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General practice / Family practice
Research
Qualitative interviews with healthcare staff in four European countries to inform adaptation of an intervention to increase chlamydia testing
  1. Cliodna McNulty1,
  2. Ellie J Ricketts2,
  3. Hans Fredlund3,
  4. Anneli Uusküla4,
  5. Katy Town5,
  6. Claire Rugman1,
  7. Anna Tisler-Sala4,
  8. Alix Mani6,
  9. Brigitte Dunais6,
  10. Kate Folkard5,
  11. Rosalie Allison1,
  12. Pia Touboul7
  1. 1 Department of Microbiology, Public Health, Primary Care Unit, Gloucestershire Royal Hospital, Derriford Hospital, Plymouth, UK
  2. 2 Derriford Hospital, Plymouth, UK
  3. 3 Department of Laboratory Medicine, County Medical Officer, Orebro University, Orebro, Sweden
  4. 4 Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
  5. 5 Department of HIV and STI, Centre for Infectious Disease Control and Surveillance, Public Health England, London, UK
  6. 6 Departement of de Sante Publique, Nice University Hospital, Nice, France
  7. 7 Department of General Practice, Nice Sophia Antipolis University, Nice, France
  1. Correspondence to Dr Cliodna McNulty; cliodna.mcnulty{at}phe.gov.uk

Abstract

Objective To determine the needs of primary healthcare general practice (GP) staff, stakeholders and trainers to inform the adaptation of a locally successful complex intervention (Chlamydia Intervention Randomised Trial (CIRT)) aimed at increasing chlamydia testing within primary healthcare within South West England to three EU countries (Estonia, France and Sweden) and throughout England.

Design Qualitative interviews.

Setting European primary healthcare in England, France, Sweden and Estonia with a range of chlamydia screening provision in 2013.

Participants 45 GP staff, 13 trainers and 18 stakeholders.

Interviews The iterative interview schedule explored participants’ personal attitudes, subjective norms and perceived behavioural controls around provision of chlamydia testing, sexual health services and training in general practice. Researchers used a common thematic analysis.

Results Findings were similar across all countries. Most participants agreed that chlamydia testing and sexual health services should be offered in general practice. There was no culture of GP staff routinely offering opportunistic chlamydia testing or sexual health advice, and due to other priorities, participants reported this would be challenging. All participants indicated that the CIRT workshop covering chlamydia testing and sexual health would be useful if practice based, included all practice staff and action planning, and was adequately resourced. Participants suggested minor adaptations to CIRT to suit their country’s health services.

Conclusions A common complex intervention can be adapted for use across Europe, despite varied sexual health provision. The intervention (ChlamydiA Testing Training in Europe (CATTE)) should comprise: a staff workshop covering sexual health and chlamydia testing rates and procedures, action planning and patient materials and staff reminders via computer prompts, emails or newsletters, with testing feedback through practice champions. CATTE materials are available at: www.STItraining.eu.

  • training
  • educational intervention
  • qualitative research
  • primary care
  • sexual health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2017-017528

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    Footnotes

    • Contributors CM and EJR had been involved in the CIRT project. CM and EJR wrote the grant application and designed the study/project and wrote the draft interview schedules and protocols for discussion. HF, CR, KT, AU, AT-S, AM, KF, BD and PT discussed and agreed the protocols and interview schedule, were involved in adapting interview schedules, conducting and analysing of interviews and meetings in their countries and commented on the paper. In England, EJR and KT (both female) conducted the interviews, AM (female) conducted the interviews in France, HF (male) conducted the interviews in Sweden and AU (female) conducted the interviews in Estonia. RA was involved in analysing the English interview transcripts. All authors contributed to the resource adaptation process. CM and EJR wrote the manuscript with contributions from all authors. All authors have reviewed and approved the final manuscript.

    • Funding This study was supported by a Leonardo Da Vinci Lifelong Learning programme project Chlamydia Testing Training in Europe (number2012-1-GB2-LEO05.08044) and Public Health England.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval In England, local research and development approvals were obtained for the qualitative interviews from NHS Islington (Ref- CSP120435), Warwickshire Primary Care Trust (Ref- WAR201212), Dorset CCG (Ref- 13/EM/0018). No approvals were needed in the other three countries. All participants gave informed consent for interviews to be recorded, transcribed and for anonymised quotes to be used in publications.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The anonymised datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.