Chabot Cathy, Gilbert Mark, Haag Devon, Ogilvie Gina, Hawe Penelope, Bungay Vicky, Shoveller Jean A
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
Clinical Prevention Services, British Columbia Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada.
BMC Health Serv Res. 2018 Jan 30;18(1):57. doi: 10.1186/s12913-018-2871-x.
Online health services are a rapidly growing aspect of public health provision, including testing for sexually transmitted and other blood-borne infections (STBBI). Generally, healthcare providers, policymakers, and clients imbue online approaches with great positive potential (e.g., encouraging clients' agency; providing cost-effective services to more clients). However, the promise of online health services may vary across contexts and be perceived in negative or ambiguous ways (e.g., risks to 'gold standard' care provision; loss of provider control over an intervention; uncertainty related to budget implications). This study examines attitudes and perceptions regarding the development of a novel online STBBI testing service in Vancouver, Canada. We examine the perceptions about the intervention's potential by interviewing practitioners and planners who were engaged in the development and initial implementation of this testing service.
We conducted in-depth interviews with 37 healthcare providers, administrators, policymakers, and community-based service providers engaged in the design and launch of the new online STBBI testing service. We also conducted observations during planning and implementation meetings for the new service. Thematic analysis techniques were employed to identify codes and broader discursive themes across the interview transcripts and observation notes.
Some study participants expressed concern that the potential popularity of the new testing service might increase demand on existing sexual health services or become fiscally unsustainable. However, most participants regarded the new service as having the potential to improve STBBI testing in several ways, including reducing waiting times, enhancing privacy and confidentiality, appealing to more tech-savvy sub-populations, optimizing the redistribution of demands on face-to-face service provision, and providing patient-centred technology to empower clients to seek testing.
Participants perceived this online STBBI testing service to have the potential to improve sexual health care provision. But, they also anticipated actions-and-reactions, revealing a need to monitor ongoing implementation dynamics. They also identified the larger, potentially system-transforming dimension of the new technology, which enables new system drivers (consumers) and reduces the amount of control health care providers have over online STBBI testing compared to conventional in-person testing.
在线健康服务是公共卫生服务中迅速发展的一个方面，包括性传播感染和其他血源感染（STBBI）检测。一般来说，医疗服务提供者、政策制定者和客户都认为在线方式具有巨大的积极潜力（例如，鼓励客户自主；为更多客户提供具有成本效益的服务）。然而，在线健康服务的前景可能因环境而异，并可能被视为负面或模糊的（例如，对“金标准”护理提供的风险；提供者对干预措施失去控制；与预算影响相关的不确定性）。本研究考察了加拿大温哥华一项新型在线STBBI检测服务发展过程中的态度和看法。我们通过采访参与该检测服务开发和初步实施的从业者和规划者，来考察对该干预措施潜力的看法。
我们对37名参与新在线STBBI检测服务设计和推出的医疗服务提供者、管理人员、政策制定者和社区服务提供者进行了深入访谈。我们还在新服务的规划和实施会议期间进行了观察。采用主题分析技术，在访谈记录和观察笔记中识别代码和更广泛的话语主题。
一些研究参与者担心新检测服务的潜在受欢迎程度可能会增加对现有性健康服务的需求，或者在财政上变得不可持续。然而，大多数参与者认为新服务有可能在几个方面改善STBBI检测，包括减少等待时间、增强隐私和保密性、吸引更多精通技术的亚群体、优化面对面服务需求的重新分配，以及提供以患者为中心的技术，使客户有能力寻求检测。
参与者认为这种在线STBBI检测服务有改善性健康护理提供的潜力。但是，他们也预期了行动和反应，这表明需要监测持续的实施动态。他们还确定了这项新技术在更大范围内可能改变系统的层面，这使得新的系统驱动因素（消费者）出现，并减少了医疗服务提供者相对于传统面对面检测对在线STBBI检测的控制程度。
