title: Barriers to and facilitators of partner notification for chlamydia trachomatis among health care professionals.
abstract: BACKGROUND
  Partner notification (PN) is an essential case-finding tool in the management of sexually transmitted infections (STIs). Yet, data on the effectiveness and factors impacting implementation of PN in the Netherlands are lacking. With the aim of further exploring and improving the PN process, the current study assessed perceived barriers and facilitators among health care professionals in the STI clinical setting. In particular, we explored the management of PN in young heterosexual patients diagnosed with Chlamydia trachomatis (Ct).
  
  
  METHODS
  We conducted semi-structured interviews among 22 health care professionals (response rate 52%) from 5 of the 8 national STI clinics in the Netherlands. We carried out qualitative content analysis using a framework approach. All participants were nurses, aged mid 20's to late 50's, and all but one were female.
  
  
  RESULTS
  All health care professionals felt comfortable discussing PN. Other perceived facilitators for PN included: time, one-on-one consultations, interviewing skills (i.e. Motivational Interviewing) and a proactive helping style. Important barriers were identified as: sub-optimal guidelines, inaccurate sexual history, a lack of feedback regarding the motivational strategies that were used, and the lack of feedback regarding overall PN effectiveness. The health care professionals placed an emphasis on the care and treatment of the individual index patient rather than on discussion of PN, or on motivating and helping patients to engage in PN.
  
  
  CONCLUSIONS
  Health care professionals identified several barriers that need to be overcome, and facilitators which need to be maintained. Future efforts should concentrate on introducing PN protocols, providing feedback on both the effectiveness of strategies used by health care professionals, and on the PN process as a whole, and educating health care professionals about Motivational Interviewing strategies. Moreover, the possible implementation of an Internet-based PN system should be explored.
authors.affiliation: Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Services, PO Box 2022, 6160 HA, Geleen, The Netherlands. Kevin.theunissen@ggdzl.nl.
authors.forename: Kevin A T M
authors.initials: KA
authors.lastname: Theunissen
authors.affiliation: Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Services, PO Box 2022, 6160 HA, Geleen, The Netherlands. p.schipper@mondriaan.eu.
authors.forename: Pim
authors.initials: P
authors.lastname: Schipper
authors.affiliation: Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Services, PO Box 2022, 6160 HA, Geleen, The Netherlands. christian.hoebe@ggdzl.nl.|Department of Medical Microbiology Maastricht Infection Centre (MINC), School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands. christian.hoebe@ggdzl.nl.
authors.forename: Christian J P A
authors.initials: CJ
authors.lastname: Hoebe
authors.affiliation: Department of Health Promotion, School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands. rik.crutzen@maastrichtuniversity.nl.
authors.forename: Rik
authors.initials: R
authors.lastname: Crutzen
authors.affiliation: Department of Work & Social Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. g.kok@maastrichtuniversity.nl.
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
authors.affiliation: Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Services, PO Box 2022, 6160 HA, Geleen, The Netherlands. nicole.dukers@ggdzl.nl.|Department of Medical Microbiology Maastricht Infection Centre (MINC), School for Public Health and Primary Care (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ, Maastricht, The Netherlands. nicole.dukers@ggdzl.nl.
authors.forename: Nicole H T M
authors.initials: NH
authors.lastname: Dukers-Muijrers
mesh_terms: D000328:Adult; D002690:Chlamydia Infections; D002692:Chlamydia trachomatis; D016358:Contact Tracing; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D062405:Motivational Interviewing; D009426:Netherlands; D012017:Referral and Consultation; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases; D055815:Young Adult