The trusted source for
healthcare information and
Case study: SPOT hits mark with at-risk youth
How can clinicians reach at-risk teens? Take a look at the SPOT (Supporting Positive Opportunities with Teens), a one-stop, drop-in center in St. Louis aimed specifically at the 13- to 24-year age group.
The center, which opened in September 2008, provides testing for HIV and sexually transmitted diseases (STDs), contraceptive services, health care and counseling, social support, prevention, and case management services at no cost. The center was launched by Washington University in St. Louis's School of Medicine's Project ARK (AIDS/ HIV Resources and Knowledge) and the Adolescent Center in the Department of Pediatrics in collaboration with community partners
The youth of St. Louis contend with serious health risks which can have lifelong consequences, says Kim Donica, LCSW, Project ARK program director. Those risks include sexually transmitted infections, HIV, and teen pregnancy, she notes.
In 2004, St. Louis had the highest rate of gonorrhea and the second-highest rate of chlamydia of all the cities in the United States, Donica says. These numbers have continued to increase. In the city of St. Louis, the number of chlamydia cases climbed from 3,206 in 2002 to 4,393 in 2007; of those, 73.8% were people ages 13-24, she states.
"Likewise, HIV infection rates among youth have continued to rise," says Donica. "In a strikingly similar pattern, youth ages 13-24 comprised 11.6% of the total new HIV infections in the region in 2001, and by 2007, the proportion had increased to 31.9%."
The center offers STD treatment, contraception, Pap smears, pregnancy tests, and some medical visits for common complaints such as rashes, sore throats, and colds, says Katie Plax, MD, the facility's medical director. The SPOT maintains partnerships with primary care providers and links people into those services if needed, says Plax, an assistant professor of pediatrics at Washington University School of Medicine and director of the Adolescent Center at St. Louis Children's Hospital.
The facility is staffed with two nurses (who share a position), three doctors, who each work a half-day, and a psychiatrist, who works a half-day, she says. Other staff members include a full-time counselor, a full-time case manager, a part-time case manager, a program manager, and a youth development specialist. The director of the center is Regina Whittington, MSW.
Get youth input
How did program officials devise the cafeteria of services at the SPOT? Donica says input from young people helped.
"A survey was conducted with youth in which they were asked which services were most important to them; in addition, the Youth Advisory Committee [a group of young people who serve as an advisory board for the St. Louis region and Missouri] also provided input regarding the range of needed services," Donica states. "In addition to input from youth, we looked at model programs in other cities to learn from them what services they felt had been most important to youth."
How has the facility been designed to put young people at ease? The drop-in center is colorful and modern, featuring a living room with cozy furniture. Everything is developed from a positive youth development perspective, says Whittington. "We believe in low threshold and high engagement with the youth. We only ask them to complete a short card, which includes their name, age, and what service they would like to access for the day," says Whittington. "Our staff are committed to engaging with the youth to identify potential needs, as well as encourage them to access services."
How is the facility getting the word out to teens about the availability of services at the SPOT? Media coverage, including television, radio, and newspaper articles, have helped get the word out, as well as cooperation from community partners, who have done a "tremendous" job of linking youth to services, says Whittington.
"The best source of information are the youth themselves," states Whittington. "We have many youth accessing services for the first time stating they came on the recommendation of a friend."
Funding for the facility has come from various foundations, including Missouri Foundation for Health, Barnes Jewish Hospital Foundation, Children's Hospital, Barnes Jewish Care, and the city of St. Louis, states Whittington. As of the end of December 2008, the center had served 491 unduplicated youth, with a total of more than 3,700 encounters for those youth, she states.