Innovative Sexual Health Education for General Practice: An Evaluation of the Sexual Health in Practice (SHIP) Scheme

Mullineux, Judith; Firmstone, Vickie; Matthews, Philippa; Ireson, Rita

doi:10.1080/14739879.2008.11493704

Cited by 4 publications

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“…12 15 Overcoming these is vital to improving testing rates. 15 24 Kirkpatrick outlined a hierarchy for the evaluation of clinical learning in response to educational interventions, [25][26][27][28] In an earlier publication, 29 SHIP demonstrated the value of its training by the use of Kirkpatrick's outcomes 1 through 3. In Haringey, general practice laboratory HIV testing rates were selected as an outcome measure because they are:…”

Section: Interventionmentioning

confidence: 99%

Unlocking the potential: longitudinal audit finds multifaceted education for general practice increases HIV testing and diagnosis

et al. 2012

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BackgroundThis longitudinal study aimed to evaluate the impact of a multifaceted educational intervention (Sexual Health in Practice, SHIP) on general practice HIV testing rates in a high prevalence London area.InterventionSHIP offered training in sexual health clinical skills to general practitioners (GPs) and practice nurses (PNs) in Haringey. SHIP training aims to break down stigma in sexual health and provide sexual history and communication tools (e.g. differential diagnosis), and provides resources to practices (including condoms).DesignNumbers of GP HIV tests were collected from laboratories for 24 months prior, 19 months during and 5 months after training. Attendance data and practice list sizes were obtained.Results39 of 51 practices had at least one trained individual. These `trained' practices conducted an average 526 HIV tests p.a. before training began which rose to a projected 1556 p.a. (on the basis of the last 6 months of data). Testing rates of trained and untrained practices increased from 2.29 to 6.66 and 1.54 to 1.90 tests/1000 registered patients/year (p=0.0016 and p=0.5195) respectively. The rate of positive diagnosis was high in the trained group (18.0 and 16.7 positives/1000 tests before and after training began; p=0.7908). This equates to a rise from 9.5 to 22 new diagnoses p.a.ConclusionsThe training intervention has been found to significantly increase general practice HIV testing rates in the absence of financial incentives. Positivity rates are substantially higher than that found in pilots of screening in London, suggesting that the training nurtured and supplemented complex clinical skills.

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Section: Interventionmentioning

confidence: 99%

Unlocking the potential: longitudinal audit finds multifaceted education for general practice increases HIV testing and diagnosis

et al. 2012

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“…Effective contraception consultations require adequate medical knowledge combined with communication skills to empower patient choice 58–60. Educational programmes for general practice have had a significant impact on improving provision 12 54 61 62. Practice champions can provide efficient ways of dispelling myths and disseminating up to date information to colleagues.…”

Section: Discussionmentioning

confidence: 99%

Understanding barriers to using long-acting reversible contraceptives (LARCs) in primary care: a qualitative evidence synthesis

Linton

Mawson

Hodges

et al. 2023

BMJ Sex Reprod Health

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BackgroundLong-acting reversible contraceptives (LARCs) are highly effective. In primary care, LARCs are prescribed less frequently than user-dependent contraceptives despite higher efficacy rates. Unplanned pregnancies are rising in the UK, and LARCs may have a role in reducing these through and redressing inequitable contraceptive access. To provide contraceptive services that offer maximal choice and patient benefit, we must understand what contraception users and healthcare professionals (HCPs) think about LARCs and uncover barriers to their use.MethodsA systematic search using CINAHL, MEDLINE via Ovid, PsycINFO, Web of Science and EMBASE identified research about LARC use for pregnancy prevention in primary care. The approach adhered to the ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ methodology, critically appraised the literature, and used NVivo software to organise data and perform thematic analysis to determine key themes.ResultsSixteen studies met our inclusion criteria. Three themes were identified: (1) trustworthiness (where and from whom participants obtained information regarding LARCs), (2) control (whether LARCs detract from personal autonomy) and (3) systems (how HCPs influenced LARC access). Misgivings about LARCs frequently arose from social networks and fears of surrendering control over fertility were prominent. HCPs perceived access issues and lack of familiarity or training as the main barriers to prescribing LARCs.ConclusionsPrimary care plays a key role in improving access to LARC but barriers need to be addressed especially those involving misconception and misinformation. Access to LARC removal services are key to empower choice and prevent coercion. Facilitating trust within patient-centred contraceptive consult is essential.

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“…SHIP can, and has been, replicated in different areas of the UK with funding and through collaboration and co-training (as occurred in Haringey). Further information on SHIP training is published elsewhere [ 23 , 24 ]. However no current detailed ‘SHIP Implementation Handbook’ has been commissioned.…”

Section: Discussionmentioning

confidence: 99%

“…Sexual Health in Practice (SHIP) is a peer-developed and -led educational intervention closely tailored to general practice that aims for broad improvement in sexual health care. In previous mixed methods evaluation of SHIP[ 23 , 24 ] a range of effects were found. SHIP appears to differ from other interventions by tackling the barriers unique to the setting ( Fig 1 ) by teaching specific verbal strategies and an approach to rapid risk assessment developed for general practice.…”

Section: Introductionmentioning

confidence: 99%

Long term effect of primary health care training on HIV testing: A quasi-experimental evaluation of the Sexual Health in Practice (SHIP) intervention

Pillay

Gardner²,

Gould

et al. 2018

PLoS ONE

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BackgroundTo examine the effect of Sexual Health in Practice (SHIP) training for general practitioners (GPs) on HIV testing rates in Haringey, a deprived area of London, UK, with a population of over 250,000 and HIV prevalence of 0.7% (in 2014). SHIP is an educational intervention delivering peer-developed and peer-led face-to-face training to improve quality of sexual and reproductive health (SRH) care.MethodsWe carried out a quasi-experimental study of intervention effects across 52 GP practices (2008–2016). We used time variation in SHIP intervention exposure for effect estimation, controlling for practice and calendar month fixed effects in panel analysis. From 2008–2010, baseline data were collected, and in the subsequent six-year period, 78 GPs in Haringey (approximately 40% of all GPs) were SHIP trained. 46 Haringey practices (of 52) had at least one trained doctor. Outcome measures were monthly HIV tests and results by practice (obtained from the hospital laboratories).ResultsSHIP significantly increased HIV testing; for every GP trained, practice HIV testing rates increased by 16% (testing rate ratio (TRR) 1.16, 95% confidence interval (CI) 1.05–1.28, p value 0.004). This significant effect was demonstrated using an 8-year observation period, and was sustained over the post-intervention period. An average of 1.42% of HIV tests were positive.ConclusionSHIP training produces a significant and sustained increase in HIV testing for each GP trained. Compared with general population screening, HIV tests used in routine clinical care have a high probability of detecting a positive person. Unlike an RCT, this evaluation is a ‘real life’ measure of the effect that commissioners of SHIP could expect in comparable areas of the UK. The effectiveness of the SHIP training may be related to the programme components not included in interventions that did not demonstrate an effect, such as peer-led teaching, and use of approaches to communication and rapid risk assessment tailored to the setting.

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Innovative Sexual Health Education for General Practice: An Evaluation of the Sexual Health in Practice (SHIP) Scheme

Cited by 4 publications

References 0 publications

Unlocking the potential: longitudinal audit finds multifaceted education for general practice increases HIV testing and diagnosis

Unlocking the potential: longitudinal audit finds multifaceted education for general practice increases HIV testing and diagnosis

Understanding barriers to using long-acting reversible contraceptives (LARCs) in primary care: a qualitative evidence synthesis

Long term effect of primary health care training on HIV testing: A quasi-experimental evaluation of the Sexual Health in Practice (SHIP) intervention

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