P92 Successful Promotion of Vaginal Swab Specimen Use for Chlamydia Trachomatis (CT) and Neisseria Gonorrhoeae (NG) Testing in the Region X Infertility Prevention Project (IPP)

Wednesday, March 14, 2012
Hyatt Exhibit Hall
Sherrell Holtshouser, RN, MPH1, Ella Gordon, FNP2, Rebekah Morisse, BSN, RN3, Chris Knutson, MN, ARNP4, Carol Elliott, RN, BSN5, Sarah Goldenkranz, MPH6 and Wendy Nakatsukasa-Ono, MPH6, 1Division of Public Health, State of Alaska/DHSS/DPH/WCFH, Anchorage, AK, 2Bureau of Clinical and Preventive Services, Family Planning, STD and HIV Programs; Division of Health, Boise, ID, 3Municipality of Anchorage Health Department, Municipality of Anchorage Reproductive Health Clinic, Anchorage, AK, 4Office of Infectious Disease and Reproductive Health, Washington State Department of Health, Olympia, WA, 5Public Health Division, Oregon Health Authority, Portland, OR, 6Cardea, Seattle, WA

Background: Vaginal specimens are deemed the specimen of choice by CDC when testing for CT and NG because of their higher sensitivity and excellent acceptability to patients. The Region X IPP Clinical Services Subcommittee (CSS) has been actively promoting use of client and clinician obtained vaginal swabs throughout Washington, Oregon, Idaho and Alaska since 2009.

Objectives: To describe Region X IPP CSS interventions and resources that successfully promoted the use of vaginal swab specimens.

Methods: In 2009, the Region X IPP CSS began developing and implementing interventions and resources to promote the use of vaginal swab specimens at the regional, state and clinic levels.  Interventions and resources used to facilitate clinical systems change include: monitoring data, presenting a regional webinar about the value of vaginal swab specimens, providing a patient instruction sheet and provider toolkit and offering technical assistance—both remotely and on-site.

Results: Client-collected vaginal swab usage rose from <1% of all female specimens during 2007 to 25% of specimens collected between January-June 2011 (ranging from 10% to 35% by state). By June 2011, clinician-collected vaginal swabs increased to 6% of specimens (range: 0.4-13.5%).  Data available for July-December 2011 will be analyzed and incorporated into this presentation.

Conclusions: Region X IPP data demonstrates a substantial increase in use of vaginal swab specimens for CT and NG testing. Efforts to promote use of vaginal swab specimens positively impacted uptake, especially for self-obtained vaginal specimens.

Implications for Programs, Policy, and Research: Region X IPP CSS interventions and resources are useful for increasing vaginal swab specimen use when testing for CT and NG.  All resources, including the Toolkit and client instruction sheet, are publically available and can be tailored to fit the various needs of other regions/states/clinics.