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Charron J, Troude P, de La Rochebrochard E, Segouin C, Piron P. Notification of STI test results by text messaging: Why do patients refuse? Cross-sectional study in a Parisian sexual health centre. Int J STD AIDS 2021; 33:257-264. [PMID: 34886724 DOI: 10.1177/09564624211048555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Text messaging has been used to notify patients of results after sexually transmitted infection (STI) testing. This study aimed to characterise the population who refused notification of results by short message services (SMS) and to explore their reasons for refusing. From January to August 2018, 1180 patients coming for STI testing in a Parisian sexual health centre were offered SMS notification of their results, completed a self-administered questionnaire and were included in the study. Factors associated with refusal of SMS notification were explored using logistic regression models. Reasons for refusal were analysed following a qualitative content analysis methodology. In the study population, 7.3% [95% CI 5.8-8.8] of patients refused SMS notification. In the multivariate logistic regression model, male gender and older age were associated with refusal, as were non-French nationality, having forgone health care for economic reasons and being unemployed. Qualitative analysis showed that preferring face-to-face medical contact (32%) and anxiety about the test result (29%) were the main reasons given by patients for refusal. Socially disadvantaged patients may have more limited access to technology and be less at ease using it in a health context. Preference for face-to-face medical contact may reflect the need for human support in vulnerable populations.
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Affiliation(s)
- Jalal Charron
- Department of Public Health, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France.,CEGIDD, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France
| | - Pénélope Troude
- Department of Public Health, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France.,Institut National d'Etudes Démographiques (INED), Aubervilliers, France
| | - Elise de La Rochebrochard
- Institut National d'Etudes Démographiques (INED), Aubervilliers, France.,UVSQ, CESP, INSERM, University Paris-Saclay, University Paris-Sud, Villejuif, France
| | - Christophe Segouin
- Department of Public Health, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France.,CEGIDD, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France
| | - Prescillia Piron
- Department of Public Health, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France.,CEGIDD, University Hospital Lariboisière Fernand-Widal, 26930AP-HP Nord, University of Paris, Paris, France
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Gan J, Kularadhan V, Chow EPF, Fairley CK, Hocking JS, Kong FYS, Ong JJ. What do young people in high-income countries want from STI testing services? A systematic review. Sex Transm Infect 2021; 97:574-583. [PMID: 34193529 DOI: 10.1136/sextrans-2021-055044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/09/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There are upward trends of STI rates among young people in most high-income countries. We reviewed the literature to provide a summary of information to support health services with the aim of increasing testing of STIs among young people living in high-income countries. METHODS We conducted a systematic review (Prospero: CRD42020179720) using PubMed, Embase, PsychINFO and CINAHL. The search was performed on 10 January 2020 for studies between January 2000 and 10 January 2020. Two reviewers independently screened articles, and any discrepancies were resolved by a third reviewer. Studies were included if they were performed in high-income countries and contained data on both young people (<26 years) and STI testing preferences. Data regarding the characteristics of STI testing services that young people preferred was extracted. We categorised these characteristics using the framework of a social-ecological model. RESULTS We identified 1440 studies, and 63 studies were included in the final review. We found 32 studies that addressed individual factors, 62 studies that addressed service factors and 17 studies that addressed societal factors. At an individual level, we identified eight attributes including the need for improved sexual health education. At a service level, 14 attributes were identified including preferences from different subgroups of young people (such as sexual and ethnic minorities) for the types of services. At a societal level, we identified two attributes including the need to address stigma associated with STIs. CONCLUSION We provide an overview of the growing body of literature capturing the preferences of young people for STI testing services. To optimise the uptake of STI testing among young people, factors from all socioecological levels should be considered. In addition, understanding and accounting for distinct preferences from subgroups of young people could increase demand for STI testing services for those at greatest need.
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Affiliation(s)
- Joscelyn Gan
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Eric P F Chow
- Central Clinical School, Monash University, Carlton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Christopher K Fairley
- Central Clinical School, Monash University, Carlton, Victoria, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Fabian Y S Kong
- Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia
| | - Jason J Ong
- Central Clinical School, Monash University, Carlton, Victoria, Australia.,Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
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Spence T, Kander I, Walsh J, Griffiths F, Ross J. Perceptions and Experiences of Internet-Based Testing for Sexually Transmitted Infections: Systematic Review and Synthesis of Qualitative Research. J Med Internet Res 2020; 22:e17667. [PMID: 32663151 PMCID: PMC7481875 DOI: 10.2196/17667] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 06/08/2020] [Accepted: 06/14/2020] [Indexed: 01/19/2023] Open
Abstract
Background Internet-based testing for sexually transmitted infections (STIs) allows asymptomatic individuals to order a self-sampling kit online and receive their results electronically, reducing the need to attend a clinic unless for treatment. This approach has become increasingly common; however, there is evidence that barriers exist to accessing it, particularly among some high-risk populations. We review the qualitative evidence on this topic, as qualitative research is well-placed to identify the complex influences that relate to accessing testing. Objective This paper aims to explore perceptions and experiences of internet-based testing for STIs among users and potential users. Methods Searches were run through 5 electronic databases (CINAHL, EMBASE, MEDLINE, PsycINFO, and Web of Science) to identify peer-reviewed studies published between 2005 and 2018. Search terms were drawn from 4 categories: STIs, testing or screening, digital health, and qualitative methods. Included studies were conducted in high-income countries and explored patient perceptions or experiences of internet-based testing, and data underwent thematic synthesis. Results A total of 11 studies from the 1735 studies identified in the initial search were included in the review. The synthesis identified that internet-based testing is viewed widely as being acceptable and is preferred over clinic testing by many individuals due to perceived convenience and anonymity. However, a number of studies identified concerns relating to test accuracy and lack of communication with practitioners, particularly when receiving results. There was a lack of consensus on preferred media for results delivery, although convenience and confidentiality were again strong influencing factors. The majority of included studies were limited by the fact that they researched hypothetical services. Conclusions Internet-based testing providers may benefit from emphasizing this testing’s comparative convenience and privacy compared with face-to-face testing in order to improve uptake, as well as alleviating concerns about the self-sampling process. There is a clear need for further research exploring in depth the perceptions and experiences of people who have accessed internet-based testing and for research on internet-based testing that explicitly gathers the views of populations that are at high risk of STIs. Trial Registration PROSPERO CRD42019146938; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=146938
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Affiliation(s)
- Tommer Spence
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Inès Kander
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Julia Walsh
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Frances Griffiths
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Jonathan Ross
- Whittall Street Clinic, University Hospitals Birmingham National Health Service Foundation Trust, Birmingham, United Kingdom
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Abstract
Participation in a short message service program after sexually transmitted infection/HIV screening seemed quite good but varied according to patient profile. Several options should be proposed for delivering the results of sexually transmitted infection screening. Background Text messaging after sexually transmitted infection (STI)/HIV screening may be a cost-effective means of improving patient care, but it may not be appropriate for all patients. This study aimed to explore the profiles of patients who did not participate in a short message service (SMS) program after STI/HIV testing. Methods In October 2016, 396 patients in Paris were screened for STI/HIV and were invited to complete an anonymous self-administered questionnaire. Patients were offered the possibility of being notified by SMS after testing, 68% accepted (SMS group) and 32% did not (no-SMS group). Each of the 100 patients from the no-SMS group who had completed the questionnaire was matched with the next patient from the SMS group. Factors associated with nonparticipation in the SMS program were studied using conditional logistic regression models. Results Participation in the SMS program was not related to STI screening characteristics (screening results and seriousness of the diseases screened) but seemed to be related to patient characteristics. In multivariate analysis, compared with patients in the SMS group, those in the no-SMS group were more often older, socially less favored (born in Africa or Asia, no university diploma, living outside Paris). They also more often declined to answer sexual questions, which could reflect a need for privacy and discretion. Conclusions Although SMS after STI/HIV screening is well accepted, it does not suit all patients. Several contact options should be proposed to comply with patients' preferences and to reduce the risk of nondelivery of STI screening results.
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Gibbs J, Aicken CRH, Sutcliffe LJ, Gkatzidou V, Tickle LJ, Hone K, Sadiq ST, Sonnenberg P, Estcourt CS. Mixed-methods evaluation of a novel online STI results service. Sex Transm Infect 2018; 94:622-624. [PMID: 29326179 PMCID: PMC6288705 DOI: 10.1136/sextrans-2017-053318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/02/2017] [Accepted: 12/10/2017] [Indexed: 11/23/2022] Open
Abstract
Objectives Evidence on optimal methods for providing STI test results is lacking. We evaluated an online results service, developed as part of an eSexual Health Clinic (eSHC). Methods We evaluated the online results service using a mixed-methods approach within large exploratory studies of the eSHC. Participants were chlamydia- positive and negative users of online postal self-sampling services in six National Chlamydia Screening Programme (NCSP) areas and chlamydia-positive patients from two genitourinary medicine (GUM) clinics between 21 July 2014 and 13 March 2015. Participants received a discreetly worded National Health Service ’NHS no-reply’ text message (SMS) informing them that their test results were ready and providing a weblink to a secure website. Participants logged in with their date of birth and mobile telephone or clinic number. Chlamydia-positive patients were offered online management. All interactions with the eSHC system were automatically logged and their timing recorded. Post-treatment, a service evaluation survey (n=152) and qualitative interviews (n=36) were conducted by telephone. Chlamydia-negative patients were offered a short online survey (n=274). Data were integrated. Results 92% (134/146) of NCSP chlamydia-positive patients, 82% (161/197) of GUM chlamydia-positive patients and 89% (1776/1997) of NCSP chlamydia-negative participants accessed test results within 7 days. 91% of chlamydia-positive patients were happy with the results service; 64% of those who had tested previously found the results service better or much better than previous experiences. 90% of chlamydia-negative survey participants agreed they would be happy to receive results this way in the future. Interviewees described accessing results with ease and appreciated the privacy and control the two-step process gave them. Conclusion A discreet SMS to alert users/patients that results are available, followed by provision of results via a secure website, was highly acceptable, irrespective of test result and testing history. The eSHC results service afforded users privacy and control over when they viewed results without compromising access.
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Affiliation(s)
- Jo Gibbs
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, UK.,Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Catherine R H Aicken
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, UK
| | - Lorna J Sutcliffe
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Voula Gkatzidou
- College of Engineering, Design and Physical Sciences, Brunel University London, Uxbridge, UK
| | - Laura J Tickle
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kate Hone
- College of Engineering, Design and Physical Sciences, Brunel University London, Uxbridge, UK
| | - S Tariq Sadiq
- Applied Diagnostic Research and Evaluation Unit, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Pam Sonnenberg
- Centre for Population Research in Sexual Health and HIV, Institute of Global Health, University College London, London, UK
| | - Claudia S Estcourt
- Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,School of Health and Life Science, Glasgow Caledonian University, Glasgow, UK
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Gibbs J, Sutcliffe LJ, Gkatzidou V, Hone K, Ashcroft RE, Harding-Esch EM, Lowndes CM, Sadiq ST, Sonnenberg P, Estcourt CS. The eClinical Care Pathway Framework: a novel structure for creation of online complex clinical care pathways and its application in the management of sexually transmitted infections. BMC Med Inform Decis Mak 2016; 16:98. [PMID: 27448797 PMCID: PMC4957844 DOI: 10.1186/s12911-016-0338-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 07/13/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Despite considerable international eHealth impetus, there is no guidance on the development of online clinical care pathways. Advances in diagnostics now enable self-testing with home diagnosis, to which comprehensive online clinical care could be linked, facilitating completely self-directed, remote care. We describe a new framework for developing complex online clinical care pathways and its application to clinical management of people with genital chlamydia infection, the commonest sexually transmitted infection (STI) in England. METHODS Using the existing evidence-base, guidelines and examples from contemporary clinical practice, we developed the eClinical Care Pathway Framework, a nine-step iterative process. Step 1: define the aims of the online pathway; Step 2: define the functional units; Step 3: draft the clinical consultation; Step 4: expert review; Step 5: cognitive testing; Step 6: user-centred interface testing; Step 7: specification development; Step 8: software testing, usability testing and further comprehension testing; Step 9: piloting. We then applied the Framework to create a chlamydia online clinical care pathway (Online Chlamydia Pathway). RESULTS Use of the Framework elucidated content and structure of the care pathway and identified the need for significant changes in sequences of care (Traditional: history, diagnosis, information versus Online: diagnosis, information, history) and prescribing safety assessment. The Framework met the needs of complex STI management and enabled development of a multi-faceted, fully-automated consultation. CONCLUSION The Framework provides a comprehensive structure on which complex online care pathways such as those needed for STI management, which involve clinical services, public health surveillance functions and third party (sexual partner) management, can be developed to meet national clinical and public health standards. The Online Chlamydia Pathway's standardised method of collecting data on demographics and sexual behaviour, with potential for interoperability with surveillance systems, could be a powerful tool for public health and clinical management.
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Affiliation(s)
- Jo Gibbs
- />Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
- />Research Department of Infection and Population Health, University College London, Mortimer Market Centre, off Capper Street, London, UK
| | - Lorna J. Sutcliffe
- />Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
| | - Voula Gkatzidou
- />School of Information Systems & Computing, Brunel University London, Uxbridge, UK
| | - Kate Hone
- />School of Information Systems & Computing, Brunel University London, Uxbridge, UK
| | | | | | | | - S. Tariq Sadiq
- />Institute of Infection and Immunity, St George’s, University of London, London, UK
| | - Pam Sonnenberg
- />Research Department of Infection and Population Health, University College London, Mortimer Market Centre, off Capper Street, London, UK
| | - Claudia S. Estcourt
- />Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK
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Robinson RF, Dillard DA, Hiratsuka VY, Smith JJ, Tierney S, Avey JP, Buchwald DS. Formative Evaluation to Assess Communication Technology Access and Health Communication Preferences of Alaska Native People. INTERNATIONAL JOURNAL OF INDIGENOUS HEALTH 2015; 10:88-101. [PMID: 27169131 DOI: 10.18357/ijih.102201515042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Information technology can improve the quality, safety, and efficiency of healthcare delivery by improving provider and patient access to health information. We conducted a nonrandomized, cross-sectional, self-report survey to determine whether Alaska Native and American Indian (AN/AI) people have access to the health communication technologies available through a patient-centered medical home. METHODS In 2011, we administered a self-report survey in an urban, tribally owned and operated primary care center serving AN/AI adults. Patients in the center's waiting rooms completed the survey on paper; center staff completed it electronically. RESULTS Approximately 98% (n = 654) of respondents reported computer access, 97% (n = 650) email access, and 94% (n = 631) mobile phone use. Among mobile phone users, 60% had Internet access through their phones. Rates of computer access (p = .011) and email use (p = .005) were higher among women than men, but we found no significant gender difference in mobile phone access to the Internet or text messaging. Respondents in the oldest age category (65-80 years of age) were significantly less likely to anticipate using the Internet to schedule appointments, refill medications, or communicate with their health care providers (all p < .001). CONCLUSION Information on use of health communication technologies enables administrators to deploy these technologies more efficiently to address health concerns in AN/AI communities. Our results will drive future research on health communication for chronic disease screening and health management.
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Use of Text Messaging for Maternal and Infant Health: A Systematic Review of the Literature. Matern Child Health J 2014; 19:969-89. [DOI: 10.1007/s10995-014-1595-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Llewellyn CD, Sakal C, Lagarde M, Pollard A, Miners AH. Testing for sexually transmitted infections among students: a discrete choice experiment of service preferences. BMJ Open 2013; 3:e003240. [PMID: 24165028 PMCID: PMC3816231 DOI: 10.1136/bmjopen-2013-003240] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To assess preferences among students for sexually transmitted infection (STI) testing services, with a view to establishing strength of preference for different service attributes. DESIGN Online discrete choice experiment (DCE) questionnaire. SETTING South East of England. PARTICIPANTS A convenience sample of 233 students from two universities. OUTCOMES Adjusted ORs in relation to service characteristics. RESULTS The study yielded 233 responses. Respondents' ages ranged from 16 to 34 years with a mean age of 22 years. Among this sample, the respondents demonstrated strong preferences for a testing service which provided tests for all STIs including syphilis, herpes and HIV (OR 4.1; 95% CI 3.36 to 4.90) and centres staffed by a doctor or nurse with specialist knowledge of STIs (OR 2.1; 95% CI 1.78 to 2.37). Receiving all test results, whether positive or negative, was also significantly preferable to not being notified when tests were all negative ('no news is good news'; OR 1.3; 95% CI 1.16 to 1.5). The length of time waiting for an appointment and the method by which results are received were not significant service characteristics in terms of preferences. Patient level characteristics such as age, sex and previous testing experience did not predict the likelihood of testing. CONCLUSIONS This study demonstrates that of the examined attributes, university students expressed the strongest preference for a comprehensive testing service. The next strongest preferences were for being tested by specialist STI staff and receiving negative as well as positive test results. However, it remains unclear how strong these preferences are in relation to characteristics which were not part of the study design and whether or not they are cost-effective.
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Affiliation(s)
- Carrie D Llewellyn
- Division of Public Health & Primary Care, Brighton & Sussex Medical School, Brighton, UK
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Miners A, Llewellyn C, Pollard A, Lagarde M, Richardson D, Cairns J, Fisher M, Smith H. Assessing user preferences for sexually transmitted infection testing services: a discrete choice experiment. Sex Transm Infect 2012; 88:510-6. [PMID: 22661632 PMCID: PMC3595497 DOI: 10.1136/sextrans-2011-050215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2012] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess user preferences for different aspects of sexually transmitted infection (STI) testing services. DESIGN A discrete choice experiment. SETTING 14 centres offering tests for STIs in East Sussex, England. PARTICIPANTS People testing for STIs. MAIN OUTCOME MEASURE (Adjusted) ORs in relation to preferred service characteristics. RESULTS 3358 questionnaires were returned; mean age 26 (SD 9.4) years. 70% (2366) were recruited from genitourinary medicine (GUM) clinics. The analysis suggested that the most important characteristics to users were whether 'staff had specialist STI knowledge' compared with 'staff without it' (OR 2.55; 95% CI 2.47 to 2.63) and whether 'tests for all STIs' were offered rather than 'some' (OR 2.19; 95% CI 2.12 to 2.25). They remained the most important two service characteristics despite stratifying the analysis by variables such as age and sex. Staff levels of expertise were viewed as particularly important by people attending CASH centres, women and non-men who have sex with men. A 'text or call to a mobile phone' and 'dropping in and waiting' were generally the preferred methods of results reporting and appointment system, respectively. CONCLUSIONS This study suggests that people testing for STIs place particular importance on testing for all infections rather than some and staff with specialist STI knowledge. Thus, targets based purely on waiting up to 48 h for an appointment are misguided from a user perspective.
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Affiliation(s)
- Alec Miners
- Faculty of Public Health and Policy, Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.
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11
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Llewellyn C, Pollard A, Miners A, Richardson D, Fisher M, Cairns J, Smith H. Understanding patient choices for attending sexually transmitted infection testing services: a qualitative study. Sex Transm Infect 2012; 88:504-9. [PMID: 22628665 PMCID: PMC3595495 DOI: 10.1136/sextrans-2011-050344] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Objectives To establish which aspects of sexually transmitted infection (STI) testing services are important to STI testing service users. Methods 10 focus groups consisting of previous or existing users of STI testing services were conducted in community settings in the south east of England. Groups were quota sampled based on age, gender and sexual orientation. Data were analysed using Framework Analysis. Results 65 respondents (58% men) participated. Perceived expertise of staff was the key reason for attendance at genitourinary medicine services rather than general practice. Although some respondents voiced a willingness to test for STIs within general practice, the apparent limited range of tests available in general practice and the perceived lack of expertise around sexual health appeared to discourage attendance at general practice. The decision of where to test for STIs was also influenced by past experience of testing, existing relationships with general practice, method of receiving test results and whether the patient had other medical conditions such as HIV. Conclusions No one type of STI testing service is suitable for all patients. This is recognised by policymakers, and it now requires commissioners and providers to make services outside of genitourinary medicine clinics more acceptable and attractive to patients, in particular to address the perceived lack of expertise and limited range of STIs tests available at alternative testing sites.
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Affiliation(s)
- Carrie Llewellyn
- Division of Public Health & Primary Care, Brighton & Sussex Medical School, Mayfield House, Falmer, Brighton BN1 9PH, UK.
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12
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Guy R, Hocking J, Wand H, Stott S, Ali H, Kaldor J. How effective are short message service reminders at increasing clinic attendance? A meta-analysis and systematic review. Health Serv Res 2011; 47:614-32. [PMID: 22091980 DOI: 10.1111/j.1475-6773.2011.01342.x] [Citation(s) in RCA: 203] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES In the last few years there has been a steady uptake of mobile phone short message service (SMS) reminders to increase medical attendance rates. We undertook a review of studies that assessed the effectiveness of SMS reminders at increasing the uptake of appointments in health care settings. METHODS We reviewed studies which involved a comparison of appointment attendance rates between patients who did and did not receive SMS reminders published prior to June 2010. We used meta-analysis methods to calculate the overall effect on attendance rates, stratified by study design and clinic type. RESULTS The review criteria were met by 18 reports, made up of eight randomized controlled trials (RCTs) and 10 controlled observational studies. Across all studies, there was significant heterogeneity in the estimated effect measure of the relationship between use of SMS reminders and clinic attendance (I(2) = 90 percent; p < .01), so a summary effect estimate was not calculated. Stratification by study design showed that the heterogeneity was due to the observational studies. The summary effect from the RCTs was 1.48 (95% CI: 1.23-1.72) with no significant subgroup differences by clinic type (primary care clinics, hospital outpatient clinics), message timing (24, 48, and 72+ hours before the scheduled appointment), and target age group (pediatric, older). CONCLUSIONS Short message service reminders in health care settings substantially increase the likelihood of attending clinic appointments. SMS reminders appear to be a simple and efficient option for health services to use to improve service delivery, as well as resulting in health benefits for the patients who receive the reminders.
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Affiliation(s)
- Rebecca Guy
- The Kirby Institute, University of New South Wales, Darlinghurst, NSW, Australia.
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13
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Bush MR, Williams H, Fairley CK. HIV is rare among low-risk heterosexual men and significant potential savings could occur through phone results. Sex Health 2010; 7:495-7. [PMID: 21062593 DOI: 10.1071/sh09088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2009] [Accepted: 02/23/2010] [Indexed: 11/23/2022]
Abstract
BACKGROUND The legislation in Victoria requires HIV-positive results to be given in person by an accredited health professional. Many sexual health clinics require all men to receive HIV results in person. Our aim was to determine the proportion of low-risk heterosexual men at a sexual health centre who tested HIV-positive. METHODS The electronic data on all HIV tests performed between 2002 and 2008 on heterosexual men at the Melbourne Sexual Health Centre (MSHC) was reviewed. The individual client files of all heterosexual men who tested HIV-positive were reviewed to determine their risks for HIV at the time that the HIV test was ordered. RESULTS Over the 6 years there were 33 681 HIV tests performed on men, of which 17 958 tests were for heterosexual men. From these heterosexual men, nine tested positive for the first time at MSHC (0.05%, 95% confidence interval (CI): 0.01%, 0.09%). These nine cases included six men who had had sex with a female partner from the following countries: Thailand, Cambodia, China, East Timor, Botswana and South Africa. Two men had injected drugs and one had a HIV-positive female partner. Of the 17 958 test results for heterosexual males, 14 902 (83% 95% CI: 84%, 86%) test results were for men who did not have a history of intravenous drug use or had sexual contact overseas. Of these 14 902 low-risk men, none tested positive (0%, 95% CI: 0, 0.00025). CONCLUSION Asking the 83% of heterosexual men who have an extremely low risk of HIV to return in person for their results is expensive for sexual health clinics and inconvenient for clients. We have changed our policy to permit heterosexual men without risk factors to obtain their HIV-negative results by phone.
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Affiliation(s)
- Matiu R Bush
- Melbourne Sexual Health Centre, Alfred Hospital, 580 Swanston Street, Vic. 3053, Australia.
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14
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Challenor R, Deegan S. What service users want: a new clinic results service. Can we satisfy both patients' needs and wants? Int J STD AIDS 2009; 20:701-3. [PMID: 19815915 DOI: 10.1258/ijsa.2009.009077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Many clinics still have a 'no news is good news' (NNIGN) policy for clinic results. We asked our service users their preferences for obtaining results. We also designed a new clinic results service. Patients were invited to complete a service evaluation questionnaire. They were given nine options for obtaining results and asked to rate acceptability on a 1-9 scale (unacceptable to acceptable). Completed questionnaires were compared with the actual method they chose to obtain results for that visit. In all, 1000 questionnaires (561 females, 439 males) were completed. Average acceptability score was highest for mobile phone (7.7), followed by text (5.8) and letter (5.7). NNIGN (3.7) and returning for results (3.6) received the least popular ratings. When compared with the actual method chosen, mobile phone was the most popular (62%) followed by letter (17%). Only 10% of patients found NNIGN acceptable. Following the evaluation we purchased texting software and redesigned our results service. There are now four options for receiving results - texting, letter, patient telephones us and NNIGN. We believe we have been able to satisfy both patients' needs and their wishes by redesigning our service around their views.
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Affiliation(s)
- R Challenor
- Genitourinary Medicine Department, Derriford Hospital, Plymouth, UK.
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15
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Using new technologies to deliver test results in primary care: structured interview study of patients’ views. Prim Health Care Res Dev 2009. [DOI: 10.1017/s146342360999034x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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