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Background:Genital chlamydial infections are the most prevalent reportable sexually transmitted disease nationally and in Hawaii. Adolescents appear to be at highest risk. The Centers for Disease Control and Prevention and US Preventive Services Task Force recommend annual screening for women aged 25 years and younger.
Objectives:To survey primary care physicians in Hawaii caring for females 15-19 years of age in order to assess chlamydia screening practices and beliefs, and identify potential barriers to screening.
Methods:A two-page survey was e-mailed or faxed from the Hawaii State Department of Health to all licensed pediatricians, obstetrician/gynecologists, and family practitioners in the state of Hawaii (n = 764) in October 2007 and March 2008.
Results:137 of 603 deliverable surveys were returned (response rate = 22.7%). 81 of 121 eligible respondents (66.9%) reported routinely screening female clients ages 15-19 years for chlamydia. Family practitioners and obstetrician/gynecologists were more likely to report routine screening than pediatricians (p < 0.001). Female providers were more likely to report routine screening than males (p < 0.001). There were no differences in reported screening practices based on provider’s age or number of patients seen per month. Providers who believed screening to be cost effective were more likely to report routine screening (p < 0.001), while providers who admitted screening only adolescents they felt to be at “high risk” were less likely to report routine screening (p < 0.001). A multivariate analysis revealed provider’s gender, specialty, and focus on “high risk” patients to be independently associated with practicing routine screening.
Conclusions:Although Hawaii ranked first nationally for chlamydia screening of young women based on recent HEDIS measures, there is room for improvement. Provider education targeting pediatricians and correcting misconceptions about chlamydia screening are potentially remedial approaches.
Implications for Programs, Policy, and/or Research: Targeted provider education could potentially increase chlamydia screening rates.