Does educating patients about chlamydia trachomatis infection increase patient self-selectivity for STI screening

Background – Professional organizations recommend annual chlamydia trachomatis (CT) screening for sexually active women aged 15 to 24 (F15-24). Healthcare providers perceive screening as important, but it is largely limited to preventative health visits. Studies have examined whether educating providers increases CT screenings, but none have examined the effect of educating patients. Objective – To increase CT screening rates of F15-24 attending a family medicine office. Methods – A 7-month (Nov 2010-May 2011) quasi-experimental design of two-week alternating periods whereby F15-24 presenting for any appointment were either provided an educational pamphlet (‘on' period) or no pamphlet (‘off' period). The pamphlet described CT infection, risk factors and local rates, and prompted the reader to request screening during the visit. Pamphlets were distributed by either front desk staff at admission or by a nurse in the exam room. Results – There was no difference by period in: average 2-week attendance by F15-24 (mean=152.40; t=0.6682; p=0.5157) or CT tests requested (mean=20.87; t=0.5200; p=0.6118). Only 4 tests were known to be specifically requested as a result of the program and none were positive. Changing the location of where the pamphlet was provided from the admissions desk to the privacy of the exam room did not affect participation. Conclusions – Engaging patients to instigate screening during a medical visit is challenging. Implementation barriers in this study included the front desk staff unease with pamphlet distribution, parental offense at the material, and patient unease with reading the material in a public setting.