be
successful and would lead the planning, implementation, and
evaluation process.
9. Winningham Foundation, for funding and other financial support.
10. Bedsiders, Tell Them SC, and SC HIV/ AIDS Council
representatives.
9

MISSION STATEMENT, GOALS,

AND OBJECTIVES
M ISSION STATEM ENT:
Our mission is to inform and provide students the necessary information
on how, where, and why to get tested for gonorrhea in order to increase
screening rates among college students, as well as inspire students to
remove the negative stigma associated with getting tested for sexually
transmitted infections.

PROGRAM GOALS:
1. Educate students about the importance of testing.
2. Increase rates of STI testing on USC?s campus.
3. Eliminate stigma associated with getting tested.

PROCESS OBJECTIVES:
1. By May 1, 2016, program planners will have secured a time and location
for screenings
2. By January 1, 2017, program planners will have held two days of free
gonorrhea screenings.

LEARNING OBJECTIVES:
1. Upon completion of the program, 75% of program participants will be
able to identify the importance of STI screening.
2. Upon completion of the program, 90% of participants will be able to
name at least one STI testing site.

BEH AVIORAL OBJECTIVE:

1. Upon completion of the program, 50% of program participants will report
being tested
10

IMPLEMENTATION
INTERVENTION TH EORY
We selected the Health Belief Model to center our intervention program around because
the constructs of this model address the factors that contribute to college students not
getting tested for STIs (e.g. gonorrhea). There are three main factors that the Health Belief
Model depends on to be happening simultaneously in order to be successful. The three
factors according to McKenzie, Neiger, & Thackeray (2013) include:
1. The existence of sufficient motivation (or health concern) to make health issues
salient or relevant.
2. The belief that one is susceptible to a serious health problem or to the sequelae of
that illness or condition.
3. The belief that following a particular health recommendation would be beneficial in
reducing the perceived threat, and at a subjectively acceptable cost (p. 173-174).
According to Barth, Cook, Downs, Switzer, and Fischhoff (2010), college students attributed
the negative consequences of testing and perceived vulnerability to infection to be the
main reasons for not getting tested.

11

H EALTH BELIEF M ODEL

12

KICK-OFF:
We will bring in a local DJ for Hip-Hop Wednesday and he will promote
our program throughout the day as we table on Greene Street and hand out
free prizes and flyers.

M ATERIALS, PERSONNEL, AND SPACE:

MATERIALS
-

5-8 tables
250 brochures
Condoms
Chairs to be used as needed
Mobile medical lab
Food and drinks from Chick-fil-A
Paper plates, cups, napkins and cutlery
Tables cloths
T-shirts
Keychains
Carolina Card Scanner
PERSONNEL

We will need student volunteers to table and promote the program on

Greene Street during Hip Hop Wednesday (3-4 volunteers)
Representative from the Sexual Health Office for educational purposes (2)
Volunteers to help run the testing clinic and direct participants to the
program (10-20)
Lab technicians (5)
Professionals from South Carolina HIV/ AIDS Council (3-4)
Volunteers to run the refreshments table (3)
Bedsiders representatives (2)
Volunteers to help disassemble the lab and clean-up after the event (5)
SPACE

A tabling spot on Greene Street to promote our intervention program

Russell House Ballroom will be needed to host screenings
13

PROGRAM RESOURCES
INTERVENTION
The intervention will be designed to run through a program created by the
South Carolina HIV/ AIDS Council using their education specialists and mobile
testing clinic. The program planners will be in charge of acquiring all of the
necessary resources, securing the venues, and making sure the program staff is
well-trained and prepared. To kick off the program, we will need three to four
student volunteers to table and promote the program on Greene Street during
Hip Hop Wednesday at USC.
To conduct the program, we are requesting two representatives from the
Sexual Health Office to serve as educators. Three to four professionals from the
South Carolina HIV/ AIDS Council, along with volunteers, will conduct testing
and set up the mobile lab. Two representatives from Bedsiders will also serve
as educators. The organization simultaneously educates women on pregnancy
prevention and safe sexual activities. Representatives from the Sexual Health
Office, Bedsiders, and the SC HIV/ AIDS Council will serve on our planning
committee. We would manage the program and guide participants through the
event.
We will be using volunteers to operate the testing clinic and to direct
participants to the testing site. Ten to twenty volunteers will be assigned to
these responsibilities. Within the mobile clinic we will have five lab
technicians. Three volunteers will be needed to run the refreshments table, and
five volunteers will help disassemble the lab and clean-up after the event.

STAFF
-

Program Planners: Book venue, hire mobile lab technicians and

volunteers, set up testing, table on Greene Street, evaluate program.
Volunteers (10-20): Promote program by tabling, set up information
booths at event, register patients, be general help at event, clean-up.
Lab Technicians (5): Conduct testing , will follow HIV/ AIDS Council
program.
Representatives: Will participate intermittently as they see fit. They will
be from Bedsiders, Sexual Health Office, Tell Them SC, and SC HIV/ AIDS
Council, and whoever else invests stock in the program.
14

TIM EFRAM E

15

PROGRAM MARKETING
Our program will aim to have at least 300 tests (150 per day) and
at least 1,000 participants (500 per day).
We will recruit through:
- Grassroots mobilization by handing out flyers at on and off
campus student housing and on Greene Street
- Social media will also be utilized by posting useful
information and program dates and times
- Promotional ads on the student-run radio station
- Advertising to fraternities and sororities at chapter meetings,
especially the four NPHC sororities
- Hip Hop Wednesday kick-off
Incentives will include:
- Condoms: Participants may take as many as they like
- Bottle opener keychains: Will be prizes for trivia/ attending
booths
- T-shirts: Will receive after getting tested
- Candy: Will be passed out at booths
- Free Chick-fil-A: Will be given to people who complete the
booth circuit

16

PROGRAM BUDGET

18

19

PROGRAM EVALUATION
DURING PROGRAM :
-

How closely are we following the timeframe?

How successful has booking the venues been?
Are our promotional tools effective? How many students have said they
will attend?
How many people from our priority population have been reached?
Should we alter our marketing approach?
Should we speed up or slow down our planning?
Are we sticking to our budget?

PROCESS EVALUATION:
-

Volunteer satisfaction survey. Did they enjoy spending their time helping
with the program?
Participant relevancy and interest poll
Talk with professionals/ lab technicians to see how our program compares
to others in terms of success and participation
Was the estimate for supplies/ equipment accurate? Was there an
overestimation? Underestimation?
Finalize total costs and compare to initial budget estimate.
Did we follow our timeframe?
Learn from first day of testing and make necessary adjustments to second
day

IM PACT EVALUATION:
-

Count the number of students who were tested by number of tests

administered
Track the number of students who came to the event through the use of
the Carolina Card scanner
Poll students before and after the event about: knowledge of
gonorrhea/ STIs and local resources
Send online survey to USC student body about STI knowledge, sexual
activity, and screening habits before and after the event
20

References
Barth, K. R., Cook, R. L., Downs, J. S., Switzer, G. E., & Fischoff, B. (2002). Social stigma and negative
consequences: Factors that influence college students' decisions to seek testing for sexually
transmitted infections. Journal of American College Health, 50(4), 153-159.
Centers for Disease Control and Prevention. (2013, February). Estimates of sexually transmitted
infections in the united states. Retrieved from http:/ / www.cdc.gov/ std/ stats/
sti-estimates-fact-sheet-feb-2013.pdf
Centers for Disease Control and Prevention. (2015a, November 17). Gonorrhea. Retrieved from
http:/ / www.cdc.gov/ std/ stats14/ gonorrhea.htm
Centers for Disease Control and Prevention. (2015b, November 17). Table 22A.
Gonorrhea-Reported cases by race/ ethnicity, age group, and sex, United States, 2014.
Retrieved from http:/ / www.cdc.gov/ std/ stats14/ tables/ 22a.htm
Centers for Disease Control and Prevention. (2015c, November 17), Table 21. Gonorrhea-Reported
cases and rates of reported cases by age group and sex, United States, 2010-2014. Retrieved
from http:/ / www.cdc.gov/ std/ stats14/ tables/ 21.htm
Manhart, L. E., Aral, S. O., Holmes, K. K., Critchlow, C. W., Hughes, J. P., Whittington, W. L. H., & Foxman
, B. (2004) Influence of study population on the identification of risk factors for sexually
transmitted diseases using a case-control design: The example of gonorrhea. American
Journal of Epidemiology, 160, 393-402. doi: 10.1093/ aje/ kwh220
McKenzie, J R., Neiger, B. L., & Thackeray, R. (2013). Planning, implementing, and evaluating health
promotion programs: A primer (6th ed.) Glenview, IL: Pearson.
South Carolina Department of Health and Environmental Control. (2014). South Carolina's
STD/ HIV/ AIDS Data Surveillance Report. Retrieved from http:/ / www.scdhec.gov/
Health/ docs/ stdhiv/ data/ sr2014.pdf
Voisin, D. R., Salazar, L. F., Crosby, R., & DiClemente, R. J. (2013). The relationship between ethnic
identity and chlamydia and gonorrhea infections among low-income detained African
American adolescent females. Psychology, Health and Medicine, 18, 355-362.
http:/ / dx.doi.org/ 10.1080/ 13548506.2012.72631.