Article Text

  1. K. Tebb1,
  2. J. Williams1,
  3. C. Wibbelsman2,
  4. A. Tipton3,
  5. M. Pai-Dhungat1,
  6. M. Shafer1
  1. 1University of California San Francisco, Division of Adolescent Medicine, San Francisco, CA
  2. 2Kaiser Permanente, San Francisco, CA
  3. 3Kaiser Permanente, Oakland, CA


Purpose Despite recommendations for annual screening of Chlamydia trachomatis (CT), the most commonly reported STI among adolescents, health care providers are falling short of meeting this goal. Since nearly two-thirds of teens who make contact with the health care system do so with an urgent care visit, the purpose of this study was to survey providers regarding their perceived barriers to screening adolescents for Chlamydia during urgent care visits.

Methods As part of a larger randomized control study to increase CT screening in 14-18 year olds, pediatric providers at 5 intervention clinics were given an anonymous survey to assess barriers to screening adolescents. Surveys were hand delivered to providers with a self-addressed envelope. Providers were asked to rate the frequency of 7 common barriers using a 4-point Likert scale where 1 = very rarely to 4 = very frequently.

Results 82 pediatric providers from 5 clinics completed the self-report questionnaire (95% response rate). The top 4 barriers included urine specimens not already obtained and in the room (mean 2.0), difficulty asking parents to leave the room (2.0), teen not able to urinate (1.9), and physician visit time constraints (1.7).

Conclusions Barriers to screening need to be identified and addressed at both the provider and the health care system levels before universal CT screening can be accomplished. Although some of the barriers may be difficult to overcome, there was no barrier that was ranked more than 2 on a scale of 1-4. Furthermore, there is a common misconception that lack of time is the most significant barrier to screening in urgent care. This study shows that providers ranked several other barriers higher than time. Interventions need to address provider and system-level barriers in order to achieve universal CT screening which includes the urgent care setting.

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