Interactive workshops increase chlamydia testing in primary care--a controlled study

Abstract

Interactive workshops for general practices can be used to successfully increase chlamydia-testing rates. Chlamydia detection rates will need to be monitored as this type of educational programme may not increase absolute numbers of chlamydia infections detected, if patients at lower risk of infection are inappropriately tested. Other interventions may need to be combined with the workshops, to reach sufficiently high chlamydia screening rates to significantly reduce prevalence of chlamydial infection.

Increasing chlamydia screening tests in general practice: a modified Zelen prospective Cluster Randomised Controlled Trial evaluating a complex intervention based on the Theory of Planned Behaviour

“…The 62% uptake of three contacts and overall results are likely to be similar if the intervention was used in other areas with similar primary care resources. The modified Zelen design is particularly useful for the pragmatic evaluation of educational interventions 16 as participants can accept or decline components of the intervention as they would in routine practice because participants are unaware they are in a trial and so do not modify their behaviour on that account. The design was feasible as the primary outcome was measured using routinely generated NCSP data and consent for practices to take part was given on their behalf by PCT public and locally respected sexual health leads.…”

“…This approach was successfully used both in an American adolescent clinic20 in which clinicians participated in a four-stage clinical improvement initiative with monthly visits and in two London PCTs where workshops were given with long-term support 21. In contrast, a single outreach interactive workshop with several practices together16 led to a lower increase in testing rates 16. Changing the subjective norms at the practice and area level are both important.…”

“…We used a prospective, cluster randomised controlled trial with a modified Zelen design 14 – 16. Random allocation is very difficult to conceal in evaluations of educational interventions, as intervention and control consenting clinicians will know they are part of a trial and may modify their behaviour.…”

Chlamydia Screening Among Young Women: Individual- and Provider-Level Differences in Testing

“…There are several interventions that increase overall screening rates, using provider education, prompts, and incentives, as well as system-level changes. [21][22][23][24][25][26][27] Although the majority of those studies showed improved chlamydia screening rates for intervention groups, overall screening rates remained fairly low. Few if any studies have addressed differences in testing rates.…”

How usual is usual care in pragmatic intervention studies in primary care? An overview of recent trials

“…40 In the majority of articles on cluster randomised trials, the information provided to control caregivers was not described. Only three papers explicitly stated that control caregivers were not aware of the exact content of the intervention; they received either an unrelated educational module, 70,71 or neutral information about the trial without an explanation of the intervention. 73 In some individually randomised and some cluster randomised trials, control caregivers were asked to complete questionnaires before or during the intervention period.…”