245376 Comparison of adherence to Chlamydia screening guidelines among Title X and non-Title X providers in California

Wednesday, November 2, 2011: 11:10 AM

Heike Thiel de Bocanegra, PhD, MPH , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Denis Hulett , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Hye-Youn Park, PhD , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Leslie A. Watts, MS , Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Michael Policar, MD, MPH , University of California, San Francisco, Bixby Center for Global Reproductive Health, University of California, San Francisco, Sacramento, CA
Philip Darney, MD, MSc , Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA
National guidelines recommend annual chlamydia screening for women under 26 years to identify and treat asymptomatic infection. In California's Family PACT (Planning, Access, Care, and Treatment) program, screening is provided through over 2,000 public and private provider entities, including all Title X funded clinics. We wanted to determine whether Title X funded clinics are more likely to screen women under 26 years for Chlamydia and analyzed screening rates of this age group during 12 months after their enrollment in 2009.

We compared mean chlamydia screening rates by provider type and conducted multivariable linear regression among providers serving 20 or more clients under age 26 to assess the association between the provider-specific chlamydia screening rate adjusted for provider covariates including rural versus urban location, client volume, and distribution of clients by race/ethnicity.

The mean chlamydia screening rate for females under 26 years was 65.6% among 253 Title X providers versus 54.2% for 481 non-Title X public providers and 63.8% for 834 private providers. After adjustment for location, client volume, race/ethnicity, and race-provider type interactions, Title X providers were significantly more likely to screen young women for Chlamydia than non-Title X public providers and private providers.(p<0.01).

Higher adherence to chlamydia screening recommendations among Title X providers may be due to inherent organizational structure and funding to support best practices and quality interventions which complement Family PACT program clinical standards.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Provision of health care to the public

Learning Objectives:
1. Participants will identify chlamydia screening coverage among young females as a priority STD prevention goal among those accessing reproductive health services. 2. Participants will be able to identify key provider types serving young women and sociodemographic differences in the characteristics of client populations served. 3. Participants will be able to identify significant differences in chlamydia screening rates among young female clients served by provider types. 4. Participants will be able to cite potential organizational differences in provider training and clinic information technology that may be associated with differences in provider screening performance.

Keywords: Chlamydia, Quality Assurance

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been working in evaluating family planning programs and have been co-investigator on the analysis that will be presented
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Improving the Management and Quality of Title X and Public Supported Services
See more of: Population, Reproductive and Sexual Health