STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing ‘usual practice’ STI care to enhanced care in remote primary health care services in Australia

BMC Infectious Diseases

John M Kaldor²  Lisa Maher²  Robyn McDermott⁶  David Glance⁷  John Boffa⁴  Donna Ah Chee⁴  Steven Skov⁹  Christopher K Fairley³  Basil Donovan²  Handan Wand²  Matthew G Law²  Amalie Dyda²  Janet Knox²  Belinda Hengel¹  Debbie Taylor-Thomson⁵  Bronwyn J Silver⁵  Linda Garton⁸  Alice R Rumbold⁵  Rebecca J Guy²  Skye McGregor²  James Ward² 

[1] Apunipima Cape York Health Council, Bungalow, Queensland 4870, Australia;The Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia;School of Population Health, University of Melbourne, Parkville, Victoria, Australia;Central Australian Aboriginal Congress, Alice Springs, Northern Territory 0870, Australia;Epidemiology and Health Systems Division, Menzies School of Health Research, PO Box 41096, Casuarina, NT 0811, Australia;Sansom Institute of Health Service, School of Health Sciences, University of South Australia City East Campus North Terrace, Adelaide, SA 5000, Australia;University of Western Australia, Perth, Western Australia 6009, Australia;Northern Territory Department of Health, 55 North Stuart Highway, Alice Springs 0870, Australia;Centre for Disease Control, Northern Territory Department of Health, Rocklands Drive, Tiwi 0811, Australia

关键词: Remote;    Prevalence;    Protocol;    Continuous quality improvement;    Trichomonas;    Gonorrhoea;    Chlamydia;    Sexually transmitted infections;    Indigenous;    Aboriginal;   

Others  :  1145835
DOI  :  10.1186/1471-2334-13-425

 received in 2013-08-28, accepted in 2013-09-04,  发布年份 2013

【 摘 要 】

Background

Despite two decades of interventions, rates of sexually transmissible infections (STI) in remote Australian Aboriginal communities remain unacceptably high. Routine notifications data from 2011 indicate rates of chlamydia and gonorrhoea among Aboriginal people in remote settings were 8 and 61 times higher respectively than in the non-Indigenous population.

Methods/design

STRIVE is a stepped-wedge cluster randomised trial designed to compare a sexual health quality improvement program (SHQIP) to usual STI clinical care delivered in remote primary health care services. The SHQIP is a multifaceted intervention comprising annual assessments of sexual health service delivery, implementation of a sexual health action plan, six-monthly clinical service activity data reports, regular feedback meetings with a regional coordinator, training and financial incentive payments. The trial clusters comprise either a single community or several communities grouped together based on geographic proximity and cultural ties. The primary outcomes are: prevalence of chlamydia, gonorrhoea and trichomonas in Aboriginal residents aged 16–34 years, and performance in clinical management of STIs based on best practice indicators. STRIVE will be conducted over five years comprising one and a half years of trial initiation and community consultation, three years of trial conditions, and a half year of data analysis. The trial was initiated in 68 remote Aboriginal health services in the Northern Territory, Queensland and Western Australia.

Discussion

STRIVE is the first cluster randomised trial in STI care in remote Aboriginal health services. The trial will provide evidence to inform future culturally appropriate STI clinical care and control strategies in communities with high STI rates.

Trial registration

Australian and New Zealand Clinical Trials Registry ACTRN12610000358044

【 授权许可】

   
2013 Ward et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 1.

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