Study protocol of the iMPaCT project: a longitudinal cohort study assessing psychological determinants, sexual behaviour and chlamydia (re)infections in heterosexual STI clinic visitors

Wees, Daphne A. van; Heijne, Janneke C. M.; Heijman, Titia; Kampman, Karlijn; Westra, Karin; Vries, Anne de; Kretzschmar, Mirjam; Daas, Chantal den

doi:10.1186/s12879-018-3498-6

Cited by 6 publications

(10 citation statements)

References 66 publications

(80 reference statements)

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“…A detailed description of the study design can be found in the iMPaCT study protocol [19]. In short, the iMPaCT study explored the link between sexual behavior, psychological determinants, and chlamydia infections over a period of one year, using online questionnaires and information routinely registered by STI clinics.…”

Section: Methodsmentioning

confidence: 99%

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Who drops out and when? Predictors of non-response and loss to follow-up in a longitudinal cohort study among STI clinic visitors

et al. 2019

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Introduction Response rates in health research are declining, and low response rates could result in biased outcomes when population characteristics of participants systematically differ from the non-respondents. Few studies have examined key factors of non-response beyond demographic characteristics, such as behavioral and psychological factors. The aim of the current study was to identify predictors of non-response and loss to follow-up in a longitudinal sexual health study. Materials and methods A longitudinal cohort study (iMPaCT) was conducted from November 2016 to July 2018 among heterosexual STI clinic visitors aged 18–24 years. At four different time points in one year, data was collected on sexual behavior, psychological determinants and chlamydia infections. The national STI surveillance database provided data on demographic, behavioral and sexual health-related characteristics for non-respondents. Predictors of non-response at baseline and of loss to follow-up were identified using multivariable logistic regression analyses. Results In total, 13,658 STI clinic visitors were eligible to participate, of which 1,063 (8%) participated. Male gender, low/medium education level, young age (≤ 20 years) and having a non-Dutch migration background were significant predictors of non-response at baseline. Furthermore, non-respondents at baseline were more likely to report STI-related symptoms, to have been notified by a partner, to have had condomless sex, and to have had ≤ 2 partners in the past six months, compared to participants. Psychological predictors of loss to follow-up differed between STI clinic regions, but low perceived importance of health at baseline was associated with loss to follow-up in all regions. The baseline chlamydia positivity rate was significantly higher in the non-respondents (17%) compared to the participants (14%), but was not a predictor of loss to follow-up. Discussion Targeted recruitment aimed at underrepresented groups in the population based on demographic, behavioral and psychological characteristics, might be necessary to decrease loss to follow-up, and to prevent non-response bias in health research.

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Section: Methodsmentioning

confidence: 99%

“…For participants, additional data on behavioral and psychological data was available from the baseline online questionnaire. The development of the questionnaire has been described in detail in the iMPaCT study protocol [19]. Behavioral data included the number of sexual partners in the past six months, and age at sexual debut.…”

Section: Methodsmentioning

confidence: 99%

Who drops out and when? Predictors of non-response and loss to follow-up in a longitudinal cohort study among STI clinic visitors

et al. 2019

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“…The protocol of the iMPaCT Study has been described in detail elsewhere (23). Briefly, selected individuals (heterosexuals aged 18–24 years and females aged 18–24 years who had sex with both men and women) who made an appointment at the STI clinic of Amsterdam, Kennemerland, Hollands Noorden, or Twente in the Netherlands between November 2016 and June 2017 were eligible to participate.…”

Section: Methodsmentioning

confidence: 99%

“…Behavioral and psychological data were collected in the online questionnaire. This questionnaire was based on several validated questionnaires, which has been described elsewhere (23). Sexual behavior questions included number of sexual partners (lifetime/past 6 months/past 4 weeks) and age at first sexual activity.…”

Section: Methodsmentioning

confidence: 99%

“…To explore the link between multiple psychological and behavioral characteristics and relate them to chlamydia diagnoses, a longitudinal cohort study entitled iMPaCT (Mathematical Models Incorporating Psychological Determinants: Control of Chlamydia Transmission) was initiated among persons being tested for chlamydia at STI clinics in the Netherlands (23). In the current study, we aimed to characterize risk classes based on psychological predictors of chlamydia diagnosis identified in the iMPaCT data.…”

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A Multidimensional Approach to Assessing Infectious Disease Risk: Identifying Risk Classes Based on Psychological Characteristics

Wees

Heijne

Heijman

et al. 2019

American Journal of Epidemiology

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Prevention of infectious diseases depends on health-related behavior, which is often influenced by psychological characteristics. However, few studies assessing health-related behavior have examined psychological characteristics to identify risk groups, and this multidimensional approach might improve disease risk assessment. We aimed to characterize subgroups based on psychological characteristics and examine their influence on behavior and disease risk, using chlamydia as a case study. Selected participants (heterosexuals aged 18–24 years and females aged 18–24 years who had sex with both men and women) in a Dutch longitudinal cohort study (the Mathematical Models Incorporating Psychological Determinants: Control of Chlamydia Transmission (iMPaCT) Study) filled out a questionnaire and were tested for chlamydia (2016–2017). Latent class analysis was performed to identify risk classes using psychological predictors of chlamydia diagnosis. Two classes were identified: class 1 (n = 488; 9% chlamydia diagnosis) and class 2 (n = 325; 13% chlamydia diagnosis). The proportion of participants with high shame, high impulsiveness, and lower perceived importance of health was higher in class 2 than in class 1. Furthermore, persons in class 2 were more likely to be male and to report condomless sex compared with class 1, but the number of recent partners was comparable. Thus, risk classes might be distinguished from each other by psychological characteristics beyond sexual behavior. Therefore, the impact of the same intervention could differ, and tailoring interventions based on psychological characteristics might be necessary to reduce chlamydia prevalence most effectively.

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Modelling the impact of tailored behavioural interventions on chlamydia transmission

Wees

Daas

Kretzschmar

et al. 2021

Sci Rep

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Behavioural interventions tailored to psychological characteristics of an individual can effectively achieve risk-reducing behaviour. The impact of tailored interventions on population-level chlamydia prevalence is unknown. We aimed to assess the impact on overall chlamydia prevalence five years after the introduction of an intervention aimed at increasing self-efficacy, social norms, attitudes and intentions towards condom use (i.e., condom intervention), and an intervention aimed at increasing health goals and decreasing impulsiveness (i.e., impulsiveness intervention). A pair model, informed by longitudinal psychological and behavioural data of young heterosexuals visiting sexual health centers, with susceptible-infected-susceptible structure was developed. The intervention effect was defined as an increased proportion of each subgroup moving to the desired subgroup (i.e., lower risk subgroup). Interventions tailored to subgroup-specific characteristics, assuming differential intervention effects in each subgroup, more effectively reduced overall chlamydia prevalence compared to non-tailored interventions. The most effective intervention was the tailored condom intervention, which was assumed to result in a relative reduction in chlamydia prevalence of 18% versus 12% in the non-tailored scenario. Thus, it is important to assess multiple psychological and behavioural characteristics of individuals. Tailored interventions may be more successful in achieving risk-reducing behaviour, and consequently, reduce chlamydia prevalence more effectively.

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Study protocol of the iMPaCT project: a longitudinal cohort study assessing psychological determinants, sexual behaviour and chlamydia (re)infections in heterosexual STI clinic visitors

Cited by 6 publications

References 66 publications

Who drops out and when? Predictors of non-response and loss to follow-up in a longitudinal cohort study among STI clinic visitors

Who drops out and when? Predictors of non-response and loss to follow-up in a longitudinal cohort study among STI clinic visitors

A Multidimensional Approach to Assessing Infectious Disease Risk: Identifying Risk Classes Based on Psychological Characteristics

Modelling the impact of tailored behavioural interventions on chlamydia transmission

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