Anna Yeung1, Jane Hocking2, Rebecca Guy3, Christopher K Fairley4,5, Kirsty Smith3, Alaina Vaisey2, Basil Donovan3,6, John Imrie7, Jane Gunn8, Meredith Temple-Smith8. 1. Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. 2. Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia. 3. Sexual Health Program, Kirby Institute, University of New South Wales, Sydney, Australia. 4. Melbourne Sexual Health Centre, Melbourne, Australia. 5. Central Clinical School, Monash University, Melbourne, Australia. 6. Sydney Sexual Health Centre, Sydney, Australia. 7. Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Durban, South Africa. 8. General Practice and Primary Health Care Academic Centre, University of Melbourne, Melbourne, Australia.
Abstract
Background: Chlamydia is the most common notifiable sexually transmissible infection in Australia. Left untreated, it can develop into pelvic inflammatory disease and infertility. The majority of notifications come from general practice and it is ideally situated to test young Australians. Objectives: The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a multifaceted intervention that aimed to reduce chlamydia prevalence by increasing testing in 16- to 29-year-olds attending general practice. GPs were interviewed to describe the effectiveness of the ACCEPt intervention in integrating chlamydia testing into routine practice using Normalization Process Theory (NPT). Methods: GPs were purposively selected based on age, gender, geographic location and size of practice at baseline and midpoint. Interview data were analysed regarding the intervention components and results were interpreted using NPT. Results: A total of 44 GPs at baseline and 24 at midpoint were interviewed. Most GPs reported offering a test based on age at midpoint versus offering a test based on symptoms or patient request at baseline. Quarterly feedback was the most significant ACCEPt component for facilitating a chlamydia test. Conclusions: The ACCEPt intervention has been able to moderately normalize chlamydia testing among GPs, although the components had varying levels of effectiveness. NPT can demonstrate the effective implementation of an intervention in general practice and has been valuable in understanding which components are essential and which components can be improved upon.
RCT Entities:
Background: Chlamydia is the most common notifiable sexually transmissible infection in Australia. Left untreated, it can develop into pelvic inflammatory disease and infertility. The majority of notifications come from general practice and it is ideally situated to test young Australians. Objectives: The Australian Chlamydia Control Effectiveness Pilot (ACCEPt) was a multifaceted intervention that aimed to reduce chlamydia prevalence by increasing testing in 16- to 29-year-olds attending general practice. GPs were interviewed to describe the effectiveness of the ACCEPt intervention in integrating chlamydia testing into routine practice using Normalization Process Theory (NPT). Methods: GPs were purposively selected based on age, gender, geographic location and size of practice at baseline and midpoint. Interview data were analysed regarding the intervention components and results were interpreted using NPT. Results: A total of 44 GPs at baseline and 24 at midpoint were interviewed. Most GPs reported offering a test based on age at midpoint versus offering a test based on symptoms or patient request at baseline. Quarterly feedback was the most significant ACCEPt component for facilitating a chlamydia test. Conclusions: The ACCEPt intervention has been able to moderately normalize chlamydia testing among GPs, although the components had varying levels of effectiveness. NPT can demonstrate the effective implementation of an intervention in general practice and has been valuable in understanding which components are essential and which components can be improved upon.
Authors: Jane S Hocking; Anna Wood; Meredith Temple-Smith; Sabine Braat; Matthew Law; Liliana Bulfone; Callum Jones; Mieke van Driel; Christopher K Fairley; Basil Donovan; Rebecca Guy; Nicola Low; John Kaldor; Jane Gunn Journal: PLoS Med Date: 2022-01-04 Impact factor: 11.069