Region II IPP Data & Infrastructure Performance Measures

1. Region II IPP Data & Infrastructure Performance Measures Kelly Opdyke, MPH Region II IPP Advisory Committee Mtg May 16-17, 2007 Cicatelli Associates Inc.

2. Region II IPP Workplan, 2006-2007 • PRIORITY 2: Incorporate Analysis of Regional Prevalence Monitoring Data for Regional and Local Data-Directed Planning and Quality Assurance • GOAL: IPP data will direct the most cost effective implementation of screening and treatment funds. • OBJECTIVE 2B: Identify what percentage of eligible women are being screened on an annual basis among select sites participating in the Region II IPP.

3. Region II IPP2005 Screening “Audit” Purpose: • Estimate chlamydia screening coverage among eligible female patients according to Region II IPP minimum screening criteria • Pilot regional methodology for assessing screening coverage and adherence to screening criteria in anticipation of CDC proposed measures of effectiveness

4. Region II IPPMinimum Screening Criteria Title X Family Planning Clinics • All women ≤ 24 years of age attending the clinic for an initial or annual visit will be screened for chlamydia. STD Clinics • All women ≤ 29 years of age attending the STD clinic will be screened for chlamydia.

5. FP Screening Coverage(Expected 85%)

6. Implications/Discussion • Region II IPP minimum screening criteria for FP include only those women who have an initial or annual (i.e. pelvic) exam • In the past, chlamydia testing required the collection of a cervical specimen. • Highly-sensitive urine-based NAATs (nucleic acid amplification tests) provide an opportunity for expanded screening to additional high-risk clients.

7. Percent of Ct Tests Reported as NAATRegion II IPP, 2004-2006

8. Current Use of Urine Specimen forCt Testing Among FemalesRegion II IPP, CY2005

9. Current Use of Urine Specimen forCt Testing Among FemalesRegion II IPP, CY2006

10. Region II IPPStrategic Plan 2005-2009 • PRIORITY 1: Target/Expand Chlamydia Screening to Young Sexually Active Women and Men at Risk for Infection in Public and Private Settings. • GOAL: All at risk men and women under the age of 25 will be screened at least annually. • OBJECTIVE 1C: By December 2007, decrease routine CT and GC screening by 50% in women >30 years of age in FP clinics where the prevalence of CT is less than 2%.

11. Screening Trends inFP Clinics, Region II IPP N (2003) = 46,077 22,691 41,609 4,684 2,030 117,091 N (2004) = 36,825 21,995 26,050 6,503 2,019 93,392 N (2005) = 47,542 20,871 95,957 7,054 966 172,390 N (2006) = 48387 14,388 101,880 6,710 800 172,165

12. Chlamydia Positivity Among Females Age 30+ Yrs in FP Clinics

13. 2007 Regional IPP Infrastructure Performance Measures Measure 1: Screening Coverage in FP Proportion of female Family Planning users screened for chlamydia, by age group • Data Source: FPAR Tables 1 & 11 Measure 2: Test Utilization Proportion of chlamydia tests conducted on females, stratified by age group • Data Source: IPP Prevalence Monitoring Data

14. IPP Infrastructure PM 1:Estimated Ct Screening Coverage

15. IPP Infrastructure PM 1:Estimated Ct Screening Coverage Proportion of Female Family Planning Users Screened for Chlamydia, by Age Group, 2006 FPAR

16. IPP Infrastructure PM 2:Chlamydia Test Utilization