Chlamydia screening in at-risk adolescent females: an evaluation of screening practices and modifiable screening correlates.
OBJECTIVE
To identify modifiable correlates of chlamydia screening that could offer intervention targets to enhance screening.


METHODS
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).


RESULTS
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 < or = .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.


CONCLUSIONS
Routine chlamydia screening among asymptomatic, at-risk adolescent females could be enhanced through additional intervention targeting specific provider attitudes and beliefs about chlamydia screening.
McClure
Jennifer B
JB
Center for Health Studies, Group Health Cooperative, Seattle, Washington 98101, USA. McClure.J@GHC.org
Scholes
Delia
D
Grothaus
Lou
L
Fishman
Paul
P
Reid
Robert
R
Lindenbaum
Jeffrey
J
Thompson
Robert S
RS
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D002690:Chlamydia Infections / Q000175:diagnosis*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008403:Mass Screening; D012307:Risk Factors; D012725:Sexual Behavior