Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011

<p>Abstract</p> <p>Background</p> <p>The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including <it>Chlamydia trachomatis</it>. Modelling studies suggest that reductions in the prevalence of chlamydia infection...

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Main Authors: Kalwij Sebastian, French Sarah, Mugezi Rumbi, Baraitser Paula
Format: Article
Language:English
Published: BMC 2012-09-01
Series:BMC Public Health
Subjects:
Online Access:http://www.biomedcentral.com/1471-2458/12/802
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author Kalwij Sebastian
French Sarah
Mugezi Rumbi
Baraitser Paula
author_facet Kalwij Sebastian
French Sarah
Mugezi Rumbi
Baraitser Paula
author_sort Kalwij Sebastian
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including <it>Chlamydia trachomatis</it>. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60%) of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs) of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems.</p> <p>Methods</p> <p>Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003–11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15–24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed.</p> <p>Results</p> <p>Chlamydia tests performed in general practice increased from 23 tests in 2003–4 to 4813 tests in 2010–11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP’s in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth) were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England.</p> <p>Conclusions</p> <p>General practices can be important potential providers of chlamydia tests.</p> <p>With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15–24 year olds. General practice is also a potentially important provider of chlamydia tests to young men.</p>
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spelling doaj.art-1f100def419245379ebfe965d0ec2aa32022-12-22T02:57:59ZengBMCBMC Public Health1471-24582012-09-0112180210.1186/1471-2458-12-802Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011Kalwij SebastianFrench SarahMugezi RumbiBaraitser Paula<p>Abstract</p> <p>Background</p> <p>The London Boroughs of Lambeth and Southwark have high levels of sexually transmitted infections including <it>Chlamydia trachomatis</it>. Modelling studies suggest that reductions in the prevalence of chlamydia infection will require a high level of population screening coverage and positivity among those screened. General practice has a potentially important role to play in delivering these levels of coverage since large numbers (up to 60%) of young people visit their general practice every year but previous work suggests that there are barriers to delivering screening in this setting. The aim of this study was to evaluate an intervention to increase chlamydia screening in general practice within Primary Care Trusts (PCTs) of Lambeth and Southwark, a strategy combining financial incentives and supportive practice visits to raise awareness and solve problems.</p> <p>Methods</p> <p>Data on age, gender, venue and chlamydia result for tests on under 25 s in Lambeth from 2003–11 was obtained from the National Chlamydia Screening Programme. We analysed the number and percentage of tests generated in general practice, and looked at the number of practices screening more than 10% of their practice cohort of 15–24 year olds, male/female ratio and positivity rates across other screening venues. We also looked at practices screening less than 10% and studied change over time. We compared data from Lambeth and Southwark with London and England. We also studied features of the level and type of educational and financial incentive interventions employed.</p> <p>Results</p> <p>Chlamydia tests performed in general practice increased from 23 tests in 2003–4 to 4813 tests in 2010–11 in Lambeth. In Southwark they increased from 5 tests in 2003/04 to 4321 in 2010/11. In 2011, 44.6% of tests came from GPs in Lambeth and 46% from GP’s in Southwark. In Lambeth 62.7% of practices tested more than 10% of their cohort and in Southwark this was 55.8%. In Lambeth, postivity rate in 2010/11 was 5.8% in men and 6.0% in women. In Southwark positivity rate was 3.9% in men and 5.3% in women. In 2003/04 13% tests in general practice (Lambeth) were from men, this increased to 25% in 2010/11. In Southwark this increased from 20% in 2003/04 to 27.6% in 2010/11. We compared the results with London and national data and showed significant differences between GP testing in Lambeth and Southwark, and GP testing in London and the rest of England.</p> <p>Conclusions</p> <p>General practices can be important potential providers of chlamydia tests.</p> <p>With a combination of sustained support, financial incentives and feedback on performance, general practice may be able to test a large percentage of 15–24 year olds. General practice is also a potentially important provider of chlamydia tests to young men.</p>http://www.biomedcentral.com/1471-2458/12/802Chlamydia trachomatisChlamydia screeningGeneral practiceLambethSouthwarkPublic healthSTI testing
spellingShingle Kalwij Sebastian
French Sarah
Mugezi Rumbi
Baraitser Paula
Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011
BMC Public Health
Chlamydia trachomatis
Chlamydia screening
General practice
Lambeth
Southwark
Public health
STI testing
title Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011
title_full Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011
title_fullStr Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011
title_full_unstemmed Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011
title_short Using educational outreach and a financial incentive to increase general practices’ contribution to chlamydia screening in South-East London 2003–2011
title_sort using educational outreach and a financial incentive to increase general practices contribution to chlamydia screening in south east london 2003 2011
topic Chlamydia trachomatis
Chlamydia screening
General practice
Lambeth
Southwark
Public health
STI testing
url http://www.biomedcentral.com/1471-2458/12/802
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