Increasing chlamydia test of re-infection rates using SMS reminders and incentives

Abstract

Background Clients diagnosed and treated for Chlamydia trachomatis are a recognised high-risk group for subsequent infection. An estimated 8% of clients treated for chlamydia at Cairns Sexual Health Service return for re-testing within the recommended 3e4-month period. There is no recall or reminder system in place. This study assesses the effectiveness of using short messaging service (SMS) reminders with and without incentive payments to increase re-testing rates. Methods Eligible consenting clients were randomly allocated to one of three groups. Group 1 (controls) received the standard advice from the clinician to return for re-testing in 3e4 months. Group 2 received the standard advice and an SMS reminder at 10e12 weeks post-treatment. Group 3 received the standard advice and the SMS reminder, which also offered an incentive payment on clinic attendance. Results 32 participants were recruited to groups 1 and 2 and 30 participants to group 3. 62 SMS reminders were sent with 13 (21.0%) reported as undelivered. Re-testing rates were 6.3%, 28.1% and 26.7% for groups 1, 2 and 3, respectively. Conclusion SMS reminders with or without an incentive payment increased re-testing rates in our clients who were diagnosed and treated for chlamydia. However, re-testing remained less than ideal, and the high rate of undelivered SMS reminders suggest that this intervention alone will not achieve desired re-testing rates and that a range of strategies will be required to increase re-testing in this population.

Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial

“…Two trials reported statistically significant increases in testing for STIs. 17, 18 Lim et al 17 reported that mobile phone-based sexual health interventions can increase discussion of sexual health with a health-care professional threefold and lead to over a doubling of STI testing. Although some trial results look promising, the effects of text messaging on key safer sex behaviours, including telling your partner about your infection, correctly following treatment advice, obtaining STI testing for yourself and your partner(s) prior to unprotected sex and condom use, have not been reliably established.…”

“…The content was designed to address attitudes, information and behaviour skills, rather than induce fear, which has been found to be ineffective. 10,17,18 The formative work carried out with the target group on the development of the messages was key to the intervention's acceptability. Interviews were conducted shortly after participants had received the messages to minimise problems with recall.…”

“…We identified seven trials. [15][16][17][18][19][20][21] Interventions were limited; they included up to three BCTs and did not address partner notification. 22 None of the trials had a low risk of bias.…”

Sexual health promotion for young people delivered via digital media: a scoping review

“…Digital interventions for sexual health promotion may encourage people to use sexual health services, for example text messages to promote STI testing, 76,[85][86][87] to increase discussion of sexual health with a health-care professional 87 or to enhance the successful treatment of STIs. 88 Mobile phones and websites are also feasible ways to reach young people to encourage the use of condoms for safer sex.…”

Chlamydia retest: how should we remind you?

“…At Cairns Sexual Health Service (CSHS), a generic SMS message with a small financial incentive increased chlamydia retesting from 7% to 28% 1. We implemented a client choice reminder system to determine if offering a choice would improve chlamydia retesting rates.…”