College Age Assessment: Sexually Transmitted Diseases

Katie Benson

Department of Nursing, Viterbo University

NURS 452: Public Health Nursing

Professors Jacobson & Richardson

February 24, 2023

 College Age Assessment: Sexually Transmitted Diseases

La Crosse houses three college communities which contributes to its diversity and

changing population throughout the year. When school is in session, the environment and

population focus shifts towards the college students. The bars become packed, downtown streets

are filled with people walking around, and the campuses are bustling with students coming and

going from classes. While this is an interesting aspect of La Crosse, in that its atmosphere

changes with the start of classes and the entrance of college students into the town, it also alters

the prevalence of health issues and disparities. The general population of La Crosse County has

been assessed for the biggest disparities and health needs in the county through community

assessments. The La Crosse County Health Department conducts a Community Health

Assessment and Improvement Plan every 5 years to promote health and prevent illness in the

county. It assesses health disparities and areas of health that need the most attention in the

county. The improvement plan also provides guidelines for community resources and an action

plan to improve these health disparities and address the county health needs.

The Community Health Assessment conducted assessments through key informant

interviews, forums, and a community wide survey. This assessment found themes of behavioral

health, access to care, and a healthy environment were the priority health concerns in the county

(La Crosse County Health Department Community Health Assessment Team, 2021). Behavioral

health needs were aimed at addressing mental health, substance use, and suicide in the

community. The health concern regarding a healthy environment was to guide care surrounding

safe housing, food, and physical activity. Some of the demographic data that contributed to the

assessment is that the population that participated in the assessment self-identified as 89.5% of

them being White or non-Hispanic, 1.9% as two or more races, 2.1% Hispanic or Latino, 1.6%
black or African American, 4.7% Asian, and 0.5% as American Indian or Alaska Native. The

assessment also recognized that the La Crosse County resides on territories of the Ho-Chunk

Nation and that there is a vast number of languages spoken in the county like English, Spanish,

Indo-European, and Asian & Pacific Island languages (La Crosse County Health Department

Community Health Assessment Team, 2021). These demographics contribute to the diversity of

La Crosse County and their views on health needs. La Crosse County is ranked as number 22 out

of 72 counties in Wisconsin in terms of healthiness. In making these rankings,

Countyhealthrankings.org reported different health outcomes and factors for each county and

compared them to the state and national averages. La Crosse County notably is ranked in the 50-

75% of healthiest counties in terms of health outcomes and in the 75-100 percentile in terms of

health factors. With these statistics in mind, some areas that they found La Crosse to be above

the state and national average are adult smoking, access to exercise opportunities, excessive

drinking, mammography screening, flu vaccinations, air pollution – particulate matter, and

driving alone to work (County Health Rankings, 2023). In general terms, La Crosse County has

many beneficial health factors and outcomes that contribute to it being in the top 25 healthiest

counties in Wisconsin. It also has some concerning health outcomes that should be addressed.

To reduce the population pool, the target population for this assessment will be reduced

to the college age population of La Crosse, focusing on UW-La Crosse and Western Technical

College. Viterbo University is excluded from this assessment due to their use of an in-house

health care team. The University of Wisconsin La Crosse and Western Technical College share a

health center in contract with Mayo Health Systems which will be the main source of data for

this assessment. This target population focuses on college age students which range in age from

17-24 years old. The focus of this assessment is on college age risky behaviors and health needs.
Some things to consider for La Crosse and the target population of college age people is that

there are three colleges/universities in close proximity. This means that there is a mixing of

student population in most areas of the city and activities that occur here. Considerations for

focus on this population is the number of legal drinking age people in this population and the

number of students coming of age. As mentioned above, La Crosse County is known for having

a higher percentile of excessive drinking than the state of Wisconsin and the United States

national average with 26% in respect to 25% and 20%. Another interesting data point to consider

is the number of alcohol-impaired driving deaths that occurred, in La Crosse County, “35% of

motor vehicle deaths involved alcohol” in comparison to Wisconsin’s total of 36% and the

national percentile of 27% (County Health Rankings, 2023).

Sexually Transmitted Infections would also be a health concern for college age students

because they tend to participate in more risky behaviors. The number of newly diagnosed

chlamydia cases per 100,000 people nationally was 551, in Wisconsin was 499.4, and in La

Crosse County 503.3 in the year 2019 (County Health Rankings, 2023). Considering the size of

La Crosse County and that the college age population are the biggest age range of people

contributing to these statistics, the number of sexually transmitted infections (STIs) is shocking.

Something worth mentioning is that college students do not necessarily live in La Crosse County

full time and may be contributing to this data during only certain times of the year. This is an

important factor to consider due to the high incidence of infection and the shorter period that the

most contributing population is not staying within La Crosse County the entire year. According

to the La Crosse Community Assessment, STIs are the most common communicable disease and

the average age of individuals contracting them are between 23 and 27 years old (La Crosse

County Health Department Community Health Assessment Team, 2021). STIs consist of
gonorrhea, chlamydia, and syphilis and are considered reportable diseases. These infections are

reportable to the public health department to track the number of cases and do contact tracing.

Contact tracing is done to notify other people who could be infected so they can be treated and to

try to limit the spread of these infections. STIs are also preventable and mostly treatable;

however, some cannot be cured and lead to complications like infertility, pelvic pain, and

infections in the reproductive tract. These long-term effects are why STIs are concerning and

why prevention and education are important for the college-age population.

A short-term goal would be for students who attend the clinic to be able to identify proper

ways to prevent STIs after the education given at the clinic. A long-term goal would be for the

number of students with positive STIs to decrease by 15% in comparison with other years for the

Spring semester of school. A priority intervention for this population is a free screening clinic to

allow for students to have a place to test for STIs without an associated cost. Screening is the

priority intervention for containing the spread of STIs (U.S. Preventative Services Task Force,

2021). Screening provides early detection of infections and allows the healthcare team to address

positive results in a timely manner to be able to treat the students efficiently and effectively. By

treating cases of positive STIs quickly, the spread of STIs is decreased. Screening for and

treating STIs early also helps to prevent any complications from recurrent or prolonged

infections like pelvic pain, infertility, and infections in the reproductive tract. UW-La Crosse and

Western Technical College are in such a proximity to each other that it would be pertinent for

these students to be tested at the same time. The nature of college campuses and college life is so

focused on sexual activity and intoxication that education and screening for students is vital for

their sexual and reproductive health. There is also a need for proper education on STIs, the long

term effects on infections, and proper ways to prevent STIs. This can be evidenced by the high
rates of STIs in La Crosse County as mentioned above as well as statistics on UW-Lacrosse and

Western Technical Colleges campuses. The free clinic is planned to happen about two weeks

before spring break to prevent students from participating in sexual acts while being infected. If

they test positive at the clinic, they will be provided with treatment and their full course of

treatment should be completed before spring break begins. This prevents the spread of infection

to other participants and areas where students travel for break. There is also another free clinic

planned for two weeks after spring break to allow for proper screening to occur again. This

allows for students who participated in sexual activity without protection during break to be

tested for infections and treated if necessary. The goal for these free clinics is to test and treat

students for STIs without the barriers of having to pay for testing. The hope is for there to be

fewer positive tests after spring break with the testing occurring before break. It is also good

advertisement to the students that the Student Health Center does provide $5 testing for STIs any

time during the school year. With more testing and education about STIs, the long-term goal for

the clinic is that there are fewer positive sexually transmitted infections.

The current plan to communicate with the college age students is to put up flyers around

campus and to set up tables with games for students to interact with the week of the event. The

tables will house games with education about STIs, complications, and prevention measures.

They will also have some small goodie bags with snacks and postcard in them that has more

information about how to prevent STIs and proper ways to protect against them (See Appendix

A). The tables will be set up in the student union and in one of the academic buildings where

there is high traffic. There will be a couple volunteers at each table to assist with attracting

students to the tables, give them information about the free clinic, and run the games available.

At the event, there is a raffle and snacks being provided as well as games set up for
entertainment while waiting to be tested. There will also be educational posters/flyers around the

clinic to provide some light reading/educational material while they make their way through the

clinic (See Appendix B). Additional incentive for reading the material is the questionnaire that

will be provided. The questions can be answered by the posters and will earn them another entry

into the raffle. Some things that should be considered when making the visual aids, games,

education materials, and posters are health literacy and visual layout. It is important to simplify

the message and not use medical terms or lengthy explanations. Visuals and pictures add to

understanding and may be useful to help demonstrate the education points (Centers for Disease

Control & Prevention, 2009). Health literacy is something that should be taken into consideration

when making the different advertisements and education pieces. Another aspect to take note of is

that young adults do not tend to read handouts and would rather have something digital to refer

to. Providing them with reliable sources is important so they are not using untrustworthy

references. A way that this can be communicated appropriately is through the use of QR codes

where they can use a smart phone to view the links through the QR code. This gives them access

to a digital version of the reputable sources provided. All these things are important to consider

when making educational handouts or posters and marketing the event.

The goals can be evaluated after the initial clinic, the clinic after spring break, and at the

end of the semester to determine how successful the measures taken to decrease STIs was at

UWL and WTC. The short-term goal where students would answer the questions on the

questionnaire correctly could be judged on the improvements in their scores from the first clinic

to the second free clinic after break. It may be beneficial to consider providing the questionnaire

prior to them viewing the educational posters. This would allow them to find the things that they

did not know or were incorrect about. As for the long-term goal of the number of positive STIs,
it would be most beneficial to compare the number of positive results to past year’s data. This

may be more difficult due to different providers and managers that were in charge the past year.

Their protocols were different and some of the data could be impacted by the change in

leadership and the source of the care team. The results could also be impacted by the effects of

the COVID pandemic and any barriers that COVID created on the clinic in years past. The long-

term goal could also be reevaluated the following semester when they do another free clinic. The

long-term goal will not be something that can be evaluated during the time of this course but

would be a great piece of information for the clinic to determine how successful the event was. It

could also be a great source of information for the county and the county statistics on sexually

transmitted infections.

Sexually transmitted diseases are prevalent in La Crosse and can spread rapidly. By

providing free clinics to test for STIs and treatment, early screening and prevention of spread

occurs. The hope is that these clinics will provide efficient, effective education to students about

STIs and proper ways to prevent infection to reduce positive infections in the future. It will also

provide screening for these infections and treatment to prevent any further complications or

long-term infection. This will improve health disparities in La Crosse County as well as the

places that students travel to/live throughout the year. It could potentially lead to better

community health in La Crosse, the county, and surrounding areas that students are from or

where they go. Sexually transmitted infections are preventable and treatable, education and

screening are the best methods for healthcare systems to provide patients for health promotion

and disease prevention.

 Resources

Centers for Disease Control & Prevention. (2009). Simply put: A guide for creating easy-to-

understand materials. U.S. Department of Health and Human Services.

County Health Rankings (2023). La Crosse, WI. University of Wisconsin Population Health

Institute: School of Medicine and Public Health. Retrieved February 08, 2023, from

https://www.countyhealthrankings.org/explore-health-rankings/wisconsin/la-crosse?

year=2022

La Crosse County Health Department Community Health Assessment Team (2021). Community

health assessment 2021. La Crosse County Health Department.

U.S. Preventative Services Task Force. (2021). Recommendation: Chlamydia and gonorrhea:

Screening. U.S. Preventative Services Task Force. Retrieved February 9, 2023, from

https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/chlamydia-and-

gonorrhea-screening
 Appendix A

Postcard Education

Figure A1

Side one of the postcard used for educational material and links to reliable sources.
Figure A2

Back side of the postcard.

 Appendix B

Flyers/Posters for Education

The following posters/flyers were made as educational materials to be posted around the

clinic. They provide educational materials for students to learn more about campus statistics of

STIs, information about chlamydia and gonorrhea, pregnancy prevention and STI prevention

methods.

Figure B1
Figure B2
Figure B3
Figure B4