Historical Context of Routine Chlamydia Screening in Young Women

Introduction

This section will explore the background and historical information about the current topic of study. Routine annual chlamydia screening of sexually active young women is one of several important preventive reproductive health-care services (Ma and Clark 2005). Research shows that introduction of chlamydia screening programmes of sexually active women between the ages of 16 to 25 years can reduce the rate of inflection and the incidence of related morbidity such as pelvic inflammatory disease.

Aims and objectives

The main aim will be to explore a qualitative research study using focus groups so as to obtain information from primary health care teams about barriers to chlamydia screening and testing. The main objective is to explore the barriers to screening and testing for chlamydial infection in sexually active women in primary care.

Study design

Qualitative, quantitative, and mixed methods

Setting

The chosen setting for this study will be general screen practice in West Midlands

Methods

Qualitative, quantitative, and mixed methods studies published after 2000 will be included. Seven databases will be searched to identify peer-reviewed publications which examined barriers and facilitators to chlamydia testing in general practice. The quality of included studies was assessed using the Critical Appraisal Skills Programme. Data (i.e., participant quotations, theme descriptions, and survey results) regarding study design and key findings will be extracted. The data will be analysed using thematic analysis.

Inclusion criteria:

Randomised and non-randomised controlled trials, pre- and post-test designs, non-experiment observational (cross-sectional, case-series, case studies), qualitative (interviews, focus groups), and mixed method paper

Population: young people (aged 15–24 years) and primary care providers (PCP; general practitioners, practice nurses, nurse practitioners)

Conducted in countries where the model of delivering healthcare in general practice is comparable to the UK (Australia, Denmark, Ireland, Netherlands, and New Zealand)

Exclusion criteria: Conducted in countries where the healthcare system and general practice setting is not comparable to that of the UK (i.e., USA, Canada)

Results

Papers will be identified that meet the inclusion criteria. Barriers and facilitators will be identified at the patient (e.g., knowledge), provider (e.g., time constraints), and service level (e.g., practice nurses).

Factors will be categorised into the subcomponents of the model: physical capability (e.g., practice nurse involvement), psychological capability (e.g.: lack of knowledge), reflective motivation (e.g., beliefs regarding perceived risk), automatic motivation (e.g., embarrassment and shame), physical opportunity (e.g., time constraints), social opportunity (e.g., stigma).

Discussion

Discussing will be based on the results of the study and how they relate to study questions. Some of the major themes include significant barriers to screening and testing of chlamydia in primary care and how whether these are affected by financial and human resources, education and training; the main benefits of chlamydia testing; ways of expanding chlamydia screening; prejudices about sexual health promotion and the barriers to communication; and the level of skills possessed by care staff to raise sexual health issues.

Conclusion

It is important for the Department of Health to be aware of the potential barriers to any screening of chlamydia in young women as well as the extreme pressures that these care staff are under during the implementation of screening and testing practices. Efforts should be made to increase chlamydia screening in primary care setting which should be accompanied by clear guidance and education. There is need to address the issue of appropriate financial and staff resources which is crucial in increasing chlamydia screening and testing.

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Reference

Allison, R., Lecky, D.M., Town, K., Rugman, C., Ricketts, E.J., Ockendon-Powell, N., Folkard, K.A., Dunbar, J.K. and McNulty, C.A.M., 2017. Exploring why a complex intervention piloted in general practices did not result in an increase in chlamydia screening and diagnosis: a qualitative evaluation using the fidelity of implementation model. BMC family practice, 18(1), pp.1-15.

Lorimer, K., Martin, S. and McDaid, L.M., 2014. The views of general practitioners and practice nurses towards the barriers and facilitators of proactive, internet-based chlamydia screening for reaching young heterosexual men. BMC family practice, 15(1), pp.1-10.

Bilardi, J.E., Sanci, L.A., Fairley, C.K., Hocking, J.S., Mazza, D., Henning, D.J., Sawyer, S.M., Wills, M.J., Wilson, D.A. and Chen, M.Y., 2009. The experience of providing young people attending general practice with an online risk assessment tool to assess their own sexual health risk. BMC Infectious Diseases, 9(1), pp.1-7.

Lorch, R., Hocking, J., Temple-Smith, M., Law, M., Yeung, A., Wood, A., Vaisey, A., Donovan, B., Fairley, C.K., Kaldor, J. and Guy, R., 2013. The chlamydia knowledge, awareness and testing practices of Australian general practitioners and practice nurses: survey findings from the Australian Chlamydia Control Effectiveness Pilot (ACCEPt). BMC Family Practice, 14(1), pp.1-10.

Freeman, E., Howell-Jones, R., Oliver, I., Randall, S., Ford-Young, W., Beckwith, P. and McNulty, C., 2009. Promoting chlamydia screening with posters and leaflets in general practice-a qualitative study. BMC Public Health, 9(1), pp.1-9.

Ma, R. and Clark, A., 2005. Chlamydia screening in general practice: views of professionals on the key elements of a successful programme. BMJ Sexual & Reproductive Health, 31(4), pp.302-306.

Hocking, J.S., Parker, R.M., Pavlin, N., Fairley, C.K. and Gunn, J.M., 2008. What needs to change to increase chlamydia screening in general practice in Australia? The views of general practitioners. BMC Public Health, 8(1), pp.1-8.