5. Knowledge is Power: Effect of Educational Interventions on Readiness for Chlamydia Screening

Purpose: Chlamydia is the most prevalent bacterial sexually transmitted infection in the United States with more than 3 million new cases reported each year. Among all age groups, men and women ages 15-24 years constitute the majority of reported cases. Despite the availability of non-invasive screening tests for Chlamydia and relatively simple treatment options, fewer thanhalf of sexually active people in this age group are screened. We sought to compare (1) the effectiveness of print and digital educational media for communicating information about Chlamydia trachomatis to adolescent and young adult women and men and (2) the influence of medium type on readiness for Chlamydia screening. Methods: Randomized Controlled Trial. Setting: Youth Center and University Campus. Participants: One hundred three young men and women, ages 15-24. Interventions: Print (tri-fold pamphlet) and digital (website). Chlamydia educational media presenting the same information about Chlamydia were developed in consultation with members of the Youth Center. Participants were randomized to review one of the two educational interventions. Participants completed preand post-intervention questionnaires that included 13 items assessing Chlamydia knowledge (1 point for each correct answer) and 1 item assessing readiness for Chlamydia screening. The readiness for Chlamydia screening item was based on the stages of change construct from the transtheoretical model of behavior change with five options ranging from ‘I’m not interested in getting a Chlamydia test’ (Pre-contemplation), to “I get Chlamydia testing every year” (Maintenance). Main outcome measures were change in Chlamydia knowledge and change in readiness for screening. Results: Baseline mean knowledge scores were 4.4 (of a possible 13) for Youth Center men, 8.1 for Youth Center women, 6.7 for University men, and 6.8 for University women. Baseline responses to several Chlamydia knowledge items were associated with preintervention stage of readiness for Chlamydia screening. For all four groups, mean knowledge score improved post-intervention, but there was no association between improved knowledge score and type of intervention medium (x2 [1, N 98] .293, p .589). There were significant differences between men and women and between site locations with regards to baseline stage of readiness for Chlamydia screening: female participants were more ready for screening than male participants (x2 [4, N 91] 10.155, p .038) and Youth Center participants were more ready than University participants (x2 [4, N 91] 10.155, p .012). Nearly one third (31%) of participants endorsed an increased post-intervention stage of readiness for screening; however, there was no association between increased stage of readiness and type of intervention medium (x2 [1, N 91] .545, p .460). Conclusions: Greater knowledge about Chlamydia infection is associated with a higher stage of readiness for screening andmay have positive effects on willingness to be screened. A larger follow-up study is needed to evaluate the efficacy of educational interventions for increasing actual screening rates. Sources of Support: None. 6.