| CoAg Title: |
Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in The United States |
|
|
|
|
|
|
|
|
|
|
|
|
|
| CoAg Number: |
PS20-2010 |
|
|
|
|
|
|
|
|
|
|
Form Approved |
|
| CDC Program Office: |
NCHHSTP |
|
|
|
|
|
|
|
|
|
|
OMB Control No. XXXX-XXXX |
|
| # of recipients: |
47 |
|
|
|
|
|
|
|
|
|
|
Exp. Date: XX/XX/20XX |
|
| CDC Program POC: |
Janet Heitgerd (DHAP)/Christina Chung (STD) |
|
|
|
|
|
|
|
|
|
|
|
|
|
| Date completed: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Sample Performance Measure Specifications Form |
|
|
Performance Measure Characteristics |
Measurement Specifications |
Data Source Attributes |
Baseline and Target |
|
| Performance Measure (PM) |
Program Objective/Strategy Statement |
Performance Measure Title |
Population Targeted |
Unit of Measurement |
Numerator |
Denominator |
Frequency of Reporting |
Key Stratifications |
Record Level of Reporting |
Data Source(s) |
Data Source Agency or Owner |
Lag in Reporting |
Baseline |
Baseline Year |
Target |
Target Year |
|
| PM-1 |
1A.1 Conduct routine HIV testing in health care settings |
1A1.1A Percentage of persons tested in health care facilities identified as a priority for routine opt-out HIV screening |
Persons served at the facility |
Percentage |
Number of persons in the denominator who are tested for HIV
|
Number of persons served at facilities identified as priority for routine opt-out HIV screening |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-2 |
1A.1 Conduct routine HIV testing in health care settings |
1A1.1B Percentage of persons who received an HIV-positive test result in a health care facility that was identified as a priority for routine opt-out HIV screening |
Persons served at the facility |
Percentage |
Number of persons in the denominator with an HIV-positive test result
|
Number of persons who are tested for HIV at a health care facility that has been prioritized for routine opt-out HIV screening |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-3 |
1A.1 Conduct routine HIV testing in health care settings |
1A1.1C Percentage of persons newly diagnosed with HIV in a health care facility that was identified as a priority for routine opt-out HIV screening |
Persons newly diagnosed at the facility |
Percentage |
Number of persons in the denominator with a new diagnosis of HIV
|
Number of persons who are tested for HIV at a health care facility that has been prioritized for routine opt-out HIV screening |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-4 |
1A.2 Conduct routine HIV testing in jails and correctional facilities in high prevalence communities |
1A2.1A Percentage of persons incarcerated in jails and correctional facilities who are tested for HIV |
Persons incarcerated |
Percentage |
Number of persons in the denominator who are tested for HIV
|
Number of persons incarcerated in jails and correctional facilities |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-5 |
1A.2 Conduct routine HIV testing in jails and correctional facilities in high prevalence communities |
1A2.1B Percentage of persons incarcerated in jails and correctional facilities with a HIV-positive test result |
Persons incarcerated who were tested for HIV |
Percentage |
Number of persons in the denominator with an HIV-positive test result
|
Number of persons incarcerated in jails and correctional facilities who were tested for HIV |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-6 |
1A.2 Conduct routine HIV testing in jails and correctional facilities in high prevalence communities |
1A2.1C Percentage of persons incarcerated in jails and correctional facilities with a new diagnosis of HIV |
Persons incarcerated who were tested for HIV |
Percentage |
Number of persons in the denominator with a new diagnosis of HIV
|
Number of persons incarcerated in jails and correctional facilities who were tested for HIV |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-7 |
1A5.1 Link persons who inject drugs (PWID) who are screened in health care settings to SSP |
1A5.1 Percentage of persons who inject drugs (PWID) tested for HIV in an STD clinic who are linked to a syringe services program (SSP) |
PWID who are tested for HIV |
Percentage |
`Number of PWID in the denominator who are linked to SSP |
Number of PWID who are tested for HIV in an STD clinic |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-8 |
1B4.3 Link persons who inject drugs (PWID) who are screened in hnon-health care settings to SSP |
1B4.3 Percentage of persons who inject drugs (PWID) tested for HIV in a non-health care settings who are linked to a syringe services program (SSP) |
PWID who are tested for HIV |
Percentage |
Number of PWID in the denominator who are linked to SSP
|
Number of PWID who are tested for HIV in a non-health care setting |
Bi-annually |
age, gender, race/ethnicity, population group |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-9 |
1B.1 Promote HIV testing in non-traditional venues |
1B1.2A Percentage of HIV tests conducted in non-traditional venues identified as a priority for EHE testing services |
HIV tests |
Percentage |
Number of tests in the denominator that were conducted in non-traditional venues identified as a priority for EHE testing services
|
Number of HIV tests conducted in non-health care settings |
Bi-annually |
Age, gender, race/ethnicity, population group, setting type (non-traditional health care setting or non-traditional non-health care setting) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-10 |
1B.1 Promote HIV testing in non-traditional venues |
1B1.2B Percentage of HIV-positive test results in non-traditional venues identified as a priority for EHE testing services |
HIV tests |
Percentage |
Number of HIV-positive test results in the denominator
|
Number of HIV tests conducted in non-traditional venues identified as a priority for EHE testing services |
Bi-annually |
Age, gender, race/ethnicity, population group, setting type (non-traditional health care setting or non-traditional non-health care setting) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-11 |
1B.1 Promote HIV testing in non-traditional venues |
1B1.2C Percentage of new HIV-positive tests in non-traditional venues identified as a priority for EHE testing services |
HIV tests |
Percentage |
Number of new HIV diagnoses in the denominator
|
Number of HIV tests conducted in non-traditional venues identified as a priority for EHE testing services |
Bi-annually |
Age, gender, race/ethnicity, population group, setting type (non-traditional health care setting or non-traditional non-health care setting) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-12 |
1B.2 and 1C.4 Promote rapid HIV self-testing in non-health care settings (1B.2) and in health care settings (1C.4) |
1B2.1 and 1C4.1 Number of HIV self-test kits distributed |
HIV self-test kits |
Number |
Number of self-test kits distributed |
NA |
Bi-annually |
Age, gender, race/ethnicity, population group, setting type (health care setting or non-health care setting) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-13 |
1B.2 and 1C.4 Promote rapid HIV self-testing in non-health care settings (1B.2) and in health care settings (1C.4) |
1B2.2 and 1C4.2 Number of persons who received at least one HIV self-test kit |
Persons who received at least one HIV self-test kit |
Number |
Number of persons who received at least one HIV self-test kit |
NA |
Bi-annually |
Age, gender, race/ethnicity, population group, setting type (health care setting or non-health care setting) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-14 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
3A1.1 Percentage of persons testing negative for HIV who are screened for PrEP |
Persons testing negative for HIV at the facility |
Percentage |
Number of persons in the denominator who are screened for PrEP
|
Total number of persons who tested negative for HIV |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-15 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
1A4.1 and 1B4.2 Percentage of persons who are screened and eligible for PrEP referral |
Persons testing negative for HIV who are screened for PrEP at the facility |
Percentage |
Number of persons in the denominator who are eligible for PrEP referral |
Number of persons screened for PrEP |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-16 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
1A4.2 and 1B4.3 Percentage of persons eligible and referred to a PrEP provider |
Persons testing negative for HIV who are eligible for PrEP |
Percentage |
Number of persons in the denominator who are referred to a PrEP provider |
Number of persons eligible for PrEP referral who were identified in STD clinic |
bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-17 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
3A1.3 Percentage of persons who are referred and linked to a PrEP provider |
Persons referred to PrEP who are linked to PrEP provider |
Percentage |
Number of persons in the denominator who are linked to a PrEP provider |
Number of persons testing negative for HIV who are referred to a PrEP provider |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-18 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
3A1.3A Percentage of persons who are linked to a PrEP provider and prescribed PrEP |
Persons linked to a PrEP provider who are prescribed PrEP |
Percentage |
Number of persons in the denominator who are prescribed PrEP |
Number of persons testing negative for HIV who are linked to a PrEP provider |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-19 |
3B.1 Ensure that SSPs provide standard services |
3B1.1 Number of SSPs operating in the jurisdiction |
Operating SSP |
Number |
Number of SSPs operating in the jurisdiction |
NA |
Bi-annually |
Provision of 1 or more standard servies, encounters at fix site SSP locations, enterners with mobile/outreach SSP locations |
Aggregate |
Agency Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-20 |
3B.1 Ensure that SSPs provide standard services |
3B1.2 Number of encounters related to at least one standard service by an SSP |
Operating SSP |
Number |
Number of encounters related to at least one standard SSP service |
NA |
Bi-annually |
Provided/refered to infectious disease prevention, substance use disorder, referal to essential support services |
Aggregate |
Agency Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-21 Optional Measure |
J1. Integrated screening (e.g., HIV/viral hepatitis; HIV/TB; HIV/STD) |
J1.1 Percentage of HIV screenings conducted that are integrated with other screenings (e.g., viral hepatitis/TB/STD) |
HIV screenings |
Percentage |
Number of HIV screenings that were integrated with other screenings (e.g., viral hepatitis/TB/STD) |
Total number of HIV screenings conducted in health care and non-health care settings |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Agency Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-22 Optional Measure |
J2. TelePrEP (PrEP delivery via Telehealth) |
J2.1 Percentage of persons who were linked to a TelePrEP provider |
Persons linked to PrEP provider |
Percentage |
Number of persons who were linked to a TelePrEP provider |
Total number of persons who were linked to a PrEP provider |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Agency Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
| PM-23 Optional Measure |
J3. Navigator assistance for HIV screenings/PrEP/SSP |
J3.1 Percentage of persons who were linked to HIV/STD screenings/PrEP/SSP with the assistance of a navigator |
Persons who are provided navigation services |
Percentage |
Of the denominator, the number of persons who were screened for HIV/STD/linked to PrEP/SSP services |
Number of persons who were assisted by navigators for HIV/STD screenings, PrEP, and SSP |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Agency Records |
|
|
|
|
|
|
|
| PM-24 Optional Measure |
J4. Social Marketing Campaign for HIV/STD screenings, PrEP, and SSP: Advertising Placements |
J4.1 Percentage of impressions from advertising conducted in HIV/STD screenings/PrEP/SSP (e.g., print; digital/internet-based; radio; television; out-of-home advertising) social marketing campaign(s) targeting specified priority groups e.g., MSM, youth, MSM of color, Hispanics/Latinos, blacks/African Americans, transgender persons etc. |
Persons in specified priority group |
Percentage |
Number of advertising impressions in HIV/STD screenings/PrEP/SSP social marketing campaign by type (e.g., print; digital/internet-based; radio; television; out-of-home advertising) |
Estimated number of persons in the specified priority group e.g., MSM, youth, MSM of color, Hispanics/Latinos, blacks/African Americans, transgender persons etc. |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Agency Records |
Health Department |
6 months |
NA |
NA |
NA |
NA |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Column Header Definitions |
|
|
|
|
|
|
|
|
|
| Performance Measure Characteristics |
|
|
|
|
|
|
|
|
| Program Objective / Strategy Statement |
A general statement about a program outcome/strategy/output. Note: Multiple performance measures may be used to assess impact of a given outcome/strategy/output |
|
|
|
|
|
|
|
|
| Performance Measure Title |
The fully defined title of the performance measure. |
|
|
|
|
|
|
|
|
| Population Targeted |
The population that the performance measure represents (e.g., tested or served persons only, the general population, subpopulations such as women or youth) |
|
|
|
|
` |
|
|
|
| Measurement Specifications |
|
|
|
|
|
|
|
|
| Unit of Measurement |
The unit of measurement or calculation for the performance measure (e.g., number, percentage, rate) |
|
|
|
|
|
|
|
|
| Numerator |
Definition and/or calculation of numerator (if applicable) |
|
|
|
|
|
|
|
|
| Denominator |
Definition and/or calculation of denominator (if applicable) |
|
|
|
|
|
|
|
|
| Frequency of Reporting |
Reporting frequency of performance measure data (e.g., annually, quarterly, monthly) |
|
|
|
|
|
|
|
|
| Key Stratifications |
List the strata of interest for assessing performance within selected substrata (e.g., race/ethnicity, age, gender, facility type etc.) |
|
|
|
|
|
|
|
|
| Record Level of Reporting |
Will data be reported as individual level records/observations (line level data), or are the reported data aggregated in any way? |
|
|
|
|
|
|
|
|
| Data Source Attributes |
|
|
|
|
|
|
|
|
| Data Source(s) |
The source(s) from which the performance measure is derived. If more than one data source is used to calculate the performance measure, note here. |
|
|
|
|
|
|
|
|
| Data Source Agency or Owner |
The organization or agency that manages the data source(s) and is responsible for constructing the database and reporting data to the awardee |
|
|
|
|
|
|
|
|
| Lag in Reporting |
The time interval between when the data are collected and when the data are reported to CDC |
|
|
|
|
|
|
|
|
| Performance Measure Baselines and Targets |
|
|
|
|
|
|
|
|
| Baseline |
The initial point estimate of the performance measure |
|
|
|
|
|
|
|
|
| Baseline Year |
The year for the baseline estimate |
|
|
|
|
|
|
|
|
| Target |
The expected improvement in the performance measure estimate and a set date in the future |
|
|
|
|
|
|
|
|
| Target Year |
The reported point estimates (and time period) of the performance measure data |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| CDC estimates the average public reporting burden for this collection of information as 30 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1282). |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| CoAg Title: |
Integrated HIV Programs for Health Departments to Support Ending the HIV Epidemic in The United States |
|
|
|
|
|
|
|
|
|
|
|
|
| CoAg Number: |
PS20-2010 |
|
|
|
|
|
|
|
|
|
|
Form Approved |
| CDC Program Office: |
NCHHSTP |
|
|
|
|
|
|
|
|
|
|
OMB Control No. XXXX-XXXX |
| # of recipients: |
47 |
|
|
|
|
|
|
|
|
|
|
Exp. Date: XX/XX/20XX |
| CDC Program POC: |
Janet Heitgerd (DHAP)/Christina Chung (STD) |
|
|
|
|
|
|
|
|
|
|
|
|
| Date completed: |
|
|
|
|
|
|
|
|
|
|
|
|
|
| STD clinic specific measures taken from Component A (with modifications noted in darker shaded cells/columns) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Sample Performance Measure Specifications Form |
|
Performance Measure Characteristics |
Measurement Specifications |
Data Source Attributes |
Baseline and Target |
| Performance Measure (PM)- reference retained from Component A worksheet |
Program Objective/Strategy Statement |
Performance Measure Title |
Population Targeted |
Unit of Measurement |
Numerator |
Denominator |
Frequency of Reporting |
Key Stratifications |
Record Level of Reporting |
Data Source(s) |
Data Source Agency or Owner |
Lag in Reporting |
Baseline |
Baseline Year |
Target |
Target Year |
| PM-1 |
1A.1 Conduct routine HIV testing in health care settings |
1A1.1A Percentage of persons tested in health care facilities identified as a priority for routine opt-out HIV screening |
Persons served at the facility |
Percentage |
Number of persons in the denominator who are tested for HIV
|
Number of persons served at facilities identified as priority for routine opt-out HIV screening |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-2 |
1A.1 Conduct routine HIV testing in health care settings |
1A1.1B Percentage of persons who received an HIV-positive test result in a health care facility that was identified as a priority for routine opt-out HIV screening |
Persons served at the facility |
Percentage |
Number of persons in the denominator with an HIV-positive test result
|
Number of persons who are tested for HIV at a health care facility that has been prioritized for routine opt-out HIV screening |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-3 |
1A.1 Conduct routine HIV testing in health care settings |
1A1.1C Percentage of persons newly diagnosed with HIV in a health care facility that was identified as a priority for routine opt-out HIV screening |
Persons newly diagnosed at the facility |
Percentage |
Number of persons in the denominator with a new diagnosis of HIV
|
Number of persons who are tested for HIV at a health care facility that has been prioritized for routine opt-out HIV screening |
Bi-annually |
Age, gender, race/ethnicity, population group |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-14 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
3A1.1 Percentage of persons testing negative for HIV who are screened for PrEP |
Persons testing negative for HIV at the facility |
Percentage |
Number of persons in the denominator who are screened for PrEP
|
Total number of persons who tested negative for HIV |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-15 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
1A4.1 and 1B4.2 Percentage of persons who are screened and eligible for PrEP referral |
Persons testing negative for HIV who are screened for PrEP at the facility |
Percentage |
Number of persons in the denominator who are eligible for PrEP referral |
Number of persons screened for PrEP |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-16 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
1A4.2 and 1B4.3 Percentage of persons eligible and referred to a PrEP provider |
Persons testing negative for HIV who are eligible for PrEP |
Percentage |
Number of persons in the denominator who are referred to a PrEP provider |
Number of persons eligible for PrEP referral who were identified in STD clinic |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-17 |
3A.1 Deliver PrEP services in health care settings and non-health care settings in communities with the highest HIV prevalence |
3A1.3 Percentage of persons who are referred and linked to a PrEP provider |
Persons referred to PrEP who are linked to PrEP provider |
Percentage |
Number of persons in the denominator who are linked to a PrEP provider |
Number of persons testing negative for HIV who are referred to a PrEP provider |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| STD clinic specific measures (unique; not in Component A) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Performance Measure Characteristics |
Measurement Specifications |
Data Source Attributes |
Baseline and Target |
| Performance Measure (PM)- reference retained from Component A worksheet |
Program Objective/Strategy Statement |
Performance Measure Title |
Population Targeted |
Unit of Measurement |
Numerator |
Denominator |
Frequency of Reporting |
Key Stratifications |
Record Level of Reporting |
Data Source(s) |
Data Source Agency or Owner |
Lag in Reporting |
Baseline |
Baseline Year |
Target |
Target Year |
| PM-STD-1 |
Conduct extragenital screening for STDs |
Percent of persons tested for rectal GC/CT who are positive for rectal GC/CT |
Persons served at the facility |
Percentage |
Number of persons in the denominator who had a positive test result for GC or CT based on rectal testing |
Number of persons tested for rectal GC/CT |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-STD-2 |
Provide PrEP at the STD clinic |
Percent of persons eligible for PrEP who receive PrEP at the STD clinic |
Persons seen at the facility who are eligible and interested in PrEP |
Percentage |
Number of persons in the denominator who received PrEP (prescription or starter pack) at the STD clinic |
Number of persons referred for PrEP |
Bi-annually |
Age, gender, race/ethnicity, population group, test setting (STD clinic, other health care setting, non-health care setting, other) |
Aggregate |
Testing records |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-STD-3 |
Strengthen STD clinic capacity to provide HIV prevention, care, and treatment services |
Number of HIV prevention and referral services provided routinely by STD clinics |
STD clinics |
Number |
Number of HIV prevention and referral services |
N/A |
Bi-annually |
N/A |
Clinic |
Clinic staff |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-STD-4 |
Strengthen STD clinic capacity to provide HIV prevention, care, and treatment services |
Number of HIV laboratory services offered routinely by STD clinics |
STD clinics |
Number |
Number of HIV laboratory services |
N/A |
Bi-annually |
N/A |
Clinic |
Clinic staff |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-STD-5 |
Strengthen STD clinic capacity to provide HIV prevention, care, and treatment services |
Number of HIV treatment services offered routinely by STD clinics |
STD clinics |
Number |
Number of HIV treatment services |
N/A |
Bi-annually |
N/A |
Clinic |
Clinic staff |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
| PM-STD-6 |
Strengthen STD clinic capacity to provide HIV prevention, care, and treatment services |
Number of service models offered routinely STD clinics |
STD clinics |
Number |
Number of service models |
N/A |
Bi-annually |
N/A |
Clinic |
Clinic staff |
STD clinic |
6 months |
NA |
NA |
NA |
NA |
|
Column Header Definitions |
|
|
|
|
|
|
|
|
| Performance Measure Characteristics |
|
|
|
|
|
|
|
| Program Objective / Strategy Statement |
A general statement about a program outcome/strategy/output. Note: Multiple performance measures may be used to assess impact of a given outcome/strategy/output |
|
|
|
|
|
|
|
| Performance Measure Title |
The fully defined title of the performance measure. |
|
|
|
|
|
|
|
| Population Targeted |
The population that the performance measure represents (e.g., tested or served persons only, the general population, subpopulations such as women or youth) |
|
|
|
|
` |
|
|
| Measurement Specifications |
|
|
|
|
|
|
|
| Unit of Measurement |
The unit of measurement or calculation for the performance measure (e.g., number, percentage, rate) |
|
|
|
|
|
|
|
| Numerator |
Definition and/or calculation of numerator (if applicable) |
|
|
|
|
|
|
|
| Denominator |
Definition and/or calculation of denominator (if applicable) |
|
|
|
|
|
|
|
| Frequency of Reporting |
Reporting frequency of performance measure data (e.g., annually, quarterly, monthly) |
|
|
|
|
|
|
|
| Key Stratifications |
List the strata of interest for assessing performance within selected substrata (e.g., race/ethnicity, age, gender, facility type etc.) |
|
|
|
|
|
|
|
| Record Level of Reporting |
Will data be reported as individual level records/observations (line level data), or are the reported data aggregated in any way? |
|
|
|
|
|
|
|
| Data Source Attributes |
|
|
|
|
|
|
|
| Data Source(s) |
The source(s) from which the performance measure is derived. If more than one data source is used to calculate the performance measure, note here. |
|
|
|
|
|
|
|
| Data Source Agency or Owner |
The organization or agency that manages the data source(s) and is responsible for constructing the database and reporting data to the awardee |
|
|
|
|
|
|
|
| Lag in Reporting |
The time interval between when the data are collected and when the data are reported to CDC |
|
|
|
|
|
|
|
| Performance Measure Baselines and Targets |
|
|
|
|
|
|
|
| Baseline |
The initial point estimate of the performance measure |
|
|
|
|
|
|
|
| Baseline Year |
The year for the baseline estimate |
|
|
|
|
|
|
|
| Target |
The expected improvement in the performance measure estimate and a set date in the future |
|
|
|
|
|
|
|
| Target Year |
The reported point estimates (and time period) of the performance measure data |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Health Department EHE Performance Measures Data Collection Tool: STD specialty clinics
CDC estimates the average public reporting burden for this collection of information as 10 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1282). |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Prevention Training Centers EHE Performance Measures Data Collection Tool: STD specialty clinics
CDC estimates the average public reporting burden for this collection of information as 20 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1282). |
|
|
|
|
|
|
|
|
|
|
|
|
|