Centre for Sexual Health and HIV Research, Research Department of Infection and Population Health, University College London, Mortimer Market Centre, off Capper Street, London WC1E 6JB, UK.
BMC Health Serv Res. 2011 Feb 9;11:30. doi: 10.1186/1472-6963-11-30.
National health strategies have called for an expansion of the role of primary care in England to increase access to sexual health services. However, there is little guidance for service planners and commissioners as to the public health impact of different combinations of specialist genitourinary medicine (GUM) clinics and primary care based services for local populations. Service planning for infectious diseases like sexually transmitted infections (STI) is further complicated because the goal of early detection and treatment is not only to improve the health of the individual, but to benefit the wider population and reduce future treatment costs by preventing onward transmission. Therefore, we are developing a survey tool that will enable service planners to better understand the needs of their local STI care-seeking population and which will help inform evidence-based decision-making about current and future service configurations. Here we describe the rationale and development of this survey tool.
METHODS/DESIGN: A pen-and-paper questionnaire asking about sociodemographics, reasons for attendance, care pathways, and recent sexual risk behaviours, is being developed for patients to complete in waiting rooms of diverse clinical services, including GUM clinics and primary-care based services in sociodemographically- and geographically-contrasting populations in England. The questionnaire was cognitively tested before being piloted. In the pilot, 67% of patients participated, of whom 84% consented to our linking their questionnaire to data on STI testing and diagnosis and partner notification outcomes from their clinical records.
The pilot study suggests that both the questionnaire and its linkage to routinely-collected clinical data are likely to be acceptable to patients. By supplementing existing surveillance, data gathered by the survey tool will inform service planners' and providers' understanding of the needs and care-pathways of their patients, facilitating improved services and greater public health benefit.
国家卫生战略呼吁扩大初级保健在英格兰的作用，以增加获得性健康服务的机会。然而，对于服务规划者和委员会来说，关于为当地人群提供不同组合的专科泌尿生殖医学（GUM）诊所和基于初级保健的服务对公共卫生的影响，几乎没有指导。由于性传播感染（STI）等传染病的服务规划更加复杂，因为早期发现和治疗的目标不仅是改善个人的健康，而且还通过预防传播来使更广泛的人群受益并降低未来的治疗成本。因此，我们正在开发一种调查工具，使服务规划者能够更好地了解其当地寻求性传播感染护理的人群的需求，并为当前和未来的服务配置提供循证决策。在这里，我们描述了该调查工具的原理和开发过程。
方法/设计：正在为患者开发一种纸笔问卷，用于询问社会人口统计学、就诊原因、护理途径和最近的性行为风险行为，患者可以在不同临床服务的候诊室中填写，包括 GUM 诊所和基于初级保健的服务，这些服务在英格兰的社会人口统计学和地理位置上具有差异。在进行试点之前，该问卷经过了认知测试。在试点中，有 67%的患者参与了调查，其中 84%的患者同意将他们的问卷与他们的临床记录中的性传播感染检测和诊断以及性伴侣通知结果相关联。
试点研究表明，问卷及其与常规收集的临床数据的链接对患者来说可能是可以接受的。通过补充现有的监测数据，调查工具收集的数据将使服务规划者和提供者更好地了解其患者的需求和护理途径，从而促进更好的服务和更大的公共卫生效益。
