onorrhea, a Prevalent Sexually Transmitted Infection (STI), Identified Growing Public Health Concern

*Do not use direct quotes. Rephrase/paraphrase what we read but still cite it.

Capstone Project Description: Gonorrhea, a prevalent sexually transmitted infection (STI), has been identified as a growing public health concern in Monterey County for age groups 15-24 years old. The rise in gonorrhea rates not only poses significant health risks to individuals but also burdens the healthcare system. By adopting a holistic strategy that includes educational initiatives, awareness campaigns, and the integration of sexual health services in schools and pediatric offices, we can reduce the incidence of gonorrhea and help mitigate its impact on the Monterey County Community.

PICOT: In adolescents and young adults ages 15-24 in Monterey County, does the implementation of incorporating education and awareness campaigns and integration with sexual health services at schools and pediatric offices, compared to the current standard sexual education, affect the incidence of gonorrhea over 12 months?

  1. What do we plan to do about it (interventions):

    1. Education and Awareness Campaigns: 

      1. Public health campaigns raise awareness about gonorrhea, its modes of transmission, the importance of regular testing and safe sexual practices, and how they can help reduce the stigma surrounding STIs and encourage individuals to seek testing and treatment.

      2. HOW WE WILL DO IT: 

        1. Gather information and resources and teach them to young adults in our healthcare setting using teaching handouts.

    2. Integration with Sexual Health Services At School and Pediatric office: 

      1. Integrating gonorrhea prevention and management into broader sexual health services can enhance overall effectiveness. This includes routine screenings, counseling, and the provision of resources for safer sex practices.

      2. HOW WE WILL DO IT: 

        1. Provide the information we have gathered on a sheet of paper that can be posted on their health board.

Outline 

  • Introduction

    • Gonorrhea is becoming a significant public health concern in Monterey County, especially for individuals aged 15-24 years old. The increasing rates of this sexually transmitted infection not only pose health risks but also put a significant burden on the healthcare system. To address this issue, we must adopt a comprehensive approach that includes education, awareness campaigns, and the integration of sexual health services in schools and pediatric offices. By doing so, we can reduce the incidence of gonorrhea and mitigate its impact on the Monterey County community. This paper will discuss the importance of public health campaigns in raising awareness about gonorrhea. These campaigns can educate individuals about the modes of transmission, the significance of regular testing, and safe sexual practices. By reducing the stigma surrounding STIs, individuals are more likely to seek testing and treatment. This comprehensive approach can help reduce the incidence of gonorrhea and mitigate its impact on public health.

  • Background and Significance of the Issue(s) lit review

    • What is STISexually transmitted diseases are a widespread issue, affecting millions of people every year in the US alone. They are also commonly referred to as sexually transmitted infections, or STIs. (CDC – STD Diseases & Related Conditions, 2023). 

    • Description of gonorrhea- Gonorrhea is a serious health concern; gonorrhea is a sexually transmitted disease that can affect women, men, and new babies. They directly cause infections in various body parts, such as the genitals, rectum, and throat. It is prevalent, particularly among individuals aged 15 to 24 years old and African Americans (CDC, 2022). According to the Centers for Disease Control and Prevention (CDC), there were approximately 1.6 million new gonococcal infections in the United States in 2018(CDC, 2022). It’s important to raise awareness about the fact that gonorrhea can be asymptomatic to encourage people to get tested regularly and prevent the spread of the disease. Gonorrhea is caused by the bacterium Neisseria gonorrhoeae (CDC, 2022). This infection is primarily transmitted through sexual contact, including but limited to vaginal, anal, and oral sex. 

    • modes of transmissionPer the World Health Organization, STIs are formed through thirty microorganisms, including bacteria, viruses, and parasites, that can be transmitted through sexual contact. The organisms can infect various body parts, such as the urethra, rectum, female reproductive tract, mouth, throat, or eyes. Also, individuals should be aware that some STIs can be passed on from mother to child during pregnancy, childbirth, and breastfeeding. In infants, the eyes are the most commonly affected area by gonorrhea. (World Health Organization, 2023). 

    • Signs and symptoms- Symptoms of Gonorrhea may start to show up after a week of infection. Some people may not experience any symptoms at all. However, in men, some common symptoms that may appear after a week of infection include polyuria, purulent drainage from the penis, swelling or erythema at the opening of the penis, swelling or pain in the testicles, and a persistent sore throat. Women may experience a range of symptoms, including discharge from the vagina, pain or burning sensation while urinating, heavier periods or spotting, pain during sexual intercourse, sharp pain in the lower abdomen, sore throat, and fever. It’s crucial to get tested and treated promptly if you suspect that you may have been infected with Gonorrhea to avoid any further complications (Mayo Clinic, 2024). 

    • Long term effects- It’s important to note that if left untreated, gonorrhea can result in serious health complications; the infection can spread to the uterus or fallopian tubes, leading to pelvic inflammatory disease (PID), infertility, and an increased risk of HIV transmission (CDC, 2022). If PID is left untreated, it can cause internal abscesses and chronic pelvic pain. Additionally, it can damage the fallopian tubes and increase the risk of ectopic pregnancy (CDC, 2022). Men who are untreated for gonorrhea can lead to epididymitis and, in rare cases, even infertility (CDC, 2022). If symptoms are ignored and left untreated in both women and men, it can spread to the blood and cause disseminated gonococcal infection (DGI), which can be a severe condition (CDC, 2022). DGI is usually characterized by arthritis, tenosynovitis, and dermatitis (CDC, 2022). It’s important to take proactive steps to protect oneself from this infection.

    • the significance of regular testing- It is vital to create awareness about the risks of gonorrhea and the significance of regular testing, particularly for those who are sexually active. It’s essential to recognize that anyone sexually active can be at risk of contracting gonorrhea. Any individual that is sexually active person can contract gonorrhea through unprotected vaginal, anal, or oral sex (Monterey County Assessment, 2024). According to the County of Monterey Public Health, if you are sexually active, you should be tested for gonorrhea and other STIs. If you are a sexually active homosexual, bisexual, or who has sex with men, you should be tested for gonorrhea every year. Sexually active women, younger than 25 years old, or older women with risk factors such as new or multiple sex partners or a sex partner who has a sexually transmitted infection. In that case, you should be tested for gonorrhea every year. If you are pregnant, it is important that you talk to your healthcare provider so that you get the correct examination, testing, and treatment, as necessary. Treating gonorrhea as soon as possible will make health complications for your baby less likely (Monterey County Assessment, 2024).

    • safe sexual practices

    • Local numbers

    • Access to healthcare services

    • reducing the stigma surrounding STIs

  • Theoretical Framework

    • Sexually Transmitted Infections: Adopting a Sexual Health Paradigm.

Psychosocial and Behavioral Interventions – Sexually Transmitted Infections – NCBI Bookshelf (nih.gov)

  • Development of the Capstone Project

    • Improving sexually transmitted infection screening, testing, and treatment among 15-24 year olds


  • Description of the Project (or Intervention)

    • Public health campaigns to raise awareness about gonorrhea

    • Education

    • Integrating of sexual health services in schools and pediatric offices

  • Evaluation


  • Implications (or Lessons Learned)


  • Conclusion 

Resources: 

  1. https://www.cdc.gov/std/gonorrhea/drug-resistant/public-health-threat/default.htm#:~:text=The%20bacteria%20that%20cause%20gonorrhea,to%20the%20last%20available%20cure.&text=Gonorrhea%20is%20the%20second%20most,infection%20in%20the%20United%20States.

  2. https://youtu.be/00–epqpVps?si=pdV3SfGSioIOepr-

  3. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Gonorrhea.aspx

  4. https://www.niaid.nih.gov/diseases-conditions/gonorrhea

  5. https://www.mass.gov/news/department-of-public-health-announces-first-cases-of-concerning-gonorrhea-strain

  6. https://www.co.monterey.ca.us/government/departments-a-h/health/diseases/gonorrhea

  7. https://www.co.monterey.ca.us/government/departments-a-h/health/diseases/gonorrhea/gonorrhea-local-data

  8. https://www.datasharemontereycounty.org/indicators/index/dashboard?id=205773323944679562

  9. https://www.thecommunityguide.org/

  10. https://www.datasharemontereycounty.org/indicators/index/view?indicatorId=248&localeId=264&localeChartIdxs=1

  11. https://doi.org/10.1111/josh.13084

  12. https://www.who.int/news-room/fact-sheets/detail/sexually-transmitted-infections-(stis)

  13. https://www.cdc.gov/std/general/default.htm#:~:text=A%20sexually%20transmitted%20infection%20%28STI%29%20is%20a%20virus%2C

  14. https://www.mayoclinic.org/diseases-conditions/gonorrhea/symptoms-causes/syc-20351774

  15.  https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm

  16.  Psychosocial and Behavioral Interventions – Sexually Transmitted Infections – NCBI Bookshelf (nih.gov)

Example:

Introduction

This section should be one or two paragraphs. Here are some things I do not want:

                  The “running head” listed on your title page

                  A repeat of the title at the top of the first page

                  An abstract

Background and Significance of the Issue(s)

(In this section, you should explain the background & significance of the issue or issues with which this Capstone is concerned – school lunches, healthcare for the homeless, etc. Here is where you bring in your scholarly and policy references: the research and the relevant policy context. How are school lunches funded? How many uninsured people are there in Monterey County? Has your intervention been tried elsewhere? One question I always ask is, why has this problem not been solved already? Usually, that is because it is a difficult problem – so tell me why it’s difficult).

This section should be fairly substantial – not necessarily long, but grounded in the literature, including demographics of the target community.  Remember the idea of “evidence-based practice”? This is the part where you show me the evidence – and the evidence should be about both the problem and the (proposed) solution).

Sub-heading level 2 looks like this.

If your discussion of the background has clear sub-sections, consider using section headers for each of those – it makes it easier for the reader (me!) to follow the argument and helps you as the writer ‘clump’ your data.  See the APA manual for the formatting of the levels. You probably won’t need more than two levels in a paper like this. Level 1 is centered, bold-faced, and key words are capitalized. Level 2 is flush left, bold-faced, and key words are capitalized. (Are we having fun yet?)  Other sections that might benefit from sub-headings are the description of the project itself, and lessons learned.

Speaking of APA Formatting

Based on my reading of N365 papers, I would say that many of you would benefit from re-visiting the APA Manual, especially in relation to in-text citations.

Do not write:

         According to an article published in the American Journal of Nursing (2014)…

         As Smith and Jones wrote in their 2016 article “Hop-Scotch Your Way to Fitness!”…

         According to an article by Scott Pruitt and Ryan Zinke (2018) entitled “Rolling Back the Regulations that Get in the Way of Wilderness Exploitation”, it was stated that…

None of that, please. You say, “Pruitt and Zinke (2018) report that…” or “Republicans have long argued that… (Pruitt & Zinke, 2018).” All the other information is in the reference list.

Please pay attention also to the rules about when you list all authors and when you use “et al.” . Finally, pay very close attention to the rules about quotations from other texts; briefly, they should be rare, clearly marked, and always linked to a page number.

Somewhere in This Paper, a Theoretical Framework

This could go in any of several places – background, development, description of the project? – but somewhere. Tell me how your project fits into a larger theory of community/ public health nursing. I encourage you to use either the 10 Essential Services of Public Health, or one of the health promotion theories we discussed in Week 7 (Health Belief Model, Social Norms theory, etc.) There are other theories out there; you might want to check with your clinical instructor first if you are considering using something else. The 10 Essential Services framework is really fine; I suggest you pick no more than two of these to focus on, rather than listing all the ones your project could conceivably be connected to.

 

Development of the Capstone Project

Here you tell me about how you came to identify this topic and this particular project as your capstone project. I would expect that this would include something about your own experiences (“We noticed as we spent time in the school that…”) as well as input from your preceptors, other agency staff, other stakeholders, your readings in the relevant literature, and your clinical instructor. How and why did you identify this topic?

 

Description of the Project (or Intervention)

Make a difference in your community! What can you do to have a positive impact at your site/on staff at the site you do your clinical/ on clients of the site? What did you do, and how did you do it? There may well be some parts of this that you actually did, for instance you designed a brochure for patients, designed a Powerpoint for educating staff at the clinic and some parts that you designed/proposed but you were not able to implement because you didn’t have time for. The intervention can be a modification to an existing plan/ policy/adding specific questions/or guideline. For instance, de-escalation/ yoga technique/anxiety reduction techniques are proposed to be taught or was taught if you had the chance..If you have done it then great, even if you do not have time or chance to do the plan, I expect you have the designed plan/PP/brochure/educational material/modification of plan/guideline/added policy/added questions/ design a website for informing about a topic, etc.. If you design a brochure/ PP, please attach in the appendix.. for instance say “a  Powerpoint was made to educate staff. See Appendix 1.”

Evaluation

If you did an evaluation of the project, describe that here. If you did not, tell me about how one might evaluate it. Consider the various types of evaluation that we learned about earlier – summative, formative, etc. “Impact” data is important – and also hardest to come by. Think about process evaluation also – did we do what we said we were going to do? Was it feasible, acceptable to the stakeholders, sustainable? Are there interim outcomes that we could document? Participation rates, information packets distributed, curriculum modules developed, etc. (Remember your logic models – short term, medium, term, long term?) Try to think of something here besides a satisfaction survey; however, it is fine if a pre-survey and post-survey works.. think of ways like visitor traffic for your website, visitors count who contact through website email address…Please mention your pre-survey and post-survey in the appendix if you used such a method.. For instance, say “A pre-survey was done. see Appendix 2. A post-survey was done. See Appendix 3.”

Implications (or Lessons Learned)

Okay, so now what? Research studies usually label this section as “implications”; policy studies often talk about “lessons learned.” Here we want a little of both – what do you think this means, and what did you learn from it? Could or should this program be continued, expanded, or modified? If you were doing something like this again, what might you do differently? (Start earlier or smaller, consult with X people first, have fewer items in your teaching demo, provide more snacks…?)

 

Conclusions

Wrap it up – briefly summarize where you were, what you did, & what you think it meant. Almost done!

 

Miscellaneous Notes

Double spaced throughout, 1 inch margins, Times New Roman or Arial, 12 point font.  Align the text to the left (not Justify).  Indent the first line of each paragraph. Don’t make your paragraphs too long! More than about half a page is generally too long.

Submit this paper online. One person from each group is enough to submit the paper.

Use active voice, not passive.  Say, “We gathered this data”, not “the data was gathered.” Say, “Smith and Jones (2016) report that longer school lunches produce happier children”, not “Longer school lunches have been shown to produce happier children (Smith & Jones, 2016).”

  Spell check.

  Please cite according to APA 7.

  It is helpful if all of the group members read the paper, proofread together or one by one do the proofreading.. read the whole paper, not just your part!

  Ask me if there is any confusion, concerns..

 

 


 

References

These should always start on a separate page, alphabetical by first author, double-spaced, with a hanging indent. Do I make the rules? I do not. They are what they are.

Author1, X. X., Author2, Y. Y., & Author3, Z. (Year). Title of article: Subtitle of article. Title of Journal, 7, 321 – 334.

Author1, X. X., Author2, Y. Y., & Author3, Z. (Year). Title of article: Subtitle of article. Title of Journal, 7, 321 – 334.

Author1, X. X., Author2, Y. Y., & Author3, Z. (Year). Title of article: Subtitle of article. Title of Journal, 7, 321 – 334.

Author1, X. X., Author2, Y. Y., & Author3, Z. (Year). Title of article: Subtitle of article. Title of Journal, 7, 321 – 334.

 

Note #1: Word will make the hanging indent for you!   Look it up.

Note #2:

 

 

a)  If it’s a source that only exists in an online form, or is most easily accessed that way, then DO include the URL. This mainly applies to government sources, policy documents, etc. Date of access not required. The URL should be as specific as possible – i.e., it should take me right to the report, not just the organization’s home page. See APA section 7.03, Technical and Research Reports, for the general format for such things.

 

Note #3:  on documenting interviews & “personal communication”:

 

The normal way to reference a conversation within APA is through the “personal communication” format (see APA Manual 6.20, p. 179).  These do not show up in the reference list.  If you have more than a few of these, however, or if they are important sources of information, you might consider listing them in an appendix, with names, dates, and titles. In the body of the paper, you would cite it like this: (A. Gonzalez, March 24, 2018, Interview #1). In the appendix, you would list the interviews either alphabetically or chronologically, with date and title: Interview #1: A. Gonzalez, Director of Food Services, Salinas Elementary School District, March 24, 2018.

Try to avoid using personal interviews as sources for data that can be obtained elsewhere, though. If the director of food services says, “Most of our students qualify for free or reduced lunch…” – you can get that data from another source. If she says, “Since we switched to a longer lunch period, I see a lot less food being wasted, because kids have more time to eat” – that’s a good quote.


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