title: Facilitators and barriers to chlamydia testing in general practice for young people using a theoretical model (COM-B): a systematic review protocol.
abstract: Chlamydia is a key health concern with high economic and social costs. There were over 200 000 chlamydia diagnoses made in England in 2015. The burden of chlamydia is greatest among young people where the highest prevalence rates are found. Annual testing for sexually active young people is recommended; however, many of those at risk do not receive testing. General practice has been identified as an ideal setting for testing, yet efforts to increase testing in this setting have not been effective. One theoretical model which may provide insight into the underpinnings of chlamydia testing is the Capability, Opportunity and Motivation Model of Behaviour (COM-B model). The aim of this systematic review is to: (1) identify barriers and facilitators to chlamydia testing for young people in general practice and (2) use a theoretical model to conduct a behavioural analysis of chlamydia testing behaviour.
  
  
  
  Qualitative, quantitative and mixed methods studies published after 2000 will be included. Seven databases (MEDLINE, PubMed, EMBASE, Informit, PsycInfo, Scopus, Web of Science) will be searched to identify peer-reviewed publications which examined barriers and facilitators to chlamydia testing in general practice. Risk of bias will be assessed using the Critical Appraisal Skills Programme. Data regarding study design and key findings will be extracted. The data will be analysed using thematic analysis and the resultant factors will be mapped onto the COM-B model components. All findings will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
  
  
  
  Ethical approval is not required. The results will be disseminated via submission for publication to a peer-review journal when complete and for presentation at national and international conferences. The review findings will be used to inform the development of interventions to facilitate effective and efficient chlamydia testing in general practice.
authors.affiliation: National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.|Research Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Lorraine K
authors.initials: LK
authors.lastname: McDonagh
authors.affiliation: National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.|National Chlamydia Screening Programme, Public Health England, London, UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Saunders
authors.affiliation: National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.|Division of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton, UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Cassell
authors.affiliation: Research Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Hamad
authors.initials: H
authors.lastname: Bastaki
authors.affiliation: National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.|Research Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hartney
authors.affiliation: National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.|Research Department of Primary Care and Population Health, University College London, London, UK.
authors.forename: Greta
authors.initials: G
authors.lastname: Rait
mesh_terms: D000293:Adolescent; D000328:Adult; D002690:Chlamydia Infections / Q000175:diagnosis*; D042241:Early Diagnosis; D005260:Female; D058006:General Practice / Q000379:methods*; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008962:Models, Theoretical; D000078202:Systematic Reviews as Topic; D055815:Young Adult
keywords: PRIMARY CARE; behavior change; chlamydia; general practice; young people