None listed
Conditions
Brief summary
STRIVE – Sexually Transmitted infections in Remote communities: ImproVed and enhanced primary health care services is a new trial which aims to reduce levels of STIs in 21 or more participating ‘trial clusters’ over a five year period. STRIVE is 5 year project in partnership between the National Centre in HIV Epidemiology and Clinical Research, the Menzies School of Health Research and government and community organisations in NT, WA and QLD. Funding for the trial was awarded by the National Health and Medical Research Council (NHMRC Project Grant, Application ID: 568806, 2009-2013). Proposed clusters of communities will be located in the NT, WA and QLD. STRIVE will test whether the development and then implementation of a Sexual Health Quality Improvement Program tailored for primary health care centres will improve STI service delivery and assist these services on reaching best practice in STI control. STRIVE will also provide incentive payments for achieving aspects of best practice in STI care.
Interventions
The intervention, called the Sexual Health Quality Improvement Program will involve the following components:
1. Development of an action plan including goals and strategies to improve clinical service delivery for diagnosis and management of bacterial STIs to reach best practice targets. STRIVE Coordinators will meet with participating primary health services annually for a day to undertake a site assessment, develop an Action Plan tailored to the individual service and discuss goals and str
The intervention, called the Sexual Health Quality Improvement Program will involve the following components: 1. Development of an action plan including goals and strategies to improve clinical service delivery for diagnosis and management of bacterial STIs to reach best practice targets. STRIVE Coordinators will meet with participating primary health services annually for a day to undertake a site assessment, develop an Action Plan tailored to the individual service and discuss goals and strategies for the Action Plan. 2. Six-monthly collaborative feedback meetings to discuss progress on the Action Plan. STRIVE Coordinators will meet with health service management to discuss the Action Plan and progress towards the goals and strategies developed. 3. Quantitative data reports will be provided to health services every 6 months showing progress towards best practice targets. 4. Training - STRIVE coordinators will provide staff with training in quality improvement and basic research skills and encourage further training in sexual health. Training requirements will be discussed at the collaborative feedback meetings. 5. Incentives payments based on progress towards the best practice targets. Opportunities exist for each health service to receive a total incentive payment of between $10,000 and $30,000 per year. Incentives will be calculated from the quantitative reports and will be paid 6 monthly. Best practice episodes and targets: Best practice episodes - 1. Offer STI screening to sexually active 14 - 34 year olds 2. Treat quickly a) Symptomatic STI infections - treat immediately b) Asymptomatic STI infections - treat within 7 days of the positive result being received from the laboratory 3. Test for re-infection at 3 months. For people with STI infection, follow up and test at 3 months after treatment 4. Contact referral. For people with STI infection, test and treat their partner/s Best practice targets - 1. 80% of the resident population aged 16 - 34 tested annually 2. 95% of syndromically diagnosed infections treated immediately 3. 80% of asymptomatic STI infections - treated within 7 days of the positive result being recieved from the laboratory 4. 80% of STI infections - re-tested within 3 months of treatment 5. 50% of STI infections - the named sexual partner/s is documented to be treated within 14 days The trial is cluster-randomised. The duration of the intervention will depend on when the cluster, in which the health service falls, is randomised. For clusters that are randomised in year 1, the intervention will continue for three years. For clusters randomised in year 2, the intervention will continue for 2 years. For clusters randomised in year 3, the intervention will continue for 1 year.
Sponsors
The University of New South Wales
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
16 Years to 34 Years
Healthy volunteers
Yes
Inclusion criteria
Communities that meet the following criteria: - Considered remote by the Australian Bureau of Statistics (ABS) - With a resident population of at least 100 Aboriginal and/or Torres Strait Islander people aged 16 - 34 years - Community and health services willing and able to provide access to de-identified clinical data - Health services able to sustain data collection, consistent with trial protocol
Exclusion criteria
Communities where there is a diverse range of health services that are accessed by Aboriginal and/or Torres Strait Islanders within the same location
Outcome results
None listed