STD Analysis

LTG Associates conducted a program-wide assessment for the Centers for Disease Control and Prevention (CDC) on their Syphilis Elimination Program, based on evaluation data collected from all CDC-funded local-level grantees working to eliminate syphilis in their local population through increased access to and utilization of testing and primary care services.  The analysis synthesized national policy assessment, as implemented locally, with program assessments to generate a diagnostic model for program effectiveness at the local, state, and national levels.  The final report was published by the CDC and an Executive Briefing was provided to CDC leadership by the LTG team.  LTG Associates, Inc., conducted qualitative and quantitative analyses of the data from 36 program assessment reports in order to identify lessons learned and derive best or promising practices from across the programs.  While all of the communities served by the programs shared some demographic features, they also varied significantly.  Some programs were concentrated in poor rural areas, while others served transient populations within large urban and metropolitan areas.  Basic public health infrastructures and the range of active community organizations that address HIV/AIDS, prostitution, injection drug use, and other related risk-behaviors also varied considerably across programs.  The 36 Assessment Reports were produced by trained CDC staff based on site visits to each of the 36 sites participating in the program.  These reports were based on a highly structured site visit guide and reporting tool.  CDC did not have the internal capacity to conduct summative research on the reports.  LTG was provided the reports, guidance, and reporting tool, along with substantial Program Operations Guidelines to allow analysis of ideal case scenarios.  LTG reviewed all the materials, verified the site visit guide, reporting tool, and implementation in the field with CDC staff.  LTG worked directly with the CDC Project Officer and convened a multi-divisional CDC Working Group that provided input to all steps in the research and report production process.  A report was developed that included an executive summary, a summary of findings within each of the three areas of assessment, a summary of best and promising practices, and a description of the information flow model produced from the analysis, as well as directions for its use.  The report was structured with linkages from findings to best and promising practices, as well as helpful hints and illustrative examples for the reader.  The report was published by the CDC and distributed to all grantees in the Syphilis Elimination Program.  The complete report, “Lessons Learned and Emerging Best Practices from the National Syphilis Elimination Program Assessment,” can be downloaded at: http://www.cdc.gov/STOPSYPHILIS/SEELessonsMonograph.pdf.  LTG’s research demonstrated that while all Syphilis Elimination Program grantees were attempting to utilize the substantial and detailed Program Operations Guidelines, local conditions affected their success or failure in implementation.  Moreover, LTG developed a diagnostic organizational information flow model to assist in diagnosing and addressing barriers to successful program implementation.  These results and the diagnostic model serve as tools for assessing internal CDC policy and guidelines for managing and monitoring program grantees.  In addition, the tool serves to assist local grantees to consider local policy barriers and potential facilitators to success.  The tool identifies where interagency communication lines, locally, at the state level, and with the CDC, affect communication necessary for successful implementation.  The grantees with CDC can adapt interagency policies and procedures at each of those levels to improve program functioning.