Chlamydia in the Youth of

Leon County, Florida

By: Annie Brownfield, Emma Grace Goodrum,
Julie Ann Howard, and Josephine Morrissey
Intervention Overview
Mission Statement: Our program’s mission is to spread awareness and knowledge
surrounding chlamydia to improve the sexual health of youth in Leon County. By
providing the youth with strategies that enable them to enhance and maintain their sexual
health (specifically through an increase in STI testing), we will reduce the incidence of
chlamydia within Leon County.
● 5 high schools and 5 colleges within Leon County randomly selected
● Staff of each of the schools will be asked to consensually recruit 50 students between the ages of
15 and 24 (500 total participants)
● In the 2022-23 academic year, six workshops will be conducted at FSU
● Each workshop will encourage STI screenings (specifically for Chlamydia) by addressing one of
the six concepts of the Health Belief Model
● Once all six workshops have been conducted, each concept of the Health Belief Model will have
been addressed
Needs Assessment
● Chlamydia is a sexually transmitted infection that is caused by an infection of
Chlamydia trachomatis (CDC, 2022)
○ Global: 127.2 million cases in 2016 (WHO, 2016)
○ United States: ~4 million cases in 2018 (CDC, 2022)
■ Two-thirds of new chlamydia infections occur among youth aged 15-24 years
○ Florida: 515.9 cases per 100,000 people in 2019 (CDC, 2019)
○ Leon County: 985.6 cases per 100,000 people in 2019 (FDH, 2020)
● Demographic description of target group: randomly selected youth between the ages
of 15-24 in Leon County, Florida
● Impact: if untreated, Chlamydia can lead to pelvic inflammatory disease and
infertility (CDC, 2022)
Source: Lynn Barkley, President and CEO, American Sexual Health Association [1]
Risk Factors
● Behavioral
○ Having more than two partners within the past 6
months [10]
■ Or engaging in “hookup culture” [2,9]
○ Lack of condom use [8]
○ Lack of regular STI screening [6]

● Biological
○ Biological females are more likely to contract
STIs due to a shorter urethra and vaginal
mucous membranes [10]
○ Men are less likely to seek reproductive care
since men do not use hormonal birth control,
do not menstruate, do not receive equivalent
to pap smear, do not have an equivalent to a
gynecologist, etc…
Risk Factors Continued…
● Environmental
○ Poor socioeconomic status or lacking money for participation in
activities [8]
■ Lack of access to healthcare
■ Exchanging sex for drugs or money [2]
○ Community beliefs and stigma
■ Perceived condom use [6]
■ Perceived stigma [5]
● The higher the perceived guilt and shame
surrounding STIs the less likely to get tested
○ Media
■ TV shows and movies that show “hookup culture” and/or
transactional sex without consequence
○ Lack of proper guidelines for men
■ There are NO national chlamydia screening guidelines
for heterosexual male youths [4]
■ Screening guidelines should be the same across all
youths
● While male anatomy makes it slightly more
difficult to men to contract STIs, lack of
knowledge of status is what spreads infection!
Implementation
● To begin working against rising Chlamydia rates in Leon County, Florida, there are many
roles that must be filled by those working or volunteering for the program and community.
In starting our program, Zoom and Microsoft Teams will be used to coordinate between
program managers, program coordinators, a health education specialist, and volunteers.
● After scheduling and coordinating the workshops with FSU and other educational
institutions, fundraising and outreach will begin to boost testing and treatment sites around
Leon County.
● Finally, six workshops providing evidence-based academic curriculum regarding
Chlamydia will be disseminated to youth throughout Leon County by licensed and trained
health educators (CDC, 2022).
● During the workshops information about free/low-cost and local testing sites will be
provided to students, as well as advertised throughout schools and universities to reduce
stigma and raise awareness.
Timeline
● This program will take place throughout the 2022-2023 school year in Leon
County, Florida. The training and scheduling will take place over Zoom (unless
in person training is required for certain health educators or volunteers) in the
summer of 2022 from June to August.
● In January marketing and fundraising for the program will begin with the help of
volunteers and the local and state health departments, and will continue
throughout the summer and into the school year with the start of the workshops.
● The six workshops will be held in August, October, December, February, April,
and May. While the program is accelerated, it will have a large enough impact on
the youth of Leon County to significantly reduce chlamydia rates within
participants.
Timeline
Program Goals
● To increase community awareness of the prevalence of Chlamydia
within Leon County
● To increase motivation among youth to get regularly tested
● To increase community knowledge on testing sites and treatments
● To reduce the incidence of Chlamydia among youth of Leon
County
Process Objectives
1. By August 2022, staff will randomly select five high schools and five colleges in
Leon County and ask each of them to consensually recruit 50 students between the
ages of 15 and 24 to participate in our program.

2. By June 2023, staff will have conducted six educational workshops available for all
of the 500 participants to encourage getting tested for Chlamydia.  Each educational
workshop will encourage STI screenings by addressing one of the concepts of the
Health Belief Model: perceived susceptibility, perceived severity, perceived benefits,
perceived barriers, cues to action, and self-efficacy.
Process Level of Evaluation (Formative)
● List will be created including the selected high schools (5) and colleges (5) as well as
their selected students (50 per school)
● List will be created that documents the completion of each workshop (6 total) and
which concept of the Health Belief Model that was covered (seen below)
Impact/Learning Objectives
1. A year after our program is implemented, at least 75% of program participants will
be able to identify at least two places that they can get tested for Chlamydia.

2. A year after our program is implemented, at least 85% of the program participants in
Leon County will be able to explain at least three ways to start a conversation with
their sexual partner(s) surrounding the importance of getting tested for Chlamydia.
Behavioral Objectives
1. Two years after the program has been implemented, 35% of program participants will
report that they have been tested for Chlamydia at least once during the past two
years.

2. Two years after our program has been implemented, at least 65% of sexually active
participants will self-report that they have had a conversation with a sexual partner
regarding the importance of getting tested for Chlamydia.
Evaluation: Pre/Post Tests (Summative)
● Level of evaluation: Impact/Learning & Behavioral
● 3 anonymous online surveys will be sent via email for completion by participants
● First test sent before the first workshop, another one year after the program launch,
and another two years after the program launch
● The results of the three tests will be compared to evaluate the success of the learning
and behavioral objectives by assessing the participants’:
○ Ability to identify centers for Chlamydia testing
○ Knowledge of different ways to explain how to start a conversation with a partner about Chlamydia
testing
○ Self-reported frequency of STI testing
○ Self-reported behavior of having a conversation with a sexual partner about the importance of getting
tested for Chlamydia
Outcome Objective
Two years after the implementation of our program, the incidence rate of
Chlamydia among program participants will decrease by 25% compared
to the incidence rate assessed at the onset of the program.

● Evaluation (Summative - Pre/Post Test): free Chlamydia testing will be provided to

program participants throughout the duration of the program
○ Baseline: determined by incidence of Chlamydia found in participants within the week of testing
after the first workshop
○ Outcome: determined by incidence of Chlamydia found in participants within the week of testing
two years after the week that baseline was established
 Theoretical Foundation
●The Health Belief Model was created to help understand why so little people utilized disease prevention and
detection resources
●This model addresses low perceived susceptibility and severity surrounding Chlamydia that is common among
youth
●This model is built upon developing long term behavioral change
○In our case this would be increased and regular STI testing/screening
Health Belief Model Applied
 References
https://docs.google.com/document/d/1C7kEXKFLuayvuB5Gi34cPAWMS1z66VR9WyH52ZcxIwA/edit?usp=sharing