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

Autor:	Angela Hogan, Louise M. Wallace, Rona Campbell, Isabel Oliver, Andre Charlett, Elaine O'Connell, Sebastian Kalwij, Ellie J Ricketts, Cliodna A. M. McNulty
Rok vydání:	2013
Předmět:	medicine.medical_specialty business.industry Theory of planned behavior Dermatology Rate ratio Test (assessment) Infectious Diseases Clinical research Intervention (counseling) Physical therapy Medicine Cluster randomised controlled trial business Prospective cohort study Mass screening
Zdroj:	Sexually Transmitted Infections
ISSN:	1472-3263 1368-4973
DOI:	10.1136/sextrans-2013-051029
Popis:	Objective: To determine if a structured complex intervention increases opportunistic chlamydia screening testing of patients aged 15-24 years attending English general practitioner (GP) practices.\ud Methods: A prospective, Cluster Randomised Controlled Trial with a modified Zelen design involving 160 practices in South West England in 2010. The intervention was based on the Theory of Planned Behaviour (TPB). It comprised of practice-based education with up to two additional contacts to increase the importance of screening to GP staff and their confidence to offer tests through skill development (including videos). Practical resources (targets, posters, invitation cards, computer reminders, newsletters including feedback) aimed to actively influence social cognitions of staff, increasing their testing intention.\ud Results: Data from 76 intervention and 81 control practices were analysed. In intervention practices, chlamydia screening test rates were 2.43/100 15-24-yearolds registered preintervention, 4.34 during intervention and 3.46 postintervention; controls testing rates were 2.61/ 100 registered patients prior intervention, 3.0 during intervention and 2.82 postintervention. During the intervention period, testing in intervention practices was 1.76 times as great (CI 1.24 to 2.48) as controls; this persisted for 9 months postintervention (1.57 times as great, CI 1.27 to 2.30). Chlamydia infections detected increased in intervention practices from 2.1/1000 registered 15-24-year-olds prior intervention to 2.5 during the intervention compared with 2.0 and 2.3/1000 in controls (Estimated Rate Ratio intervention versus controls 1.4 (CI 1.01 to 1.93).\ud Conclusions: This complex intervention doubled chlamydia screening tests in fully engaged practices. The modified Zelen design gave realistic measures of practice full engagement (63) and efficacy of this educational intervention in general practice; it should be used more often.\ud Trial registration: The trial was registered on the UK Clinical Research Network Study Portfolio database. UKCRN number 9722.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::53c4851b3a73505fcf9e54a623ec3e86 https://doi.org/10.1136/sextrans-2013-051029 Zobrazit plný text záznamu