The use of focus groups to design an internet-based program for chlamydia screening with self-administered vaginal swabs: what women want
Charlotte A. Gaydos A C , Patricia A. Rizzo-Price A , Mathilda Barnes A , Karen Dwyer B , Billie Jo Wood A and M. Terry Hogan AA Johns Hopkins University, Baltimore, MD, USA.
B Thomas Jefferson University, Philadelphia, PA, USA.
C Corresponding author. Email: cgaydos@jhmi.edu
Sexual Health 3(4) 209-215 https://doi.org/10.1071/SH05059
Submitted: 6 December 2005 Accepted: 17 March 2006 Published: 17 November 2006
Abstract
Objective: To ascertain the opinions, concerns and perceptions of sexually active women to guide the development of an internet-based chlamydia outreach and screening program using self-administered vaginal swabs as a first step to prevention. Methods: Seven focus groups were conducted by trained facilitators. Questions were designed to initially open the discussion and elicit the members’ own perceptions. Secondary, more probing questions were asked later to confirm participants’ responses and elicit truthful answers. The main discussion topics were women’s ideas about internet recruitment for chlamydia screening, preferred genital sample type, self-sampling at home using vaginal swabs and using the mail to return specimens. Participants were 42 women, aged 14–49 years. Structured discussions were facilitated using open-ended questions about access to chlamydia testing via the internet. Data were collected and reviewed for common themes and emphasis. Results: All women actively participated in the discussions, providing valuable information. The concepts of self-sampling and the overall project were viewed positively, along with draft advertisements, questionnaires and self-sampling instructions; some modifications were suggested. Common themes included offering free kits available within their community or by direct mail, as well as pre-addressed, stamped mailers for returning the kit to the laboratory for testing. Commonly perceived obstacles and potential risks included: maintenance of confidentiality; situations of embarrassment; and ensuring simplicity of packaging. Women indicated confidence in their ability to collect vaginal specimens and willingness to call for their test results. Conclusions: Focus-group surveys were a useful tool and provided valuable feedback to inform the design of a specialised website to educate and facilitate access to chlamydia screening through home sampling.
Additional keywords: Chlamydia trachomatis, internet screening.
Acknowledgements
Funding support for this study was from the Baltimore City Health Department, Contract # 28838, who approved the design of the study and approved the manuscript.
[1]
[2] Washington AE, Cates W, Wasserheit J. Preventing pelvic inflammatory disease. JAMA 1991; 266 2574–80.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [accessed 28 July 2005].
[17] Slack WV. A 67-year-old man who emails his physician. JAMA 2004; 292 2255–61.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[18] Blake DR, Kearney MH, Oakes JM, Druker SK, Bibace R. Improving participation in chlamydia screening programs. Arch Pediatr Adolesc Med 2003; 157 523–9.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[19] Millstein SG, Adler NE, Irwin CE. Sources of anxiety about pelvic examinations among adolescent females. J Adolesc Health Care 1984; 5 105–11.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[20] Serlin M., Shafer MA, Tebb K, Gyamfi A-A, Moncada J, Schachter J. What sexually transmitted disease screening method does the adolescent prefer? Adolescents’ attitudes towards first-void urine, self-collected vaginal swab, and pelvic examination. Arch Pediatr Adoesc Med 2002; 155 676–9.
[21] Macleod J, Rowsell R, Horner P, Crowley T, Caul EO, Low N, et al. Postal urine specimens: are they a feasible method for gential chlamydial infection screening? Br J Gen Pract 1999; 49 455–8.
| PubMed |
[22] Ostergaard L, Moller JK, Andersen B, Olesen F. Diagnosis of urogential Chlamydia trachomatis infection in women based on mailed samples obtained at home: multipractice comparative study. BMJ 1996; 313 1186–9.
| PubMed |
[23] Stephenson J, Carder C, Copas A, Robinson A, Ridgway G, Haines A. Home screening for chlamydial gential infection: is it acceptable to young men and women? Sex Transm Infect 2000; 76 25–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[24] Bloomfield PJ, Steiner KC, Klausner JD. Repeat chlamydia screening by mail, San Francisco. Sex Transm Infect 2003; 79 28–30.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[25] Kjaer HO, Dimcevski G, Hoff G, Olsen G, Ostergaard L. Recurrence of urogenital Chlamydia trachomatis infection evaluated by mailed samples obtained at home: 24 weeks’ prospective follow up study. Sex Transm Infect 2000; 76 169–72.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[26] Ellen JM, Lane MA, McCright J. Are adolescents being screened for sexually transmitted diseases? A study of low income African Americans adolescents in San Francisco. Sex Transm Infect 2000; 76 94–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |
[27] ACOG Committee Opinion Sexually transmitted diseases in adolescents. Obstet Gynecol 2004; 104 891–8.
| PubMed |
[28] Freed LH, Ellen JM, Irwin CE, Millstein SG. Determinants of adolescents’ satisfaction with health care providers and intentions to keep follow-up appointments. J Adol Health 1998; 22 475–9.
| Crossref | GoogleScholarGoogle Scholar |
[29] Lane MA, McCright J, Garrett K, Millstein SG, Bolan G, Ellen JM. Features of sexually transmitted diseases services important to African American adolescents. Arch Pediatr Adolesc Med 1999; 153 829–33.
| PubMed |
