Comparative effectiveness of two self-collected sample kit distribution systems for chlamydia screening on a university campus

Abstract

Objectives Chlamydia trachomatis (CT) rates and incidence continue to increase, and university students are known to engage in high-risk activities, but studies of CT prevalence in this population are limited by poor screening rates. Utilisation of self-obtained sample (SoS) kits in private student residencies may reduce screening barriers. The authors sought to determine the relative effectiveness, and comparative effectiveness, of two SoS kit distribution mechanisms: one which provided kits directly to students and another encouraging students to order kits from a website. Methods During 2010–2011, residents of six university dormitories were provided training sessions describing CT, the project and SoS kit use. Students in three dormitories were provided kits, and the remaining students directed to the website (http://www.iwantthekit.org). Results Of 391 resident students, 163 were provided with kits and 175 were directed to the website. Of provided kits, 12 (8 women) were returned and 2 (16.7%; both women) were positive. Of only three internet-requested kits, all were returned (all women) and none were positive. In a post-project survey examining non-participation, 26.2% of students were unaware of the project (no difference by dormitory or gender) and 58.5% of women cited prior testing as part of a medical exam. Conclusions Though direct kit distribution was more effective in student screening engagement, overall participation was poor despite widespread advertising. The methodology of online testing and SoS kits has been well validated elsewhere, but research is needed to successfully engage university students in screening and refine SoS target populations in light of changing healthcare policies.

Bacterial Sexually Transmitted Disease Screening Outside the Clinic—Implications for the Modern Sexually Transmitted Disease Program

“…Although the www.iwantthekit.org and other home-based testing administered by STD programs are free to the participants, there are costs associated with Web site development, maintenance, reimbursement for treatment, and the follow-up care typically provided in affiliated local health department or other publicly funded health program partners. Jenkins and colleagues 48 noted that unless the absolute number of persons reached increased through Internet recruitment, even with high positivity, the program costs may not outweigh the costs of averted cases. The program costs increase beyond Web site development and maintenance when the additional cost of marketing home-based specimen collection is considered.…”

Vouchers versus Lotteries: What Works Best in Promoting Chlamydia Screening? A Cluster Randomized Controlled Trial

“…Students living in halls are mostly approached through a proactive strategy by outreach organisations that offer free screening on site (Jenkins et al 2012). Zenner and colleagues (2012) confirmed that most incentives schemes were offered through outreach work (55%); thus, this is also the strategy employed in this study.…”

“…The National Chlamydia Program in the UK works mostly through opportunistic screening that occurs mostly when young people register with the National Health Service (NHS) or visit their general practitioner. Students living in halls are mostly approached through a proactive strategy by outreach organizations that offer free screening on site (Jenkins et al 2012). Zenner and colleagues (2012) confirmed that most incentives schemes were offered through outreach work (55%); thus, this is also the strategy employed in this study.…”

Highlights from this issue

“…The authors suggest that education is most commonly objectively associated with measures of chlamydia morbidity. This has interesting implications for the many post compulsory education based chlamydia screening interventions, some of which have been explored in this journal (Jenkins et al 18 and Johnson et al 19). …”