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Milwaukee Alliance for Sexual Health (MASH) Community Mobilization Initiative Addressing Disparities in STDs

and Unintended Pregnancies

Community Voices

Milwaukee Alliance for Sexual Health (MASH) Community Mobilization Initiative Addressing Disparities in STDs

and Unintended Pregnancies

Community Voices

Community Working Group OrientationD. Garcia, MPH June 7th, 2006

City of Milwaukee Health Department

Community Working Group OrientationD. Garcia, MPH June 7th, 2006

City of Milwaukee Health Department

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OverviewOverview

• Background: MASH & Community Voices (CV)• Target Population • Roles of Community Working Group (CWG)• CV – RARE Methodology • CV Project Area• CWG Input on CV Community Mapping• CWG Input on CV Participants Recruitment• Questions

• Background: MASH & Community Voices (CV)• Target Population • Roles of Community Working Group (CWG)• CV – RARE Methodology • CV Project Area• CWG Input on CV Community Mapping• CWG Input on CV Participants Recruitment• Questions

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BackgroundBackground

• Milwaukee Alliance for Sexual Health– Collaboration with WDHFS, MCW, HCET and

MHD– Funded by Healthier Wisconsin Partnership

Program (Blue Cross/Blue Shield) to explore the growing health disparities of sexually transmitted infections and unintended pregnancies among African American youth in Milwaukee.

• Milwaukee Alliance for Sexual Health– Collaboration with WDHFS, MCW, HCET and

MHD– Funded by Healthier Wisconsin Partnership

Program (Blue Cross/Blue Shield) to explore the growing health disparities of sexually transmitted infections and unintended pregnancies among African American youth in Milwaukee.

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BackgroundBackground

• Community Voices – Problem Assessment – investigate the norms, beliefs

and behaviors that lead to adverse health consequences

– RARE Methodology• Focus Groups, interviews, street intercept surveys,

observation and mapping

– Goal: For community voices to be heard and documented! - gain rich, contextual data to mobilize and help guide a larger community planning group with an action plan

• Community Voices – Problem Assessment – investigate the norms, beliefs

and behaviors that lead to adverse health consequences

– RARE Methodology• Focus Groups, interviews, street intercept surveys,

observation and mapping

– Goal: For community voices to be heard and documented! - gain rich, contextual data to mobilize and help guide a larger community planning group with an action plan

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Target PopulationTarget Population

• Sexually transmitted diseases and unintended pregnancies disproportionately impact the African American community in Milwaukee, particularly among youth ages 15-19.

• In 2004, Milwaukee County had the highest reported STD case rates (Chlamydia, Gonorrhea, Syphilis and HSV) among African American youth ages 15-19, accounting for 56.1% of all reportable STDs within Wisconsin.

• Sexually transmitted diseases and unintended pregnancies disproportionately impact the African American community in Milwaukee, particularly among youth ages 15-19.

• In 2004, Milwaukee County had the highest reported STD case rates (Chlamydia, Gonorrhea, Syphilis and HSV) among African American youth ages 15-19, accounting for 56.1% of all reportable STDs within Wisconsin.

6Wisconsin STD Control Section

Reported STD case rates*, by county, reportable STDs**, persons 15-19 years of age, Wisconsin, 2004

* Cases per 100,000 population.** Chlamydia, gonorrhea, syphilis and genital HSV infection.***Excludes 9 cases among out of state residents and 6 cases without county specified.**** Rate not calculated for counties with less than 5 cases.

2,244100.0%9,180State***

1,00033.1%3,042Other

5,85766.9%6,138Subtotal

2,2832.8%256Rock

2,4343.1%288Kenosha

2,5090.2%20Forest

2,7994.3%392Racine

6,5460.3%29Menominee

7,74756.1%5,153Milwaukee

Rate*PercentCases**County

Six counties with rates* >2,000

Rate*Not calculated****

<500

1,000-1,999

2000-2999

3000+

500-999

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Target PopulationTarget Population

• The highest prevalence zip codes in Milwaukee County account for 75.3% of all reportable STDs among persons 15-19 years of age within the county.

• These same zip codes are home to 81% of the African American population within Milwaukee county

• The highest prevalence zip codes in Milwaukee County account for 75.3% of all reportable STDs among persons 15-19 years of age within the county.

• These same zip codes are home to 81% of the African American population within Milwaukee county

8Wisconsin STD Control Section

7,747 100.0%5,153 Milwaukee Co

2,991 24.7%1,271 Other zip

16,165 75.3%3,882 Subtotal

10,215 3.3%171 53225

13,778 10.0%516 53209

14,428 8.7%448 53208

14,465 7.8%403 53216

14,868 9.7%500 53218

17,241 3.5%180 53205

17,906 9.5%489 53210

18,885 8.8%454 53212

22,795 14.0%721 53206

Rate**PercentCases*Zip code

Nine zip codes with rates* >10,000

Reported STD cases* by zip code,persons 15-19 years of age, Milwaukee County, 2004

* Chlamydia, gonorrhea, syphilis and genital HSV infection.** Cases per 100,000 population.

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Target PopulationTarget Population

• In 2002, Milwaukee had one of the highest percentages (18.7%) of adolescent births from total births to teens in the country, ranking it 49th highest out of 50 major metropolitan areas.[1]

• A 10 year average (1995-2004) of African American teen birth rates among 15-17 year olds was 3.4 times that of the White population.[2] [1] Annie E Casey Foundation, KIDS COUNT, Right Start http://www.aecf.org/kidscount/

• [2] Partington, S. et al., Teen Pregnancy and Repeat Pregnancy, City of Milwaukee 1993-2002, RWJ Health and Society Scolars Program Collaborative Pilot Research Project

• In 2002, Milwaukee had one of the highest percentages (18.7%) of adolescent births from total births to teens in the country, ranking it 49th highest out of 50 major metropolitan areas.[1]

• A 10 year average (1995-2004) of African American teen birth rates among 15-17 year olds was 3.4 times that of the White population.[2] [1] Annie E Casey Foundation, KIDS COUNT, Right Start http://www.aecf.org/kidscount/

• [2] Partington, S. et al., Teen Pregnancy and Repeat Pregnancy, City of Milwaukee 1993-2002, RWJ Health and Society Scolars Program Collaborative Pilot Research Project

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Community Working GroupCommunity Working Group

• Members will attend three scheduled meetings: June 7th, July 19th and September 20th (may add another)

• Serve as an advisory body throughout project development – Questions for listening sessions– Input on community mapping– Assist with recruitment strategies of research

participants for a focus group session and/or interview.

• Participate in the development of the strategic/action plan (MASH - CPG).

• Members will attend three scheduled meetings: June 7th, July 19th and September 20th (may add another)

• Serve as an advisory body throughout project development – Questions for listening sessions– Input on community mapping– Assist with recruitment strategies of research

participants for a focus group session and/or interview.

• Participate in the development of the strategic/action plan (MASH - CPG).

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Community VoicesRARE MethodologyCommunity VoicesRARE Methodology

• Rapid, Assessment, Response and Evaluation– Designed by HHS, Managed by OMH– Implemented in 45 cities since 2000 with

each site focusing on enhancing prevention efforts addressing the needs of specific at risk minority population

– Evidence-based, qualitative data collection and assessment method .

• Rapid, Assessment, Response and Evaluation– Designed by HHS, Managed by OMH– Implemented in 45 cities since 2000 with

each site focusing on enhancing prevention efforts addressing the needs of specific at risk minority population

– Evidence-based, qualitative data collection and assessment method .

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RARERARE

– Provides a scientific structure and process for collecting local community data and for analyzing the data to develop practical, community-focused interventions and services that will change risk behaviors, knowledge, and community structures

• Methodology:– Focus Group– Interviews– Street Surveys– Observation– Mapping

– Provides a scientific structure and process for collecting local community data and for analyzing the data to develop practical, community-focused interventions and services that will change risk behaviors, knowledge, and community structures

• Methodology:– Focus Group– Interviews– Street Surveys– Observation– Mapping

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RARERARE

– Responds rapidly to emerging public health problems based on specific local situations and actual conditions.

• Development of Strategic plan and overarching goal of MASH - CPG

– Responds rapidly to emerging public health problems based on specific local situations and actual conditions.

• Development of Strategic plan and overarching goal of MASH - CPG

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CV Project – Target AreaCV Project – Target Area

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Input on Community Mapping Input on Community Mapping

• Need to focus on smaller area – 22 block radius– Locations where people gather – ex. Bars, drug

dealing areas, parks, secluded area, abandominiums (places that can contribute to risk)

– Residences and hang out sites of our target – African American youth 15-19, 20-24

– Boundaries affecting assessment – area that separate two different social groups (ethnic groups) – “mixing” areas

– Main zone of activity of CBOs – catchment areas for services

• Need to focus on smaller area – 22 block radius– Locations where people gather – ex. Bars, drug

dealing areas, parks, secluded area, abandominiums (places that can contribute to risk)

– Residences and hang out sites of our target – African American youth 15-19, 20-24

– Boundaries affecting assessment – area that separate two different social groups (ethnic groups) – “mixing” areas

– Main zone of activity of CBOs – catchment areas for services

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Input on Listening sessionsInput on Listening sessions

• What would you ask African American Youth 15-19, 20-24 with regards to STDs and Unintended Pregnancies?

• What would you ask service providers?• Who else would you ask to participate in

focus groups? Who are the cultural experts?

• What would you ask African American Youth 15-19, 20-24 with regards to STDs and Unintended Pregnancies?

• What would you ask service providers?• Who else would you ask to participate in

focus groups? Who are the cultural experts?

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CV Recruitment Groups CV Recruitment Groups

• Cultural Experts– Cultural experts are not only knowledgeable but are

willing and able to share their information. They are able to describe and discuss key issues about their culture and can provide special insights into both the process and the rationale for what people do, why they do it, how they do it, where, when, and with whom they do it.

– HIV/AIDS prevention and care, DV, sexual assault, general health, social service, etc.

• Cultural Experts– Cultural experts are not only knowledgeable but are

willing and able to share their information. They are able to describe and discuss key issues about their culture and can provide special insights into both the process and the rationale for what people do, why they do it, how they do it, where, when, and with whom they do it.

– HIV/AIDS prevention and care, DV, sexual assault, general health, social service, etc.

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RARE Project ScheduleRARE Project Schedule

• CV Project Timeline– 3.5 months project– Funding in July, will look for two cultural

experts to help with project.

• CWG next meeting: – July 19th - 1:30-3:30 – United Way 225 Vine St

• Project Update• Community mapping assessment• Street Survey Design• Listening Sessions

• CV Project Timeline– 3.5 months project– Funding in July, will look for two cultural

experts to help with project.

• CWG next meeting: – July 19th - 1:30-3:30 – United Way 225 Vine St

• Project Update• Community mapping assessment• Street Survey Design• Listening Sessions

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Questions?Questions?

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Contact informationContact information

• David Garcia, MPH

UW-Madison Population Health Fellow

dgarci@milwaukee.gov

414.286.2050

Visit our website: http://www.mashp.net/

• David Garcia, MPH

UW-Madison Population Health Fellow

dgarci@milwaukee.gov

414.286.2050

Visit our website: http://www.mashp.net/