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15 <br />• ~ EVALUATION <br />1 Evaluation of ongoing appropriateness of elan ' <br />To gather information on how we can best target prevention anal screening activities on an <br />ongoing basis, several sources. of data will be examined quarterly. First, DIS v~nll include the <br />following questions ~ their interviews of syphilis infected individuals in the five-county area: <br />1. Has the patient been to an emergency room within the last month? three months? <br />2. Has the patient been in a drug treatment program in the last month? three months? <br />3. Has the patient been in jail or prison in the last month?three months? <br />. 4. Has the patient been to a health department clinic in the last month? three months? <br />5. If yes to 4,-which clinic? (STD, Family Planning, Adult Health, Prenatal, etc.) <br />6. Has the patient received health care in other settings in the last month? three months? <br />7. If yes to 6, where? (Specify which private physician, community health center, etc.) <br />Responses to these questions will suggest locations where screening would be an effective case- <br />finding tool Second, early syphilis case data will be analyzed to monitor the demographics of <br />case patients, the routes through which cases are identified (partner notification,.clustering, jail <br />screening, community-based organization screening, etc.), and the behavioral risk factors of <br />cases. Third, DIS activity will be analyzed to assess the effectiveness of partner notification <br />activities and the ongoing need for alternative methods such as clustering. Examination of these <br />data will allow us to promptly identify changes in the local epidemiology of syphilis, including <br />new outbreaks, and to provide a response appropriate to the specific sociocultural setting of the <br />cases. <br />?. Evaluation through Process Objectives <br />Achievement of objectives TI-3 will be monitored and documented by the project coordinator, <br />and achievement of specific objectives under objective n~ will be monitored and documented <br />once implementation of the syphilis elimination plan has be„wn. These achievements will be <br />reported quarterly to all participating organizations, the Regional Health Director's Group, and <br />the Section. <br />3. Evaluation through Outcomes <br />Reported primary and secondary syphilis morbidity in the five-county area will be monitored and <br />documented. Cases are expected to increase initially as case-finding efforts are intensified and as <br />• active surveillance increases reports from some agencies. Cases should then decline as <br />transmission is interrupted by prompt identification and treatment of infectious cases. Due to the <br />uncertain. impact of reporting changes on morbiairy trends, prevalence monitoring will provide a <br />_ more rigorous evaluation of the impact of this project. Prevalence monitoring ~dll be undertaken <br />" in several setdngs, including local jails, health department prenatal clinics, and health department <br />STD clinics. Prevalence data will be collected from the beginning of jail screening, and is <br />available from health departrnent clinics. ~ Project staff will compile data quarterly and report it to <br />all participating organizations, the Regional Health Director's Crrotip, and the Section. <br />10 <br />