Chlamydia screening in at-risk adolescent females: An evaluation of screening practices and modifiable screening correlates

• Published in: Journal of adolescent health 2006-06, Vol.38 (6), p.726-733
• Main Authors: McClure, Jennifer B., Scholes, Delia, Grothaus, Lou, Fishman, Paul, Reid, Robert, Lindenbaum, Jeffrey, Thompson, Robert S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Behavior; Adolescent girls; Adolescents; Adult; Attitude to Health; Bacterial diseases; Bacterial diseases of the genital system; Biological and medical sciences; Chlamydia; Chlamydia Infections - diagnosis; Chlamydia trachomatis; Female; Health Surveys; Human bacterial diseases; Humans; Infectious diseases; Mass Screening; Medical sciences; Prevention and actions; Preventive care; Preventive health care; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Factors; Screening; Sexual Behavior; Specific populations (family, woman, child, elderly...)
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/j.jadohealth.2005.07.004

To identify modifiable correlates of chlamydia screening that could offer intervention targets to enhance screening. We surveyed a representative sample of primary care providers (n = 186) at an integrated healthcare delivery system to document their self-reported adherence to annual screening of sexually-active adolescents and to identify specific, modifiable constructs that were correlated with annual chlamydia screening. To cross-validate providers’ self-report, we also used automated data to examine adolescent screening in an anonymous sample of primary care providers (n = 143). Forty-two percent of providers reported annual chlamydia screening of sexually-active adolescents. Univariate correlates of annual screening were: provider type (non-physician) ( p = .01), female gender ( p = .001), fewer years of clinical experience ( p = .001), greater perceived knowledge about chlamydia ( p = .001), greater confidence across a range of screening-related activities ( p ≤ .01), greater comfort recommending screening for sexually transmitted diseases ( p = .001), and greater perceived patient comfort discussing sexual issues ( p < .01). In multivariate analyses, providers’ perceived knowledge, confidence, comfort, and perceived patient comfort continued to be significantly associated with annual chlamydia screening after controlling for other relevant provider characteristics. Self-reported screening practices were consistent with observed screening rates in the anonymous provider sample. Routine chlamydia screening among asymptomatic, at-risk adolescent females could be enhanced through additional intervention targeting specific provider attitudes and beliefs about chlamydia screening.