Bilardi Jade E, Sanci Lena A, Fairley Christopher K, Hocking Jane S, Mazza Danielle, Henning Dot J, Sawyer Susan M, Wills Michelle J, Wilson Debra A, Chen Marcus Y
Melbourne School of Population Health, The University of Melbourne, Carlton, Victoria 3053, Australia.
BMC Infect Dis. 2009 Mar 12;9:29. doi: 10.1186/1471-2334-9-29.
Targeted chlamydia screening has been advocated to reduce chlamydia associated reproductive sequelae. General practitioners are well positioned to play a major role in chlamydia control. The primary aim of this pilot study was to measure the effect of offering an online sexual health assessment tool, Youth Check Your Risk, on chlamydia testing rates among young people attending general practices. The secondary aim was to test the acceptability of the tool among general practitioners and young people.
General practitioners at three practices in Melbourne, Australia, referred patients aged 16 to 24 years to Youth Check Your Risk http://www.checkyourrisk.org.au for use post-consultation between March to October 2007. The proportion of young people tested for chlamydia before and during the implementation of the tool was compared. Acceptability was assessed through a structured interviewer-administered questionnaire with general practitioners, and anonymous online data provided by Youth Check Your Risk users.
The intervention did not result in any significant increases in the proportion of 16 to 24 year old males (2.7% to 3.0%) or females (6.3% to 6.4%) tested for chlamydia. A small increase in the proportion of 16 to 19 year old females tested was seen (4.1% to 7.2%). Of the 2997 patients seen during the intervention phase, 871 (29.1%) were referred to Youth Check Your Risk and 120 used it (13.8%). Major reasons for low referral rates reported by practitioners included lack of time, discomfort with raising the issue of testing, and difficulty in remembering to refer patients.
Offering an online sexual risk assessment tool in general practice did not significantly increase the proportion of young people tested for chlamydia, with GPs identifying a number of barriers to referring young people to Youth Check Your Risk. Future interventions aimed at increasing chlamydia screening in general practice with the aid of an online risk assessment tool need to identify and overcome barriers to testing.
靶向衣原体筛查已被提倡用于减少与衣原体相关的生殖后遗症。全科医生在衣原体控制方面具有重要作用。这项试点研究的主要目的是评估提供在线性健康评估工具“青年检查你的风险”对在全科诊所就诊的年轻人衣原体检测率的影响。次要目的是测试该工具在全科医生和年轻人中的可接受性。
2007年3月至10月期间，澳大利亚墨尔本三家诊所的全科医生将16至24岁的患者转介至“青年检查你的风险”网站（http://www.checkyourrisk.org.au），以便患者在咨询后使用。比较了该工具实施前后年轻人衣原体检测的比例。通过对全科医生进行结构化访谈问卷以及“青年检查你的风险”用户提供的匿名在线数据来评估可接受性。
干预措施并未使16至24岁男性（从2.7%增至3.0%）或女性（从6.3%增至6.4%）的衣原体检测比例显著增加。16至19岁女性的检测比例有小幅增加（从4.1%增至7.2%）。在干预阶段就诊的2997名患者中，871名（29.1%）被转介至“青年检查你的风险”，其中120名（13.8%）使用了该工具。医生报告的低转介率的主要原因包括时间不足、提出检测问题时感到不适以及难以记住转介患者。
在全科医疗中提供在线性风险评估工具并未显著增加年轻人衣原体检测的比例，全科医生指出了将年轻人转介至“青年检查你的风险”的一些障碍。未来旨在借助在线风险评估工具增加全科医疗中衣原体筛查的干预措施需要识别并克服检测障碍。
