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In-TOUCH: Innovative technology-based outreach and utilization of client home-testing to improve chlamydia/gonorrhea re-testing
(Archived Project)
Investigator (PI): Bauer, Heidi
Performing Organization (PO): (Current): California Department of Public Health / (916) 558-1784
Supporting Agency (SA): United States Department of Health and Human Services (DHHS), Office of Population Affairs (OPA)
Initial Year: 2009
Final Year: 2010
Award Type: Grant
Data Source: Cohorts study
Number of Subjects: 2100
Population Base: Community
Abstract: This applied research evaluates whether two different levels of clinic and client interventions improving logistics, services and options related to chlamydia/gonorrhea (CT/GC) re-testing are effective in increasing re-testing rates in California family planning (FP) clinics. The long-term objectives of this study are to reduce women's adverse health outcomes associated with repeat CT/GC infections and improve overall reproductive health by identifying effective, easy-to-implement strategies to increase CT/GC re-testing in FP settings. To achieve these objectives, an experimental pre-/post-evaluation will be conducted comparing historic controls and two intervention cohorts of women infected with CT or GC. The first intervention phase, called the Enhanced Technical Assistance (TA) Phase, will aim to increase retesting rates by applying a combination of easy-to-implement clinical improvements, including 1) a review and revision of clinic retesting protocol; 2) an all-staff training on CDC retesting recommendations and related counseling and education messages for CT-positive clients; 3) the provision of client education materials for CT-positive clients with information about the importance of getting retested approximately 3 months post-treatment; 4) the institution of an effective chart-flag system for clients who need to be re-tested; and 5) a review and revision of existing protocol for express STD testing visits to ensure forms and procedures include options for clients who are returning to clinic specifically for a CT or GC retest. The second intervention phase, called the Client Options Phase, will build on the Enhanced TA Phase, adding customized options for clients that are designed to improve their retesting compliance, including 1) an option to complete their retesting at home using a mailed-in self-administered vaginal swab (SVS); and 2) an option to choose to receive a retesting reminder at 3 months post-treatment that can be delivered via self-addressed postcard, automated text message, and/or automated email. The primary outcome of the study will be the proportion of women from each cohort (historic, Enhanced TA, and Client Options Phases) who are retested for CT/GC within 1 to 6 months after treatment. Additional client outcomes that will be measured include the acceptability, usage, and client satisfaction of each enhanced service and option; clinical outcomes include rates of reinfection with CT/GC and of related complications (e.g., pelvic inflammatory disease [PID]); and clinic service outcomes include feasibility, cost-effectiveness, staff acceptability and satisfaction, and ease of implementation. The effectiveness, acceptability, and satisfaction among different subpopulations of clients (e.g., adolescents, racial/ethnic minority clients) will also be assessed. Outcomes from this study will directly support the widespread implementation of cost-effective strategies to increase CT/GC re-testing in FP clinics in California and throughout the country. Inexpensive new technologies for communicating with clients will be developed and, if shown to be effective, will be made widely available to public clinics and health care agencies. Further, effectiveness data will inform national evidence-based clinical and programmatic practice guidelines.
MeSH Terms:
  • Adolescent
  • Automation
  • California
  • Chlamydia Infections /*diagnosis
  • Cohort Studies
  • Communicable Disease Control /methods
  • Counseling
  • Female
  • Gonorrhea /*diagnosis
  • Humans
  • Minority Groups
  • Outcome Assessment, Health Care
  • Pelvic Inflammatory Disease /complications
  • Self Care /*methods
  • Time Factors
Country: United States
State: California
Zip Code: 94804
UI: 20111007
Project Status: Archived