The Champaign Urbana Public Health District (CUPHD) in Champaign County, Illinois, serves a diverse population of approximately 210,000 residents with a median age of 30.4 and a median household income of $53,936. Champaign County is a micro-urban community that is composed of various ethnic groups, with White (Non-Hispanic) being the largest at 66.5%, followed by Black or African American (Non-Hispanic) at 13.3%, and Asian (Non-Hispanic) at 10.8%. One of the primary public health issues addressed by CUPHD is the high prevalence of sexually transmitted infections (STIs), particularly gonorrhea and chlamydia, within certain populations. Vulnerable populations that are disproportionately affected by STIs in Champaign County are young adults aged 15-24, men who have sex with men, and racial and ethnic minorities. The goals and objectives of the proposed practice involved implementing the "Pee N Flee" program to overcome barriers to STI testing. This program aims to increase testing opportunities by offering a convenient and accessible testing option. The “Pee N Flee” program provides a cost-free, contactless, walk-in service that ensures patients are screened for gonorrhea and chlamydia infections and are out of the clinic in as little as 5 minutes. This program seeks to encourage more frequent and timely testing, ultimately leading to early detection and improved health outcomes. The "Pee N Flee" program was strategically designed to streamline the testing process. Patients complete a consent form, supply a urine sample, and drop their documents and sample off in a designated locker. The test results are later communicated to them via a phone call, irrespective of the results. By making testing easy to access, the program seeks to attract diverse segments of the community and reduce the stigma associated with seeking STI testing services. 

The data analysis of the "Pee N Flee" program demonstrates its significant success in achieving its objectives. Since its introduction in August 2022, the “Pee N Flee” program has helped the CUPHD STI testing clinic expand significantly. The 211 “Pee N Flee” visits represented nearly 15% of all tests conducted by CUPHD’s STI clinic between August 2022 and August 2023. Overall, the addition of the “Pee N Flee” program to CUPHD’s STI clinic resulted in a substantial 41% increase in total test volume compared to the previous year.  

Notably, the program has been successful in reaching vulnerable populations. Approximately 45% of tests were conducted among Black or African American patients, despite this group making up about 13% of the county's population. The program's appeal to young adults is evident, with approximately one-third of tests being conducted among individuals aged 15-24, a vital age group that historically accounts for a significant proportion of STI diagnoses in the United States each year. Patient survey results further validate the program's success, with over 90% of patients reporting the "Pee N Flee" program as "Very Easy" to use. The free testing and walk-in availability were key motivating factors for 95% of respondents in utilizing the program. Moreover, 61% of respondents stated that the "Pee N Flee" program influenced them to get tested, indicating its positive impact on encouraging regular testing behaviors. 

The overrepresentation of Black or African American patients in the program's tests indicates successful efforts in addressing health disparities within the community. Moreover, the program's focus on eliminating financial barriers has enabled low-income populations (68% of survey respondents) to access STI testing, which is crucial in reducing health disparities among vulnerable communities. The "Pee N Flee" program has encouraged timely diagnosis and treatment of STIs, leading to better sexual health outcomes for individuals in the community. 

The financial burden of the "Pee N Flee" program is minimal. Outside of start-up costs, the only continuous cost is staff time to process samples and notify participant of their results. CUPHD can access free laboratory testing through the Illinois Department of Public Health (IDPH) State Laboratory. This free testing is a huge component to this program’s sustainability.  If CUPHD ever loses access to the IDPH State Laboratory, CUPHD is already contracted with the University of Illinois Laboratory and is charged $13 per specimen to test for gonorrhea and chlamydia. A cost CUPHD could potentially absorb into the STI clinic budget or through DIS funding to keep the Pee N Flee free and accessible to all. Additionally, the "Pee N Flee" program has allowed for clients to be tested, even if appointments were not available that day. CUPHD has faced staffing issues in recent years and had been forced to turn clients away when there was no availability remaining that day. With the implementation of the "Pee N Flee", asymptomatic clients were able to be referred to this testing option for their needs. This both reduced the burden on staff to see high volumes of clients per day and enabled for more timely results for clients.  

The "Pee N Flee" program implemented by the Champaign Urbana Public Health District has proven to be a highly effective and impactful model practice. Its convenience, accessibility, and lack of cost and appointment requirements have resulted in an increase in STI testing. By successfully engaging underrepresented populations and young adults, the program has addressed health disparities and promoted equitable access to vital testing services. The "Pee N Flee" program's achievements underscore its importance as a valuable resource in improving the overall health of the community. Through its successful implementation, the program has made a meaningful difference in reducing the prevalence of STIs and promoting early detection, ultimately contributing to better public health outcomes in Champaign County.