Fast-track services for all? The preferences of Chinese-, Korean-, and Thai-speaking women attending a sexual health service.
BACKGROUND
Sydney Sexual Health Centre (SSHC) Xpress clinic has significantly reduced the length of stay and waiting time for clients at SSHC but is currently only available to clients who can read and understand a high level of English. This reduces access for culturally and linguistically diverse (CALD) clients. This study sought to determine the acceptability of 4 proposed components of an express clinic model among CALD clients: computer-assisted self-interview (CASI), self-collection of swabs/urine specimens, not having a physical examination, and consultation with a health promotion officer rather than with a clinician. Differences in acceptability based on language group, new or return client status, sex worker status, clinic visited status, and age were analyzed.


METHODS
A cross-sectional, anonymous questionnaire was offered to all female Chinese, Thai, and Korean clients attending SSHC between March and November 2012. Multivariate regression and Pearson χ statistical analyses were conducted using STATA 12 software.


RESULTS
A total of 366 questionnaires were returned from 149 Thai, 145 Chinese, and 72 Korean participants. After multivariate analysis, the only predictor of willingness to use an express model of service provision was language group: overall, 67% Thai (odds ratio, 3.74: confidence interval [CI], 2.03-6.89; P < 0.01) and 64% Korean (odds ratio, 3.58; CI, 1.77-7.25, P < 0.01) said that they would use it compared with 35% Chinese. Age, history of sex work, new or returning clients, and general or language clinic attendance did not impact on choices. Within the preference for individual components of the model, more Thai women were happy with using a health promotion officer (43.2%) than Chinese (14.1%) or Korean (8.5%) (P < 0.001); no groups were happy with forfeiting a physical examination; Thai (48.6%) and Korean (40.9%) were happier with self-swabbing than Chinese women (23.9%, P < 0.001); and more Thai were happy to use a CASI (44.2%) than Chinese (12%) or Korean (11.1%; P < 0.001).


CONCLUSIONS
This research shows that the components of an express model used at SSHC are not favorable to our CALD client base. Despite a CALD express clinic having the potential to reduce waiting times, most clients did not favor reduced waiting time over being physically examined or using a CASI.
From the *Sydney Sexual Health Centre, Sydney, NSW, Australia; †Sexual Health Program, The Kirby Institute, and ‡School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia.
Lynne
L
Martin
Vickie
V
Knight
Phillip J
PJ
Read
Anna
A
McNulty
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D044466:Asian People; D001315:Australia / Q000453:epidemiology / Q000208:ethnology; D003144:Communication Barriers; D003430:Cross-Sectional Studies; D003936:Diagnosis, Computer-Assisted; D005006:Ethnicity; D005260:Female; D006801:Humans; D057240:Patient Preference / Q000208:ethnology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000208:ethnology / Q000706:statistics & numerical data*; D010808:Physical Examination; D057566:Self Report; D060386:Sex Workers / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data*; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013997:Time Factors