Background:
National guidelines recommend annually chlamydia screening for women age <=5 years. However, reports of screening coverage suggest that most young women are not being screened and quality improvement interventions are needed.

Objective:
To evaluate a targeted provider intervention strategy to improve chlamydia screening rates among family planning providers.

Method:
Paid claims data from laboratories and clinician providers serving female clients in the Family PACT (Planning, Access, Care, Treatment) program were used to calculate the provider-specific proportion of female clients age 15-25 years served in FY01/02 that were screened for chlamydia. Letters with specific provider screening results and targeted messages based on low (<50%), medium (50-79%), and high (>80%) screening rates were mailed in September 2003 to providers who served >=100 female clients in this age group. Screening rate increases were compared between the month of mailing and 4 months post-mailing by initial screening performance category.

Result:
Females age 15-25 years (n=567,284) were screened for chlamydia by 394 low screeners, 416 medium screeners, and 56 high screeners. 65% of low screeners had at least a 5% increase in screening over baseline as compared with 37% of medium screeners and 9% of high screeners. Median % relative increase over baseline screening was 22% for low screeners as compared with 2% for medium screeners and
-7% for high screeners. Private sector low screeners had a significantly higher mean screening rate (61%) than public sector low screeners (55%) at 4 months post-mailing (p=0.01).


Conclusion:
Mailed targeted provider feedback regarding chlamydia screening significantly improved screening rates among the lowest performing providers.

Implications:
Regularly mailed data and screening messages in the form of provider profiles may be effective for improving performance among providers with low chlamydia screening rates.