General practice chlamydia testing: a qualitative study of staff approaches using behavioural change theory

Area of Science:

• Public Health
• Sexual Health
• General Practice Research

Background:

• Chlamydia is the most common bacterial STI in England.
• Opportunistic chlamydia testing rates in general practice are low, particularly among young people.
• Existing efforts to increase testing have yielded limited success, necessitating further investigation.

Purpose of the Study:

• To explore general practice staff perceptions of opportunistic chlamydia testing.
• Identify barriers, facilitators, interventions, and policies influencing testing rates.
• Utilize the Behaviour Change Wheel (BCW) framework for analysis.

Main Methods:

• Qualitative study involving general practice staff in England.
• Conducted 23 semi-structured individual interviews and 7 focus groups.
• Employed inductive thematic analysis and categorized findings using the BCW.

Main Results:

• Barriers identified include low perceived knowledge, contextual factors, cultural norms, prioritization issues, and patient reaction concerns.
• Proposed interventions encompass education, persuasion, incentives, training, and environmental restructuring.
• Policy suggestions include enhanced communication campaigns and flexible service provision.

Conclusions:

• This study highlights significant barriers to chlamydia testing within English general practices.
• Identified barriers and proposed interventions offer insights for improving testing rates.
• Findings can inform the development of multi-component strategies to reduce chlamydia-related harm.