Iyamu Ihoghosa, Kassam Rosemin, Worthington Catherine, Grace Daniel, Pedersen Heather, Haag Devon, Bondyra Mark, Salmon Amy, Koehoorn Mieke, Gilbert Mark
School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
BC Centre for Disease Control (BCCDC), Vancouver, Canada.
Digit Health. 2024 Sep 2;10:20552076241277653. doi: 10.1177/20552076241277653. eCollection 2024 Jan-Dec.
Digital testing services for sexually transmitted and blood-borne infections (STBBIs), such as GetCheckedOnline, experience significant user drop-offs. For example, 32% of GetCheckedOnline users needing testing at account creation do not test, constituting missed opportunities. We explored the influence of users' expectations and experiences of GetCheckedOnline's web design and implementation on missed opportunities.
This interpretive description purposively sampled 14 GetCheckedOnline users who created accounts between April 2022 and February 2023, indicated needed testing at account creation but did not test. We conducted semi-structured interviews and cognitive walkthroughs of GetCheckedOnline on Zoom, exploring participants' expectations and experiences, including problems using the service. Interviews were audio recorded, transcribed verbatim, and analyzed using reflexive thematic analyses.
Three themes were identified: (a) transitioning between GetCheckedOnline and laboratory services is a major testing barrier; (b) users' appraisal of their health and social contexts is a determinant of testing through GetCheckedOnline; and (c) tailoring GetCheckedOnline's design and implementation to accommodate varying user needs can promote equitable testing. Health equity issues occurred along sociodemographic gradients as the GetCheckedOnline-laboratory transition was more onerous for older users. Users' appraisal of their testing needs which varied by age and gender, and their assessment of time, and travel requirements for testing in remote communities influenced testing. Learning about GetCheckedOnline from healthcare providers improved testing compared with learning about the service through Google search which raised trust concerns regarding GetCheckedOnline's authenticity. Suggested improvements to promote health equity include personalized education, mail-in testing options, and simpler seamless web experiences.
To promote equitable access to digital STBBI testing services such as GetCheckedOnline, we can adapt web-design and implementation to suit user needs and contexts, ensuring simplicity and options for testing that reduce user burdens.
诸如GetCheckedOnline等性传播和血源感染（STBBIs）的数字检测服务存在大量用户流失情况。例如，32%在创建账户时需要检测的GetCheckedOnline用户未进行检测，这构成了错失的机会。我们探讨了用户对GetCheckedOnline网站设计和实施的期望及体验对错失机会的影响。
本解释性描述研究有目的地抽取了14名在2022年4月至2023年2月期间创建账户、在创建账户时表示需要检测但未进行检测的GetCheckedOnline用户。我们通过Zoom对GetCheckedOnline进行了半结构化访谈和认知走查，探讨参与者的期望和体验，包括使用该服务时遇到的问题。访谈进行了录音，逐字转录，并使用反思性主题分析进行分析。
确定了三个主题：（a）在GetCheckedOnline和实验室服务之间过渡是主要的检测障碍；（b）用户对自身健康和社会背景的评估是通过GetCheckedOnline进行检测的决定因素；（c）调整GetCheckedOnline的设计和实施以适应不同用户需求可促进公平检测。随着GetCheckedOnline与实验室的过渡对老年用户来说更为艰巨，健康公平问题沿着社会人口学梯度出现。用户对检测需求的评估因年龄和性别而异，以及他们对时间的评估，还有在偏远社区进行检测的出行要求，都影响了检测。与通过谷歌搜索了解该服务相比，从医疗保健提供者那里了解GetCheckedOnline可提高检测率，因为通过谷歌搜索了解该服务会引发对GetCheckedOnline真实性的信任担忧。为促进健康公平而提出的改进建议包括个性化教育、邮寄检测选项和更简单无缝的网络体验。
为促进公平获取诸如GetCheckedOnline等数字STBBI检测服务，我们可以调整网站设计和实施以适应用户需求和背景，确保检测的简单性和选项，以减轻用户负担。
