McDonagh Lorraine K, Saunders John M, Cassell Jackie, Bastaki Hamad, Hartney Thomas, Rait Greta
National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.
Research Department of Primary Care and Population Health, University College London, London, UK.
BMJ Open. 2017 Mar 9;7(3):e013588. doi: 10.1136/bmjopen-2016-013588.
Chlamydia is a key health concern with high economic and social costs. There were over 200 000 chlamydia diagnoses made in England in 2015. The burden of chlamydia is greatest among young people where the highest prevalence rates are found. Annual testing for sexually active young people is recommended; however, many of those at risk do not receive testing. General practice has been identified as an ideal setting for testing, yet efforts to increase testing in this setting have not been effective. One theoretical model which may provide insight into the underpinnings of chlamydia testing is the Capability, Opportunity and Motivation Model of Behaviour (COM-B model). The aim of this systematic review is to: (1) identify barriers and facilitators to chlamydia testing for young people in general practice and (2) use a theoretical model to conduct a behavioural analysis of chlamydia testing behaviour.
Qualitative, quantitative and mixed methods studies published after 2000 will be included. Seven databases (MEDLINE, PubMed, EMBASE, Informit, PsycInfo, Scopus, Web of Science) will be searched to identify peer-reviewed publications which examined barriers and facilitators to chlamydia testing in general practice. Risk of bias will be assessed using the Critical Appraisal Skills Programme. Data regarding study design and key findings will be extracted. The data will be analysed using thematic analysis and the resultant factors will be mapped onto the COM-B model components. All findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Ethical approval is not required. The results will be disseminated via submission for publication to a peer-review journal when complete and for presentation at national and international conferences. The review findings will be used to inform the development of interventions to facilitate effective and efficient chlamydia testing in general practice.
衣原体感染是一个重大的健康问题，会带来高昂的经济和社会成本。2015年，英格兰有超过20万例衣原体感染确诊病例。衣原体感染在年轻人中造成的负担最重，其患病率最高。建议对性活跃的年轻人进行年度检测；然而，许多有感染风险的人并未接受检测。全科医疗已被视为进行检测的理想场所，但在这一场所增加检测的努力并未取得成效。行为的能力、机会和动机模型（COM-B模型）可能有助于深入了解衣原体检测的基础。本系统评价的目的是：（1）确定全科医疗中年轻人衣原体检测的障碍和促进因素；（2）使用理论模型对衣原体检测行为进行行为分析。
将纳入2000年后发表的定性、定量和混合方法研究。将检索七个数据库（MEDLINE、PubMed、EMBASE、Informit、PsycInfo、Scopus、Web of Science），以识别经过同行评审的、研究全科医疗中衣原体检测障碍和促进因素的出版物。将使用批判性评估技能计划评估偏倚风险。将提取有关研究设计和主要发现的数据。将使用主题分析对数据进行分析，并将所得因素映射到COM-B模型组件上。所有结果将按照系统评价和Meta分析的首选报告项目指南进行报告。
无需伦理批准。研究完成后，将通过提交给同行评审期刊发表以及在国内和国际会议上展示的方式传播结果。本评价的结果将用于为制定干预措施提供信息，以促进全科医疗中衣原体检测的有效和高效开展。
