title: Acceptability of the internet-based Chlamydia screening implementation in the Netherlands and insights into nonresponse.
abstract: BACKGROUND
  The study assessed the acceptability of internet-based Chlamydia screening using home-testing kits among 16- to 29-year-old participants and nonparticipants in the first year of a Chlamydia Screening Implementation program in the Netherlands.
  
  
  METHODS
  Questionnaire surveys were administered to randomly selected participants (acceptability survey) and nonparticipants (nonresponse survey) in 3 regions of the Netherlands where screening was offered. Participants received email invitations to an online survey; nonparticipants received postal questionnaires. Both surveys enquired into opinions on the screening design, reasons for (non-) participation and future willingness to be tested.
  
  
  RESULTS
  The response rate was 63% (3499/5569) in the acceptability survey and 15% (2053/13,724) in the nonresponse survey. Primary motivation for participating in the screening was "for my health" (63%). The main reason for nonresponse given by sexually active nonparticipants was "no perceived risk of infection" (40%). Only 2% reported nonparticipation due to no internet access. Participants found the internet (93%) and home-testing (97%) advantages of the program, regardless of test results. Two-thirds of participants would test again, 92% via the screening program. Half of nonparticipants were appreciative of the program design, while about 1 in 5 did not like internet usage, home-testing, or posting samples.
  
  
  CONCLUSIONS
  The screening method was highly acceptable to participants. Nonparticipants in this survey were generally appreciative of the program design. Both groups made informed choices about participation and surveyed low-risk nonparticipants accurately perceived their low-risk status. Although many nonparticipants were not reached by the nonresponse survey, current insights on acceptability and nonresponse are undoubtedly valuable for evaluation of the current program.
authors.affiliation: Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands. katie.greenland@rivm.nl
authors.forename: Katie E
authors.initials: KE
authors.lastname: Greenland
authors.forename: Eline L M
authors.initials: EL
authors.lastname: Op de Coul
authors.forename: Jan E A M
authors.initials: JE
authors.lastname: van Bergen
authors.forename: Elfi E H G
authors.initials: EE
authors.lastname: Brouwers
authors.forename: Han J S A
authors.initials: HJ
authors.lastname: Fennema
authors.forename: Hannelore M
authors.initials: HM
authors.lastname: Götz
authors.forename: Christian J P A
authors.initials: CJ
authors.lastname: Hoebe
authors.forename: Rik H
authors.initials: RH
authors.lastname: Koekenbier
authors.forename: Lydia L
authors.initials: LL
authors.lastname: Pars
authors.forename: Sander M
authors.initials: SM
authors.lastname: van Ravesteijn
authors.forename: Ingrid V F
authors.initials: IV
authors.lastname: van den Broek
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D020407:Internet; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D011933:Reagent Kits, Diagnostic; D045808:Refusal to Participate / Q000523:psychology*; D012725:Sexual Behavior; D015231:Sexually Transmitted Diseases, Bacterial / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic