Improving access to syphilis screening among unhoused people in Yolo County

Background: This study aimed to increase syphilis screening rates amongst unhoused residents of Yolo County, California, through the implementation of plan-do-study-act (PDSA) cycles. Yolo County has a strategic goal to eliminate congenital syphilis cases. Homelessness is a known risk factor for sy...

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Main Authors: Jenna Kupa, Ren Bruguera, Nadia Agnoli, Alicia Agnoli, Liliana Melgoza, Anna Portnoy, P. Suzanne Portnoy
Format: Article
Language:English
Published: University Library System, University of Pittsburgh 2024-10-01
Series:International Journal of Medical Students
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Online Access:http://ijms.info/IJMS/article/view/2553
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author Jenna Kupa
Ren Bruguera
Nadia Agnoli
Alicia Agnoli
Liliana Melgoza
Anna Portnoy
P. Suzanne Portnoy
author_facet Jenna Kupa
Ren Bruguera
Nadia Agnoli
Alicia Agnoli
Liliana Melgoza
Anna Portnoy
P. Suzanne Portnoy
author_sort Jenna Kupa
collection DOAJ
description Background: This study aimed to increase syphilis screening rates amongst unhoused residents of Yolo County, California, through the implementation of plan-do-study-act (PDSA) cycles. Yolo County has a strategic goal to eliminate congenital syphilis cases. Homelessness is a known risk factor for syphilis.  Methods: The primary researcher was embedded in a street medicine team. Using quality improvement tools like stakeholder interviews, workflow diagrams, and best practices from literature, we outlined the team's workflow for syphilis screening and developed ideas to improve uptake and expand capacity. The most effective cycle implemented gift card incentives for syphilis screening. During the patient intake we offered the option to receive a syphilis test, informing the patient of the gift card incentive.  Results: Prior to gift card incentives, the team screened 1.6 patients on average per clinic for a total of 30 patients screened in April to June of 2022. After the gift card incentive was implemented, the team screened 3.0 patients on average per clinic, screening a total of 223 patients from July 2022 to May 2023. The intervention produced an 87.5% increase in screening rates (P=0.0094). The data showed a significant increase in syphilis testing upon implementing the gift card incentive program. Conclusion: These findings contribute to evidence supporting the use of patient incentives for public health prevention measures. This model could be applied to other populations to increase health screening participation. More research is needed on the effect of gift card incentives on confirmatory testing and treatment rates for syphilis.  
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spelling doaj-art-7e132223ba2c4e7c8e928e432c5b5a2d2025-08-20T02:16:55ZengUniversity Library System, University of PittsburghInternational Journal of Medical Students2076-63272024-10-0112310.5195/ijms.2024.2553Improving access to syphilis screening among unhoused people in Yolo CountyJenna Kupa0Ren Bruguera1Nadia Agnoli2Alicia Agnoli3Liliana Melgoza4Anna Portnoy5P. Suzanne Portnoy6Third-year medical student. Tufts University, Boston, United StatesFourth-year medical student. University of California, Davis, United StatesBA. Homeless Program Coordinator. Yolo County Department of Health and Human Services, Woodland, United States.M.D. Associate Professor. School of Medicine, University of California, Davis, United States. B.S. Prospective medical student. Diabetes Educator, CommuniCare Health Centers. West Sacramento, United StatesFourth-year pre-medical student. New York University, New York, United States.DNP. Family nurse practitioner. San Francisco VA Health System, United States. Background: This study aimed to increase syphilis screening rates amongst unhoused residents of Yolo County, California, through the implementation of plan-do-study-act (PDSA) cycles. Yolo County has a strategic goal to eliminate congenital syphilis cases. Homelessness is a known risk factor for syphilis.  Methods: The primary researcher was embedded in a street medicine team. Using quality improvement tools like stakeholder interviews, workflow diagrams, and best practices from literature, we outlined the team's workflow for syphilis screening and developed ideas to improve uptake and expand capacity. The most effective cycle implemented gift card incentives for syphilis screening. During the patient intake we offered the option to receive a syphilis test, informing the patient of the gift card incentive.  Results: Prior to gift card incentives, the team screened 1.6 patients on average per clinic for a total of 30 patients screened in April to June of 2022. After the gift card incentive was implemented, the team screened 3.0 patients on average per clinic, screening a total of 223 patients from July 2022 to May 2023. The intervention produced an 87.5% increase in screening rates (P=0.0094). The data showed a significant increase in syphilis testing upon implementing the gift card incentive program. Conclusion: These findings contribute to evidence supporting the use of patient incentives for public health prevention measures. This model could be applied to other populations to increase health screening participation. More research is needed on the effect of gift card incentives on confirmatory testing and treatment rates for syphilis.   http://ijms.info/IJMS/article/view/2553syphilisHomeless PersonsHomelessnessVulnerability of homeless patientsIncentive-based strategyCongenital
spellingShingle Jenna Kupa
Ren Bruguera
Nadia Agnoli
Alicia Agnoli
Liliana Melgoza
Anna Portnoy
P. Suzanne Portnoy
Improving access to syphilis screening among unhoused people in Yolo County
International Journal of Medical Students
syphilis
Homeless Persons
Homelessness
Vulnerability of homeless patients
Incentive-based strategy
Congenital
title Improving access to syphilis screening among unhoused people in Yolo County
title_full Improving access to syphilis screening among unhoused people in Yolo County
title_fullStr Improving access to syphilis screening among unhoused people in Yolo County
title_full_unstemmed Improving access to syphilis screening among unhoused people in Yolo County
title_short Improving access to syphilis screening among unhoused people in Yolo County
title_sort improving access to syphilis screening among unhoused people in yolo county
topic syphilis
Homeless Persons
Homelessness
Vulnerability of homeless patients
Incentive-based strategy
Congenital
url http://ijms.info/IJMS/article/view/2553
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