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Current challenges and opportunities to providing sexually transmitted disease services in STD clinics: A public health leadership perspective
Author(s) -
Kovar Cheryl L.,
Fazzone Patricia,
Bynum Susan
Publication year - 2019
Publication title -
public health nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 55
eISSN - 1525-1446
pISSN - 0737-1209
DOI - 10.1111/phn.12645
Subject(s) - public health , thematic analysis , accreditation , medicine , sexually transmitted disease , nonprobability sampling , nursing , medical education , public relations , family medicine , qualitative research , environmental health , political science , sociology , population , social science , syphilis , human immunodeficiency virus (hiv)
Objective To assess leaders’ perceptions of challenges and opportunities to providing sexually transmitted disease (STD) services in public health departments. Design and Sample Semi‐structured interviews were conducted in 2017 with health directors and other designated leaders in 19 public health departments who have an STD clinic. Purposive sampling accounted for geographical differences, providing balanced representation of urban, suburban, and rural agencies in North Carolina. Measurement Audiotaped interviews were transcribed verbatim. All transcripts were independently coded, with cross comparison and agreement between researchers. Rigorous thematic and content analyses were performed. Results Perceived stigma, funding constraints, and client‐centered issues were identified as the greatest challenges to providing services. Opportunities to improve these services were offering comprehensive screening methods, quality improvement, and public health accreditation. Focused training on revenue and billing practices for staff was acknowledged as the most needed technical assistance. A “culture of free services”, perceived by clients and staff, was revealed throughout several themes. Conclusions Leaders in publicly funded STD clinics face many challenges and opportunities to providing clinical services. Health directors often serve as change agents and improving the sexual health of communities remains a priority. Results of this study will assist in crafting future policy and practice for STD clinics in the public health sector.