A web-based personally controlled health management system increases sexually transmitted infection screening rates in young people: a randomized controlled trial

Nathan J Mortimer; Joel Rhee; Rebecca Guy; Andrew Hayen; Annie Y S Lau

doi:10.1093/jamia/ocu052

A web-based personally controlled health management system increases sexually transmitted infection screening rates in young people: a randomized controlled trial

J Am Med Inform Assoc. 2015 Jul;22(4):805-14. doi: 10.1093/jamia/ocu052. Epub 2015 Mar 15.

Authors

Nathan J Mortimer¹, Joel Rhee², Rebecca Guy³, Andrew Hayen⁴, Annie Y S Lau⁵

Affiliations

¹ Centre for Health Informatics, Australian Institute of Health Innovation, University of New South Wales, Sydney, Australia.
² School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia University Health Service, University of New South Wales, Sydney, Australia.
³ The Kirby Institute, University of New South Wales, Sydney, Australia.
⁴ School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
⁵ Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney, Australia annie.lau@mq.edu.au.

PMID: 25773130
DOI: 10.1093/jamia/ocu052

Abstract

Objective: To determine if a web-based personally controlled health management system (PCHMS) could increase the uptake of sexually transmitted infections (STI) screening among a young university population.

Methods: A non-blinded parallel-group randomized controlled trial was conducted. Participants aged 18-29 years were recruited from a university environment between April and August 2013, and randomized 1:1 to either the intervention group (immediate online PCHMS access) or control group (no PCHMS access). The study outcome was self-reported STI testing, measured by an online follow-up survey in October 2013.

Results: Of the 369 participants allocated to the PCHMS, 150 completed the follow-up survey, and of the 378 in the control group, 225 completed the follow-up survey. The proportion of the PCHMS group who underwent an STI test during the study period was 15.3% (23/150) compared with 7.6% (17/225) in the control group (P = .017). The difference in STI testing rates within the subgroup of sexually active participants (20.4% (23/113) of the PCHMS group compared with 9.6% (15/157) of the control group) was significantly higher (P = .027) than among non-sexually active participants.

Discussion: Access to the PCHMS was associated with a significant increase in participants undergoing STI testing. This is also the first study to demonstrate efficacy of a PCHMS targeting a health concern where susceptibility is generally perceived as low and the majority of infections are asymptomatic.

Conclusion: PCHMS interventions may provide an effective means of increasing the demand for STI testing which, combined with increased opportunistic testing by clinicians, could reduce the high and sustained rates of STIs in young people.

Keywords: eHealth; personally controlled health management system; screening; sexually transmitted infection; young adult.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Chlamydia Infections / diagnosis*
Female
Health Records, Personal*
Humans
Internet*
Logistic Models
Male
Mass Screening / statistics & numerical data*
New South Wales
Patient Acceptance of Health Care / statistics & numerical data*
Sexually Transmitted Diseases / diagnosis*
Young Adult