TABLE 4.
Table Position | Author (Year) Country, Study Design | Population Characteristics | Objective | Intervention | Main Findings | Absolute % Difference* | Effect Category† | Cost‡ |
---|---|---|---|---|---|---|---|---|
Adolescents/Young adults | ||||||||
4A | Bilardi et al.53 (2009), Australia, PPI | Patients aged 16–24 y attending 3 general practice clinics | Increase CT screening | Providers referred all patients aged 16–24 y to educational Web site www.checkyourrisk.org.au after clinical consultation | There was no significant increase in testing among males during the intervention (3.0%; 30/995) compared with baseline (2.7%; 20/752) or females during intervention (6.4%; 129/2002) and at baseline (6.3%; 98/1548). | 0.3 males 0.1 females |
☆☆ | $ |
4B | Chacko et al.54 (2010), USA, RCT | Females aged 16–22.5 y attending reproductive health clinic | Improve STI retesting | Offered client-centered motivational behavioral counseling to females attending clinic, encouraging them to return for STI testing in response to high-risk sexual behavior | There was no improvement in the percent of females that returned for an STI testing visit in the intervention group (46%; 78/168) as compared with the control group (54%; 90/168). | −8.0 | ☆☆ | $$ |
4C | Malotte et al.55 (2004), USA, RCT | Patients aged 14–30 y treated for CT or GC at 1 STD clinic | Improve CT and GC repeat testing after initial diagnosis and treatment | Conducted motivational interviewing | Retesting was not significantly increased among patients that received motivational interviewing (12.0%) as compared with those receiving an appointment card at the treatment visit (3.4%). | 8.6 | ★☆ | $$ |
4D | Malotte et al.55 (2004), USA, RCT | Patients aged 14–30 y treated for CT or GC at 1 STD clinic | Improve CT and GC repeat testing after initial diagnosis and treatment | Provided motivational interviewing plus telephone or letter reminders | Retesting was significantly increased among patients that received motivational interviewing along with a reminder as compared with patients receiving an appointment card at the treatment visit (23.9% vs. 11.4%). | 12.5 | ★☆ | $$ |
4E | Malotte et al.55 (2004), USA, RCT | Patients aged 14–30 y treated for CT or GC at 1 STD clinic | Improve CT and GC repeat testing after initial diagnosis and treatment | Provided phone reminders to return to STD clinic for repeat testing | Retesting was significantly higher (33.3%) among patients that received a telephone reminder for rescreening as compared with those receiving an appointment card at the treatment visit (3.4%). | 29.9 | ★★ | $ |
4F | Malotte et al.55 (2004), USA, RCT | Patients aged 14–30 y treated for CT or GC at 2 STD clinics | Improve CT and GC repeat testing after initial diagnosis and treatment | Paid $20 patient incentive for return for repeat testing | Retesting was not significantly different among patients that received the $20 incentive (13.2%) as compared with those who did not (11.4%). | 1.8 | ☆☆ | $$ |
4G | Morgan and Haar56 (2009), New Zealand, NRCT | Patients aged <25 y attending 49 clinics serving Māori, low socioeconomic, or rural populations | Increase CT screening | Offered free sexual health consultations and testing in 20 clinics | Among females aged 18–24 y, screening coverage increased from 13.9% to 16.8% in the intervention group, and from 13.0% to 13.2% in the control group. No change in screening coverage was observed among males, with 13% and 13.2% in the intervention and control groups, respectively For all age and gender groups, intervention practices had higher test positivity (8.7%) compared with nonintervention practices (5.9%) (P < 0.01). | 2.9 females 0.2 males |
☆☆ | $$$ |
4H | Paneth-Pollak et al.57 (2010), USA, CO | Patients diagnosed as having CT or GC at 10 STD clinics | Improve CT and GC repeat testing after initial diagnosis and treatment | Mailed reminder postcards for repeat testing to patients | Retesting was higher among patients that received a reminder postcard (14.1 %; 179/1267) compared with patients that did not receive reminder postcards (7.7%; 382/4953). There was a decrease in reinfection among persons retesting during intervention (12.3%; 22/179) compared with preintervention period (25.5%; 24/94) (P = 0.015) and compared with nonintervention clinics (20.1%; 58/288) (P = 0.05). | 6.4 | ★☆ | $ |
4I | Zenner et al.58 (2012), UK, NRCT | Patients aged 15–24 y attending medical care in 84 Primary Care Trusts (PCTs) | Increase CT screening | Used patient incentives including prize draws (£50 voucher, £2000 vacation), condoms, tokens and vouchers (£5–£10) to increase uptake of CT screening | Among PCTs using incentives, the mean CT screening coverage rate increased 1.08% as compared with 0.41% in matched PCTs not using incentives (P = 0.02). Positivity did not change (0.07%, P = 0.9) among PCTs using incentives. | N/A | N/A | $$$ |
MSM and HIV-infected patients | ||||||||
4J | Bourne et al.59 (2011), Australia, PPI | HIV-negative MSM at a community STI clinic | Increase STI rescreening at 3- to 6-mo intervals | Sent SMS (text) reminders to MSM for repeat STI screening | In the SMS group, 64.4% (n = 714) were retested as compared with 29.7% (322/1084) in the non-SMS group (P < 0.001). SMS cost was AU$0.05 each. | 34.7 | ★★ | $ |
4K | Zou et al.60 (2013) Australia, NRCT | MSM at a sexual health center | Improve asymptomatic STD screening among MSM | Sent MSM computer-generated, automated text message and e-mail reminders | MSM who chose SMS reminders had higher testing rates (49.2%; 435/885) for complete testing visits (GC and CT at genital and nongenital sites, syphilis and HIV) than those who did not choose text reminders (25.5%, 249/97S)(P < 0.001). Men receiving reminders had higher positivity rectal CT (6.6% vs. 2.8%), rectal GC (3.7% vs. 1.2%), urethral CT (3.1% vs. 1.4%), and early latent syphilis (1.4% vs. 0.4%) compared with controls. (P < 0.03 for all) | 23.7 | ★★ | $ |
Absolute difference in the percent screened (intervention group minus the comparison group).
Effect categories: ★★ = >20% absolute increase, ★☆ = 5%–19% absolute increase, and ☆☆ = <5% absolute increase.
Cost categories (estimated): $ = <$1000, $$ = $1000–$10,000, $$$ = $10,001–$100,000, and $$$$ > $100,000.
NRCT indicates nonrandomized controlled trial; PPI, preintervention/postintervention evaluation; CO, controlled observational.