From: Congenital syphilis in East Baton Rouge parish, Louisiana: providers’ and women’s perspectives
SEM Level | Potential Strategy | Supporting comments |
---|---|---|
Individual-level | • Increase knowledge about risk from congenital syphilis • Increase perceived effectiveness of screening and treatment of syphilis especially early in pregnancy | • “About 30% of them initiate their care … well into their second trimester. And I’d say another 30% in their third trimester or no care at all.”(provider) • “My last pregnancy ___ actually turned me away at 33 weeks. It was because of my insurance.”(community woman) |
Social and sexual network | • Address barriers to partner testing and assist persuading male partners to prevent reinfection • Track all sexual partners for syphilis case patients | • “We can tell them … that their partner needs to be treated but we have almost no way to follow that up or have evidence that it actually happened.” (provider) • “A woman can be honest and don’t cheat, and the man can be out there cheating behind your back.” (community member) |
Community | • Provide education and support to prenatal care providers • Accept walk-ins for initial pregnancy diagnosis and screening tests • Simplify STD testing • Comprehensive case manager • Confidential services to help women seeking services • Transportation service • Utilize text messages and apps to better inform pregnant women and assist their access to services • Provide flyers after in-person consultation • Host community events to educate and screen both men and women in the community | • “We fax and we get nothing faxed [back]. … And there’s often questions of: Who’s obligated? Is the lab reporting?” (provider) • “If you call the doctor to make an appointment, they will ask you, “What type of Medicaid do you have?” … If they don’t accept it, they won’t even schedule your appointment.”(community woman) • “We usually have to call them to come back in to get treated. And so some of them actually don’t return” (provider) • “Community perinatal clinics have been effective in the past of helping with these types of issues.” (provider) • “Trying to get people, for example to come here, with transportation issues is just not gonna work.” (provider) • I use two apps. I use the Pregnancy Plus app … I also use the Baby Center app … they answer many questions. (community woman) • “I think we should be given more information.” (community woman) • “So aside from social media and television, if there was a gatherin’— … where information is gonna be provided, testing can be done, and free stuff given.”(provider) |
Policy/Enabling Environment | • Post billboards and ads to raise awareness in the community • Correct administrative barriers in Medicaid that delay accessing prenatal care • Offer in-class information sessions | • Providers suggested several community-based educational strategies, including billboards, social media, and television • “It sometimes takes forever for you to even sign up online.”(community woman)” • “Educational seminars, but.. it has to be done in the particular area where people live.” (provider) |