STI in remote communities

improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia

James Ward, Skye McGregor, Rebecca Guy, Alice Rumbold, Linda Garton, Bronwyn Joy Silver, Debbie Taylor-Thomson, Belinda Hengel, Janet Knox, Amalie Dyda, Matthew Law, Handan Wand, Basil Donovan, Christopher Fairley, Steven Skov, Donna Ah Chee, John Boffa, David Glance, Robyn McDermott, Lisa Maher & 1 others John Kaldor

Research output: Contribution to journalComment/debateResearch

Abstract

Background: Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population.


Methods/design: STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia.


Discussion: STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates.

Original languageEnglish
Article number425
Pages (from-to)1-9
Number of pages9
JournalBMC Infectious Diseases
Volume13
DOIs
Publication statusPublished - 9 Sep 2013

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Health Services
Primary Health Care
Randomized Controlled Trials
Infection
Chlamydia
Gonorrhea
Reproductive Health
Trichomonas
Western Australia
Queensland
Quality Improvement
Practice Guidelines
Motivation
Referral and Consultation
Population

Cite this

Ward, James ; McGregor, Skye ; Guy, Rebecca ; Rumbold, Alice ; Garton, Linda ; Silver, Bronwyn Joy ; Taylor-Thomson, Debbie ; Hengel, Belinda ; Knox, Janet ; Dyda, Amalie ; Law, Matthew ; Wand, Handan ; Donovan, Basil ; Fairley, Christopher ; Skov, Steven ; Ah Chee, Donna ; Boffa, John ; Glance, David ; McDermott, Robyn ; Maher, Lisa ; Kaldor, John. / STI in remote communities : improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia. In: BMC Infectious Diseases. 2013 ; Vol. 13. pp. 1-9.
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title = "STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia",
abstract = "Background: Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population. Methods/design: STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia. Discussion: STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates.",
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author = "James Ward and Skye McGregor and Rebecca Guy and Alice Rumbold and Linda Garton and Silver, {Bronwyn Joy} and Debbie Taylor-Thomson and Belinda Hengel and Janet Knox and Amalie Dyda and Matthew Law and Handan Wand and Basil Donovan and Christopher Fairley and Steven Skov and {Ah Chee}, Donna and John Boffa and David Glance and Robyn McDermott and Lisa Maher and John Kaldor",
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Ward, J, McGregor, S, Guy, R, Rumbold, A, Garton, L, Silver, BJ, Taylor-Thomson, D, Hengel, B, Knox, J, Dyda, A, Law, M, Wand, H, Donovan, B, Fairley, C, Skov, S, Ah Chee, D, Boffa, J, Glance, D, McDermott, R, Maher, L & Kaldor, J 2013, 'STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia', BMC Infectious Diseases, vol. 13, 425, pp. 1-9. https://doi.org/10.1186/1471-2334-13-425

STI in remote communities : improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia. / Ward, James; McGregor, Skye; Guy, Rebecca; Rumbold, Alice; Garton, Linda; Silver, Bronwyn Joy; Taylor-Thomson, Debbie; Hengel, Belinda; Knox, Janet; Dyda, Amalie; Law, Matthew; Wand, Handan; Donovan, Basil; Fairley, Christopher; Skov, Steven; Ah Chee, Donna; Boffa, John; Glance, David; McDermott, Robyn; Maher, Lisa; Kaldor, John.

In: BMC Infectious Diseases, Vol. 13, 425, 09.09.2013, p. 1-9.

Research output: Contribution to journalComment/debateResearch

TY - JOUR

T1 - STI in remote communities

T2 - improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing 'usual practice' STI care to enhanced care in remote primary health care services in Australia

AU - Ward, James

AU - McGregor, Skye

AU - Guy, Rebecca

AU - Rumbold, Alice

AU - Garton, Linda

AU - Silver, Bronwyn Joy

AU - Taylor-Thomson, Debbie

AU - Hengel, Belinda

AU - Knox, Janet

AU - Dyda, Amalie

AU - Law, Matthew

AU - Wand, Handan

AU - Donovan, Basil

AU - Fairley, Christopher

AU - Skov, Steven

AU - Ah Chee, Donna

AU - Boffa, John

AU - Glance, David

AU - McDermott, Robyn

AU - Maher, Lisa

AU - Kaldor, John

PY - 2013/9/9

Y1 - 2013/9/9

N2 - Background: Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population. Methods/design: STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia. Discussion: STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates.

AB - Background: Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population. Methods/design: STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia. Discussion: STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates.

KW - Aborigine

KW - adolescent

KW - adult

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KW - geographic distribution

KW - gonorrhea

KW - health care delivery

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KW - health care quality

KW - health education

KW - human

KW - major clinical study

KW - male

KW - prevalence

KW - primary health care

KW - randomized controlled trial (topic)

KW - sexually transmitted disease

KW - trichomoniasis

KW - workshop

KW - Adolescent

KW - Adult

KW - Female

KW - Humans

KW - Male

KW - Primary Health Care

KW - Program Evaluation

KW - Research Design

KW - Rural Health

KW - Sexually Transmitted Diseases

KW - Young Adult

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DO - 10.1186/1471-2334-13-425

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JO - BMC Infectious Diseases

JF - BMC Infectious Diseases

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