Leveraging Technology as a Clinician Extender to Screen Culturally Diverse Young Women for Chlamydia
Condition: Chlamydia; Screening
MeSH terms: Chlamydia Infections
Study type: Observational

Summary: 
      The purpose of this study is to conduct a quality improvement intervention to improve the
      ability of health care providers to deliver an important preventive health service (CT
      screening) in order to meet the goal of universal CT screening for young women age 25 or
      younger as recommended by the CDC and virtually all major health organizations. This novel
      approach utilizes a bilingual (English-Spanish) computer kiosk module to deliver education
      about CT and allow patients to request a CT screening test. This module should significantly
      increase CT screening among at risk women (18-25yo) attending urgent care clinics and
      emergency departments.
    

Detailed description: 
      Chlamydia trachomatis (CT) remains epidemic among sexually young adult and adolescent females
      especially ethnic minority women. Despite recommendations for at least annual screening of
      all sexually active women up to age 25, CT screening rates remain low. Most young women do
      not regularly attend primary care clinics where preventive care such as CT screening should
      be done; and clinicians lack time and comfort to address CT screening during the context of
      an urgent care or emergency department visit. This proposed study takes advantage of a
      "missed opportunity" for screening these at-risk young women for CT when they come in contact
      with the health care system during an urgent care or emergency department visit. The purpose
      of this study is to conduct a quality improvement intervention, to improve the ability of
      health care providers to deliver an important preventive health service (CT screening) in
      order to meet the goal of universal CT screening recommended by virtually all major health
      organizations. CT screening should be done as a routine part of health care but currently is
      not. In this study, we will help providers do what they should already be doing using this
      novel health care delivery approach. In this study, we created and are evaluating a bilingual
      (English-Spanish) computer kiosk module to increase CT screening among at risk English and
      Spanish speaking women (18-25 yo) attending urgent care clinics and emergency departments
      (ED). This computer technology will be able to conduct many of the steps necessary for CT
      screening including assessing clients' CT risk and prompting the client and health care
      professionals for CT urine specimen collection. This study will also examine the extent to
      which this computer kiosk module intervention use is acceptable and feasible among both
      English and Spanish speaking young women, and health care professionals who care for them in
      urgent care and ED settings. This type of intervention to improve CT screening is potentially
      translatable to a wide variety of health delivery settings as it is not dependent on staff
      time, motivation or skill to assess sexual history in the busy urgent care setting. This
      project also supports current recommendations of Healthy People 2010, the U.S. Preventive
      Services Task Force and other professional organizations to screen all sexually active young
      adult females at least annually for CT to address this important public health problem
      especially among our young ethnic minority women who carry the largest STI disease burden.
      Early detection through routine CT screening coupled with appropriate treatment of CT
      infections can eliminate widespread infection and prevent such major reproductive morbidity.
    

Intervention name(s): CT Screening
Intervention type(s): Other
Intervention description(s): Patients will use a kiosk module that will provide information about CT screening and assess their risk for CT. Patients choosing to get a CT screening will receive a printout instructing the provider or nurse to collect a urine sample for CT screening.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Female patients 18-25 yo receiving care at urgent care or ED sites.
      
Keywords: Chlamydia, Screening, young women, kiosk, computer module