Fine David, Warner Lee, Salomon Sarah, Johnson David M
Cardea Services, Seattle, Washington.
Division of Reproductive Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
J Adolesc Health. 2017 Jul;61(1):32-39. doi: 10.1016/j.jadohealth.2017.03.011. Epub 2017 May 17.
We assessed the impact of staff, clinic, and community interventions on male and female family planning client visit volume and sexually transmitted infection testing at a multisite community-based health care agency.
Staff training, clinic environmental changes, in-reach/outreach, and efficiency assessments were implemented in two Family Health Center (San Diego, CA) family planning clinics during 2010-2012; five Family Health Center family planning programs were identified as comparison clinics. Client visit records were compared between preintervention (2007-2009) and postintervention (2010-2012) for both sets of clinics.
Of 7,826 male client visits during the time before intervention, most were for clients who were aged <30 years (50%), Hispanic (64%), and uninsured (81%). From preintervention to postintervention, intervention clinics significantly increased the number of male visits (4,004 to 8,385; Δ = +109%); for comparison clinics, male visits increased modestly (3,822 to 4,500; Δ = +18%). The proportion of male clinic visits where chlamydia testing was performed increased in intervention clinics (35% to 42%; p < .001) but decreased in comparison clinics (37% to 33%; p < .001). Subgroup analyses conducted among adolescent and young adult males yielded similar findings for male client volume and chlamydia testing. The number of female visits declined nearly 40% in both comparison (21,800 to 13,202; -39%) and intervention clinics (30,830 to 19,971; -35%) between preintervention and postintervention periods.
Multilevel interventions designed to increase male client volume and sexually transmitted infection testing services in family planning clinics succeeded without affecting female client volume or services.
我们评估了在一个多地点社区医疗保健机构中,员工、诊所及社区干预措施对计划生育男性和女性客户就诊量以及性传播感染检测的影响。
2010 - 2012年期间,在两家家庭健康中心(加利福尼亚州圣地亚哥)的计划生育诊所实施了员工培训、诊所环境改善、内展/外展及效率评估;另外五家家庭健康中心的计划生育项目被确定为对照诊所。对两组诊所干预前(2007 - 2009年)和干预后(2010 - 2012年)的客户就诊记录进行比较。
在干预前的时间段内,7826名男性客户就诊,其中大多数年龄小于30岁(50%)、为西班牙裔(64%)且未参保(81%)。从干预前到干预后,干预诊所的男性就诊人数显著增加(从4004人次增至8385人次;变化量= +109%);对照诊所的男性就诊人数略有增加(从3822人次增至4500人次;变化量= +18%)。干预诊所中进行衣原体检测的男性就诊比例有所增加(从35%增至42%;p < 0.001),而对照诊所中这一比例则有所下降(从37%降至33%;p < 0.001)。在青少年和青年男性中进行的亚组分析,在男性客户量和衣原体检测方面得出了类似结果。在干预前和干预后期间,对照诊所(从21800人次降至13202人次;-39%)和干预诊所(从30830人次降至19971人次;-35%)的女性就诊人数均下降了近40%。
旨在增加计划生育诊所男性客户量和性传播感染检测服务的多层次干预措施取得了成功,且未影响女性客户量或服务。