Oh MK, Grimley D, Heudebert G
Schools of Medicine and Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
J Pediatr Adolesc Gynecol. 2000 May;13(2):95. doi: 10.1016/s1083-3188(00)00030-9.
Background: HEDIS 2000 measure includes chlamydia screening in women which is designed to assess the percentage of sexually active women 15 to 25 years who have received at least one screening test for chlamydia during the reporting year. This study is being undertaken to determine feasibility of implementing a population-level intervention within HMOs to promote chlamydia screening. This abstract presents preliminary findings from the Birmingham project of this multicenter study.Methods: In partnerships with two HMOs, series of outreach methods were used in a stepwise fashion to determine potential barriers and enabling factors for the implementation of chlamydia HEDIS measure in a conservative social environment. Mail outreach was sequentially combined with newspaper, TV, radio advertisements and poster displays. Both qualitative and quantitative impact of the outreach efforts were measured across the timeline. The measures included reporting for chlamydia screening (urine LCR) and infection rate, monitoring chlamydia hotline and staffed phoneline use, and assessment of untoward effects and cost-analysis of the chlamydia outreach campaign.Results: The key findings are: the benefit of chlamydia screening is not understood by general public, letters send by Health Plans to their members are not read by many subscribers, and there are wide gaps between adolescents and their parents, in knowledge, attitudes, beliefs in regard to obtaining information and accessing the screening services (teens prefer hotline, brochure in an envelop addressed to teens, incentives for reporting to the clinic for screening, vs. parents prefer staffed phone consults, "exposed" brochure addressed to parents, and no incentives). A month of sustained and repeat multi-media campaign resulted in 330 hotline calls, 83 phone calls and only 17 subjects being tested (3 were positive) though many more intended to come. Cumulative effects and cost of various outreach efforts are being monitored. Informational chlamydia brochures and free test cards mailed to the homes generated no negative response from the subscribers, contrary to the concerns of the HMOs. Conclusion: To be effective, investment in public education campaign and social marketing strategies must be integrated in population-level intervention for the implementation of the chlamydia HEDIS 2000 measure.
2000年医疗效果数据和信息集（HEDIS）指标包括对女性进行衣原体筛查，旨在评估15至25岁性活跃女性在报告年度内接受至少一次衣原体筛查测试的百分比。本研究旨在确定在健康维护组织（HMO）内实施一项人群水平干预措施以促进衣原体筛查的可行性。本摘要展示了这项多中心研究中伯明翰项目的初步结果。
与两家健康维护组织合作，逐步采用一系列外展方法，以确定在保守社会环境中实施衣原体HEDIS指标的潜在障碍和促成因素。邮件外展依次与报纸、电视、广播广告及海报展示相结合。在整个时间范围内对这些外展工作的定性和定量影响进行了测量。测量指标包括衣原体筛查报告（尿液连接酶链反应）和感染率、监测衣原体热线和人工电话的使用情况，以及评估衣原体外展活动的不良影响和成本分析。
主要发现如下：普通公众不了解衣原体筛查的益处，健康计划机构发给其成员的信件许多订阅者并未阅读，青少年与其父母在获取信息和接受筛查服务的知识、态度和信念方面存在很大差距（青少年更喜欢热线、写给青少年的装在信封里的宣传册、到诊所筛查的激励措施，而父母更喜欢人工电话咨询、写给父母的“公开”宣传册，且没有激励措施）。为期一个月的持续且重复的多媒体宣传活动导致330次热线呼叫、83次电话咨询，仅有17人接受检测（3人呈阳性），尽管更多人有意前来。正在监测各种外展工作的累积影响和成本。邮寄到家庭的衣原体信息宣传册和免费检测卡并未收到订阅者的负面反馈，这与健康维护组织的担忧相反。
为使措施有效，在实施2000年衣原体HEDIS指标的人群水平干预中，必须将对公众教育活动和社会营销策略的投入整合进去。
