Community Health

Preventative strategies

St. Lucie County is a rapidly growing region on the east coast of south Florida famous for its tropical weather and lush landscape. It is a community that benefits from a strong supporting organisation, the ‘Shared Service Network Executive Roundtable (ERT)’, a group of 24 chief executive policy-makers; elected officials; and leaders from various funding agencies, state and local government entities, and non-profit organisations. The ERTs mission is to create and implement system change that will result in improved outcomes for youths in local schools and in the community (Weiss et al., 2010).   

Unfortunately, St. Lucie County is not all paradise. Rates of sexually transmitted disease (STD) and teenage pregnancy are exceptionally high, in fact, much greater than other counties in the state of Florida (Weiss et al., 2010). In 2005, St. Lucie County ranked fourth in Florida for the number of STDs with concomitant HIV infections (Department of Health, 2006). Recognising the alarming increase in the incidence of HIV/AIDS, and teenage pregnancy among the St. Lucie community, a group of concerned individuals decided to take action. Community members including social workers, health educators, and county health department (CHD) leaders, became members of a HIV/AIDS action group, and a teenage pregnancy prevention group (TIPPS-Teen Impact for Pregnancy Prevention and Services) specifically to address the problems of HIV/AIDS and teenage pregnancy in the County. Although equally important, teenage pregnancy prevention was clearly a moral issue while the need for HIV/AIDS prevention was undisputed. Accordingly, the focus of the action plan ultimately became HIV/AIDS prevention.

This case study outlines the success story of a community-based participatory action group taking decisive action against an increase in teenage pregnancy, and HIV/AIDS in St. Lucie County. This group were highly commended for their efforts by state health officials as a direct result of the increased awareness of HIV/AIDS and the need for testing in the community (Copsey, 2009).

The community of St. Lucie were extremely concerned about the increase in sexually transmitted infections including HIV/AIDS, and the high incidence of teenage pregnancy in the County. Their focus was to inform and educate community members about the importance of sex education, and HIV prevention and testing strategies.

Initial community empowerment among St. Lucie residents was very strong and members were motivated to identify ways to make the requisite changes that would provide information and education on HIV/AIDS [Link Principle 8, Empowerment]. In this context, the development of inclusiveness among participants was essential to drive the research from a ‘bottom-up” approach [Link Principle 1, Inclusiveness]. A number of engaging approaches that created opportunities for participation were utilised to generate awareness among the St. Lucie community regarding the benefits of integrating a more comprehensive sex education into the public school system, and the greater community [Link Principle 1, Inclusiveness]. Moreover, joint participation in the coordination of sex education information into the school curriculum and the dissemination of a HIV/AIDS information DVD to provide community outreach was valuable in creating public awareness [Principle 5, Joint Ownership].  The Shared Service Network Executive Roundtable (ERT) was essential in providing key support strategies and tools that would help the working group accomplish specific goals [Principle 7, Accessible Information and Tools] Moreover, fluidity in membership across a diverse range of actors in the HIV/AIDS subcommittee ensured the inclusion of all individuals in the decision-making, design and action processes [Principle 3, Participation] [Principle 5, Joint Ownership].

A number of valuable lessons from this project created an opportunity to further refine and evaluate the methods utilised in disseminating and integrating information into the public schools and community systems. For example, identifying obstacles and disagreements that may hinder the flow of knowledge and information within the community was essential. This involved building mutual trust and a concerted effort to share the responsibility for the education of youths of St. Lucie County between the parents, community and public school systems [Principle 2, Respect, understanding and trust] [Principle 4, Communication].

Furthermore, sex education in the public school system was a sensitive issue. Several people in the community were opposed to any change in the current abstinence-only strategies. Thus, terminology was very important in defining the processes of introducing a new component of sex education into the schooling system. Therefore, terminology needed to be accurate and acceptable to the broader community [Link Principle 9, Equity and consensus]. Moreover, knowledge of the community views was essential to build developmental assets, strengthen existing community programs and interventions, and supplement current science and health curricula into the program [Link Principle 11, Action].