Resident Physician John R. Oishei Children's Hospital Kenmore, New York, United States
Background: Sexually transmitted infections (STIs) are on the rise, most notably in adolescents. Adolescents in the Buffalo Public School (BPS) District have access to free, confidential urine chlamydia and gonorrhea testing (and treatment) in the school nurse’s office; however, in the 2021-2022 school year less than 1% of the adolescents took advantage of this service. To increase awareness of sexual health programs such as this, the University at Buffalo pediatric residents collaborated with the school district, the local health department, and community-based organizations to develop a Student Health Ambassador (SHA) program–thus empowering students to educate their peers about sexual health. Objective: Increase the number of STI screens performed in Buffalo Public Schools. Increase SHA’s knowledge and comfort in speaking to their peers about sexual health. Design/Methods: The SHA program was developed and implemented through the following steps: (1) engage stakeholders, (2) recruit students from BPS high schools, (3) initiate bi-monthly peer educator training and mentorship, and (4) empower SHAs to promote public health messaging in their schools. Training included a wide variety of topics including STIs, gender identity, resource availability, sexual consent, body image, and communication skills. Outcomes were measured via tracking of the total number of chlamydia and gonorrhea tests completed in the school nurses’ offices, SHA bi-monthly meeting evaluations, and a SHA pre-post knowledge assessment. Results: A total of 11 SHAs were initially recruited for the 2022-2023 academic year with a retention rate of 55%. After initiation of the SHA program, district-wide urine collection for STI testing increased by nearly 200% from an average of 6.4 tests/month to 12.6 tests/month (See Figure 1). SHA survey feedback revealed that 100% of SHAs felt that the sessions were a good use of their time and allowed for active participation. Based on the pre-post quiz, the percent of SHAs who feel very comfortable (4 or 5 out of 5) talking to peers about STIs increased from 73% to 100%. In regards to the pre-post knowledge assessment, those that answered all 8 questions correctly increased from 27% to 75%.
Conclusion(s): While this pilot program only engaged a relatively small number of SHAs, their involvement in public health promotion seemed to play an integral role in the increased utilization of school-based STI tests. Perhaps even more importantly, the program increased the knowledge and confidence of the SHAs, empowering future leadership roles in their schools and community.
