254628 Recruitment of patients for STI screening in the emergency department

Tuesday, October 30, 2012

Brittany Wold, MD , Center for Clinical Research, SIU School of Medicine, Springfield, IL
Wiley D. Jenkins, PhD, MPH , Family and Community Medicine, Southern Illinois University School of Medicine, Springfield, IL
Regina Kovach, MD , Internal Medicine, Siu School of Medicine, Springfield, IL
Whitney Zahnd, MS , Center for Clinical Research, SIU School of Medicine, Springfield, IL
Background – Recruiting patients to participate in sexually transmitted infection (STI) studies in the emergency department (ED) is difficult, and participation rates are typically poor (<59%). However, the prevalence of chlamydia and gonorrhea in ED patients frequently exceeds 8% and 4%, respectively, demonstrating that EDs can be important sites for screening. Objective – To identify potential factors in our current ED STI screening study contributing to our high participation rate. Methods – A qualitative review of participant reasons, recruiter observations, and study design factors. Results – From Aug 15-Dec 30, 2011, 122 of 175 (69.7%) females agreed to participate by completing a survey and providing a urine sample. Non-participating subjects were often accompanied by another person or reported current involvement in a committed relationship. Participating subjects cited “fear of being infected” or belief their partner had other sex partners. Recruiter observations included a subject preference for female recruiter, recruitment after receipt of primary treatment, and recruiting patients with minor illnesses versus those critically ill. The study design included a $10.00 cash incentive, but multiple participants stated this did not influence their decision. Conclusions – Patient recruitment in the ED for STI screening is feasible and potentially highly successful. The purposeful incorporation of factors contributing to participation may make recruitment in screening more effective. The financial incentive may be a barrier to some programs, but is likely highly cost-effective considering the potential morbidity associated with untreated STI. Further work should examine the utility of specific engagement strategies to reduce reliance upon incentives and increase participation.

Learning Areas:
Provision of health care to the public
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Describe identified patient reasons for participating in emergency department STI screening. 2. Describe recruiter observed factors influencing participation in screening. 3. Assess how identified factors positively influencing screening participation may be incorporated into a local emergency department STI screening program.

Keywords: Emergency Department/Room, Screening

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a MPH and PhD in public health (epidemiology and policy), 13 years experience in public health at the state level, and five years research in academics in STD epidemiology.
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.