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Tx dshs std hiv gis final


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Mapping data allows easy visualization of occurrence of and trends in health events. Interventions for adolescent sexual health outcomes such as sexually transmitted infections (STIs) and teen births have rarely been evaluated using GIS. Geocoded data and maps from a program in Texas County school districts will be shown as examples. The maps show chlamydia cases and teen births and rates in the program school districts. These maps will be used to compare sexual health outcomes geographically (between County school districts) as well temporally (years).

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Tx dshs std hiv gis final

  1. 1. Using Geographical Information Systems (GIS) to Represent Sexual Health Outcome Trends in El Paso County, Texas Sheetal Malhotra, MBBS, MS Nancy Ronquillo Katherine A Hendricks, MD, MPH&TM
  2. 2. Innovative Evaluation Practices <ul><li>Geographical Information Systems (GIS) </li></ul><ul><li>Example </li></ul><ul><ul><li>show changes in sexual health outcomes such as chlamydia and teen births </li></ul></ul>
  3. 3. GIS <ul><li>Mapping tool </li></ul><ul><ul><li>a strategy to show data on maps. </li></ul></ul><ul><li>Maps </li></ul><ul><ul><li>allow easy visualization of health events or problems </li></ul></ul><ul><ul><li>how they change over time </li></ul></ul><ul><ul><li>visualize results easily </li></ul></ul>
  4. 4. Example of GIS Mapping-Texas Birth Rate for 10- to 19-Year-Olds 1996 1998 2000 2002
  5. 5. Using GIS for Program Evaluation <ul><li>Get updated area maps </li></ul><ul><ul><li>state, city, county, or school district levels </li></ul></ul><ul><li>Geocode data </li></ul><ul><ul><li>assign a location to the data. </li></ul></ul><ul><li>Place data on a map </li></ul><ul><ul><li>cases </li></ul></ul><ul><ul><li>rates (for better comparisons) </li></ul></ul><ul><li>Maps displayed as shades of the same color or different colors to signify different categories </li></ul>
  6. 6. Advantages <ul><li>Identify problem areas and factors that may be contributing to the health care problems </li></ul><ul><li>Compare sexual health outcomes </li></ul><ul><ul><li>geographically </li></ul></ul><ul><ul><li>temporally </li></ul></ul><ul><li>More sophisticated analyses </li></ul><ul><ul><li>spatial analyses </li></ul></ul>
  7. 7. Birthrates for 15- to 19-Year-Olds <ul><li>US 65/1000 </li></ul><ul><li>TX 77/1000 </li></ul><ul><li>El Paso County 89/1000 </li></ul><ul><li>San Elizario & Fabens ISDs 190/1000 </li></ul><ul><li>~ 70% of county births are to teen mothers </li></ul>Source: DSHS Office of Border Health
  8. 8. STI Rates/100,000 Population by Area Source: Texas Department of Health. 2001 Selected Health Fact Sheets. Available from: 20 11 13 HIV 14 11 18 AIDS 328 292 342 Chlamydia 141 28 42 Gonorrhea Texas Border El Paso STI
  9. 9. Paso a Paso: Purpose <ul><li>Promote abstinence/risk avoidance among youth aged 12-18 years in 2 independent school districts (ISDs) in El Paso County </li></ul><ul><li>Provide community-based sexual health education </li></ul><ul><ul><li>abstinence-based </li></ul></ul><ul><ul><li>relationship skills training </li></ul></ul>
  10. 10. Paso a Paso: Goals & Objective <ul><li>Goals: implement community-wide activities to support </li></ul><ul><ul><li>abstinence education (adolescents) </li></ul></ul><ul><ul><li>parenting education (adults) </li></ul></ul><ul><li>Objectives: </li></ul><ul><ul><li>promote the practice of abstinence until marriage </li></ul></ul><ul><ul><li>promote return to abstinence </li></ul></ul>
  11. 11. Paso a Paso : Components <ul><li>Medical Institute Project, El Paso </li></ul><ul><ul><li>school-based curriculum, grades 6-12 </li></ul></ul><ul><ul><li>parenting adult curriculum </li></ul></ul><ul><ul><li>community mobilization </li></ul></ul><ul><ul><li>evaluation </li></ul></ul><ul><ul><li>geocode chlamydia & pregnancies </li></ul></ul>
  12. 12. What does evaluation involve? <ul><li>Surveys </li></ul><ul><ul><li>pre-tests – before the program </li></ul></ul><ul><ul><li>post-tests – soon after the program </li></ul></ul><ul><ul><li>follow-up – next school year </li></ul></ul><ul><li>GIS </li></ul><ul><ul><li>births </li></ul></ul><ul><ul><li>chlamydia cases </li></ul></ul>
  13. 13. Measures to Protect Participant Rights <ul><li>Approval from </li></ul><ul><ul><li>Institutional Review Board (IRB) </li></ul></ul><ul><li>Partnership with </li></ul><ul><ul><li>State Health department </li></ul></ul><ul><ul><li>County Public Health department </li></ul></ul>
  14. 14. GIS Mapping <ul><li>Data from health department </li></ul><ul><ul><li>chlamydia case reports </li></ul></ul><ul><ul><li>teen births </li></ul></ul><ul><li>Data geo-coded by residence </li></ul><ul><li>Geo-coded data used to map outcomes </li></ul><ul><li>Maps easily show </li></ul><ul><ul><li>areas of need </li></ul></ul><ul><ul><li>increase/decrease over time </li></ul></ul>
  15. 15. Teen Birth Rates 2006-07
  16. 16. Teen Birth Rates 2007-08
  17. 17. Chlamydia Rate 2006-07
  18. 18. Chlamydia Rate 2007-08
  19. 19. Challenges <ul><li>Data integrity </li></ul><ul><li>Electronic transfer </li></ul><ul><li>Security and privacy </li></ul><ul><li>Address matching </li></ul><ul><li>STI underreporting </li></ul><ul><li>Updated boundary lines </li></ul><ul><li>Population data for school districts </li></ul>
  20. 20. Funding for the Study <ul><li>This study was supported by grant # 90AE0147 from the Administration of Children and Families (ACF). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the ACF, the Department of Health and Human Services or the U.S. government. </li></ul>
  21. 21. Thank You! <ul><li>For more information contact </li></ul><ul><li>Sheetal Malhotra </li></ul><ul><li>[email_address] </li></ul><ul><li>512-328-6268 </li></ul>