Multicomponent Internet continuing medical education to promote chlamydia screening.
BACKGROUND
Low Chlamydia trachomatis screening rates create an opportunity to test innovative continuing medical education (CME) programs. Few studies of Internet-based physician learning have been evaluated with objective data on practice patterns.


METHODS
This randomized controlled trial tested a multicomponent Internet CME (mCME) intervention for increasing chlamydia screening of at-risk women aged 16 to 26 years.


METHODS
Eligible physician offices had > or =20 patients at risk for chlamydia as defined by the Health Plan Employer Data and Information Set (HEDIS), had at least one primary care physician (internal medicine, family medicine/general practice, pediatrics) with Internet access, and participated in the study managed care organization. The 191 randomized primary care offices represented 20 states.


METHODS
The intervention, available from February to December 2001, consisted of four case-based learning modules, was tailored in real time to each physician based on theory of behavior change, and included office-level feedback of chlamydia screening rates.


METHODS
HEDIS chlamydia screening rates for the pre-intervention (2000) and post-intervention (2002) periods.


RESULTS
Pre-intervention screening rates for the intervention and comparison offices were 18.9% and 16.2% (p =0.135). Post-intervention screening rates for the intervention and comparison offices were 15.5% and 12.4%, respectively (p =0.044, adjusting for baseline performance).


CONCLUSIONS
The substantial decline in chlamydia screening rates observed in the comparison offices was significantly attenuated for the intervention offices. The mCME favorably influenced chlamydia screening by primary care physicians.
Allison
Jeroan J
JJ
Division of General Internal Medicine, University of Alabama at Birmingham, 720 Faculty Office Tower, 1530 3rd Avenue South, Birmingham, AL 35294-3407, USA. jallison@uab.edu
Kiefe
Catarina I
CI
Wall
Terry
T
Casebeer
Linda
L
Ray
Midge N
MN
Spettell
Claire M
CM
Hook
Edward W
EW
Oh
M Kim
MK
Person
Sharina D
SD
Weissman
Norman W
NW
D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D002692:Chlamydia trachomatis / Q000472:pathogenicity*; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008511:Medicine; D010818:Practice Patterns, Physicians' / Q000639:trends*; D013038:Specialization; D014481:United States