Screening for chlamydia in Spokane County: Implications for a local public health department

Stacy Lee. Reisenauer

Objectives: The purpose of this study was to evaluate the extent to which providers in Spokane County are screening patients for chlamydia, to identify potential barriers to screening, and to recommend strategies for public health intervention. Methods: A survey was mailed out to all (N = 663) Spokane County providers practicing in specialties that see the majority of STD cases. The final response rate was 47.8%. The association between provider and practice characteristics, and attitudes and beliefs to frequency of screening was determined using chi-square statistics. Results: The majority (62.1%) reported screening females age 15 to 25 for chlamydia all or most of the time during a routine new or annual patient visit. Only 21.7% reported screening males all or most of the time. Providers were significantly (p < .02) less likely to screen females for chlamydia if they specialized in emergency medicine. Providers were significantly (p < .02) more likely to screen females if they reported regularly taking a sexual history from patients, following clinical practice guidelines for STD-related care, or using patient-administered support tools to elicit a sexual history. Attitudes significantly (p < .02) associated with screening, included feeling responsible for ensuring that patients received STD prevention services, believing that screening would prevent unnecessary health care costs, and believing that screening was a priority. Providers were significantly (p < .02) less likely to regularly screen females for chlamydia if they felt that their patients did not want STD prevention services, if they believed that most of their adolescent patients were not sexually active, if they felt that laboratory tests were to costly, or if they felt that chlamydia was too uncommon in their practice to justify the costs of screening. Conclusion: Almost 40% of providers are not screening according to recommended clinical guidelines. Public health should provide information on STD risk and prevalence, and inform providers regarding the cost-effectiveness of screening for chlamydia. Additionally, all providers should be educated with regard to the role of males in the transmission of infection, specimen collection and diagnostic laboratory technologies, and effective sexual risk assessment. Further investigation and subsequent interventions aimed at providers practicing in emergency care settings are also warranted.

Screening for chlamydia in Spokane County: Implications for a local public health department

Files and links (1)

Abstract

Metrics

Details