Yeung Anna, Hocking Jane, Guy Rebecca, Fairley Christopher K, Smith Kirsty, Vaisey Alaina, Donovan Basil, Imrie John, Gunn Jane, Temple-Smith Meredith
Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
Fam Pract. 2018 Sep 18;35(5):626-632. doi: 10.1093/fampra/cmy011.
Chlamydia is the most common notifiable sexually transmissible infection in Australia. Left untreated, it can develop into pelvic inflammatory disease and infertility. The majority of notifications come from general practice and it is ideally situated to test young Australians.
The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a multifaceted intervention that aimed to reduce chlamydia prevalence by increasing testing in 16- to 29-year-olds attending general practice. GPs were interviewed to describe the effectiveness of the ACCEPt intervention in integrating chlamydia testing into routine practice using Normalization Process Theory (NPT).
GPs were purposively selected based on age, gender, geographic location and size of practice at baseline and midpoint. Interview data were analysed regarding the intervention components and results were interpreted using NPT.
A total of 44 GPs at baseline and 24 at midpoint were interviewed. Most GPs reported offering a test based on age at midpoint versus offering a test based on symptoms or patient request at baseline. Quarterly feedback was the most significant ACCEPt component for facilitating a chlamydia test.
The ACCEPt intervention has been able to moderately normalize chlamydia testing among GPs, although the components had varying levels of effectiveness. NPT can demonstrate the effective implementation of an intervention in general practice and has been valuable in understanding which components are essential and which components can be improved upon.
衣原体感染是澳大利亚最常见的需通报的性传播感染疾病。若不加以治疗，可能会发展为盆腔炎和不孕症。大多数通报病例来自全科医疗，全科医疗非常适合对澳大利亚年轻人进行检测。
澳大利亚衣原体控制有效性试点项目（ACCEPt）是一项多方面的干预措施，旨在通过增加对16至29岁到全科医疗就诊者的检测来降低衣原体感染率。通过采访全科医生，运用规范化过程理论（NPT）来描述ACCEPt干预措施在将衣原体检测纳入常规医疗中的有效性。
根据年龄、性别、地理位置和基线及中期时诊所规模，有目的地选择全科医生。对采访数据进行分析，了解干预措施的各个组成部分，并运用NPT对结果进行解读。
共采访了44名基线时的全科医生和24名中期时的全科医生。大多数全科医生报告称，在中期时根据年龄进行检测，而在基线时根据症状或患者要求进行检测。季度反馈是促进衣原体检测的ACCEPt项目中最重要的组成部分。
ACCEPt干预措施已能够在一定程度上使全科医生对衣原体检测常态化，尽管各组成部分的有效性程度不同。规范化过程理论（NPT）能够证明一项干预措施在全科医疗中的有效实施，并且对于理解哪些组成部分至关重要以及哪些组成部分可以改进具有重要价值。
