O06.6 Refreshing the British Columbia Syphilis Control Strategy: Thematic Analysis of a Multi-Stakeholder Consultation Process
Bibliographic record
Abstract
Background A provincial syphilis control strategy for British Columbia was developed in 2016 in response to a syphilis epidemic, predominantly among gay, bisexual and other men who have sex with men (gbMSM). Current data shows significant increases among women of childbearing age and congenital syphilis has recurred. Given these epidemiologic changes, a stakeholder engagement process aimed at understanding priorities and gaps was initiated to inform a refresh of the strategy. Methods A provincial committee was developed to oversee the refresh and engage key stakeholder groups including public health, clinicians, laboratory leads, researchers, Indigenous communities, community organizations, and people affected by syphilis. The socio-ecological model was used to guide discussions about contributing factors and leverage points. Thematic analysis of responses was performed to develop a conceptual framework and identify priority areas for inclusion into a refreshed syphilis control strategy. Results A total of nineteen consultations were held with the various stakeholder groups. Themes were mapped to the socio-ecological model and included: 1) individual level: syphilis knowledge (e.g. risk awareness, pre- and post-exposure prevention options), 2) behavioural/biological level: substance use (e.g. in the context of party-and-play, as a coping mechanism) and syphilis testing (e.g. accessibility, opportunity to shift to an opt-out testing strategy), 3) community/relationship level: sexual networks (e.g. bridging between the gbMSM and heterosexual populations), relationships between clients and care providers (e.g. cultural safety and humility, outreach services), and relationships between public health and primary care (e.g. increasing capacity for syphilis care, integration of public health with primary care), and 4) societal/structural level: social determinants (e.g. housing), relationships with Indigenous communities (e.g. building trust, support for Indigenous-led land-based activities), and importance of using a sexual health framework (e.g. sex-positive messaging). Conclusion Based on these identified themes, eight goals with supporting actions were prioritized in a refreshed syphilis control strategy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.051 | 0.042 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.020 | 0.009 |
| Scholarly communication | 0.009 | 0.004 |
| Open science | 0.003 | 0.010 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".