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

James Ward, Skye McGregor, Rebecca J. Guy, Alice R. Rumbold, Linda Garton, Bronwyn J. Silver, Debbie Taylor-Thomson, Belinda Hengel, Janet Knox, Amalie Dyda, Matthew G. Law, Handan Wand, Basil Donovan, Christopher K. Fairley, Steven Skov, Donna Ah Chee, John Boffa, David Glance, Robyn McDermott, Lisa Maher & 1 others John M. Kaldor

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

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.

LanguageEnglish
Article number425
JournalBMC Infectious Diseases
Volume13
Issue number1
DOIs
Publication statusPublished - 1 Sep 2013

Keywords

  • Aboriginal
  • Chlamydia
  • Continuous quality improvement
  • Gonorrhoea
  • Indigenous
  • Prevalence
  • Protocol
  • Remote
  • Sexually transmitted infections
  • Trichomonas

ASJC Scopus subject areas

  • Infectious Diseases

Cite this

Ward, James ; McGregor, Skye ; Guy, Rebecca J. ; Rumbold, Alice R. ; Garton, Linda ; Silver, Bronwyn J. ; Taylor-Thomson, Debbie ; Hengel, Belinda ; Knox, Janet ; Dyda, Amalie ; Law, Matthew G. ; Wand, Handan ; Donovan, Basil ; Fairley, Christopher K. ; Skov, Steven ; Ah Chee, Donna ; Boffa, John ; Glance, David ; McDermott, Robyn ; Maher, Lisa ; Kaldor, John M. / 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. In: BMC Infectious Diseases. 2013 ; Vol. 13, No. 1.
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abstract = "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.",
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author = "James Ward and Skye McGregor and Guy, {Rebecca J.} and Rumbold, {Alice R.} and Linda Garton and Silver, {Bronwyn J.} and Debbie Taylor-Thomson and Belinda Hengel and Janet Knox and Amalie Dyda and Law, {Matthew G.} and Handan Wand and Basil Donovan and Fairley, {Christopher K.} and Steven Skov and {Ah Chee}, Donna and John Boffa and David Glance and Robyn McDermott and Lisa Maher and Kaldor, {John M.}",
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Ward, J, McGregor, S, Guy, RJ, Rumbold, AR, Garton, L, Silver, BJ, Taylor-Thomson, D, Hengel, B, Knox, J, Dyda, A, Law, MG, Wand, H, Donovan, B, Fairley, CK, Skov, S, Ah Chee, D, Boffa, J, Glance, D, McDermott, R, Maher, L & Kaldor, JM 2013, '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, vol. 13, no. 1, 425. https://doi.org/10.1186/1471-2334-13-425

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. / Ward, James; McGregor, Skye; Guy, Rebecca J.; Rumbold, Alice R.; Garton, Linda; Silver, Bronwyn J.; Taylor-Thomson, Debbie; Hengel, Belinda; Knox, Janet; Dyda, Amalie; Law, Matthew G.; Wand, Handan; Donovan, Basil; Fairley, Christopher K.; Skov, Steven; Ah Chee, Donna; Boffa, John; Glance, David; McDermott, Robyn; Maher, Lisa; Kaldor, John M.

In: BMC Infectious Diseases, Vol. 13, No. 1, 425, 01.09.2013.

Research output: Contribution to journalArticle

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T2 - BMC Infectious Diseases

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AU - McGregor, Skye

AU - Guy, Rebecca J.

AU - Rumbold, Alice R.

AU - Garton, Linda

AU - Silver, Bronwyn J.

AU - Taylor-Thomson, Debbie

AU - Hengel, Belinda

AU - Knox, Janet

AU - Dyda, Amalie

AU - Law, Matthew G.

AU - Wand, Handan

AU - Donovan, Basil

AU - Fairley, Christopher K.

AU - Skov, Steven

AU - Ah Chee, Donna

AU - Boffa, John

AU - Glance, David

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AU - Maher, Lisa

AU - Kaldor, John M.

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N2 - 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.

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KW - Indigenous

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KW - Protocol

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KW - Sexually transmitted infections

KW - Trichomonas

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