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Background: In response to recent increases in reportable STIs in Rhode Island, a novel peer-to-peer public health detailing program was designed to outreach to clinicians about STI prevention interventions and reporting.
Methods: Fifteen obstetric gynecologic (obgyn) practices were selected for detailing because they reported 88%% of chlamydia cases from obgyn practices in 2013. An infectious disease physician and public health nurse interacted with office clinicians for 30-60 minutes, providing standardized messages on screening for STI reinfection, expedited partner therapy, and case reporting. A survey assessing knowledge and intent to change practice was administered, and STI surveillance data for EPT usage and case report form completeness was compared using chi-square, 6 months before and after detailing visits.
Results: Fifteen practices and 52 clinicians were detailed. On a 5-point scale (5 very knowledgeable or very likely) self-evaluating knowledge or likelihood to perform test of reinfection at 3 months, use expedited partner therapy, and report STIs, knowledge improved by 0.56-0.88 of a point, and likelihood of implementation improved 0.35-0.59 of a point, before and after detailing. EPT usage for chlamydia cases was 12.6% and 13.2% before and after detailing (P=0.82); non-detailed practices used EPT on 7.1% and 6.9% of cases over similar time periods (P=0.85). The proportion of chlamydia cases with race/ethnicity reported (proxy for case report form completeness) was 64.0% and 64.2% before and after detailing (P=0.96); non-detailed practices were 58.0% and 57.5% complete (P=0.85).
Conclusions: Public health detailing is feasible, and detailed clinicians self-report gains in knowledge and intent to change practice for STI prevention interventions and reporting. However, increases in EPT usage or reporting were not found after detailing. Detailed practices appeared more likely to use EPT or complete case report forms even prior to detailing, indicating detailed practices are more familiar with both EPT and case reporting at baseline.