Dataset Information

Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

ABSTRACT:

Background

A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future.

Methods and findings

We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run.

Conclusions

Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level, the effectiveness of screening on prevalence will remain limited.

SUBMITTER: Schmid BV

PROVIDER: S-EPMC3604006 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

Schmid Boris V BV Over Eelco A B EA van den Broek Ingrid V F IV Op de Coul Eline L M EL van Bergen Jan E A M JE Fennema Johan S A JS Götz Hannelore M HM Hoebe Christian J P A CJ de Wit G Ardine GA van der Sande Marianne A B MA Kretzschmar Mirjam E E ME

PloS one 20130320 3

<h4>Background</h4>A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the ...[more]

PMID: 23527005

Similar Datasets

Project description:BackgroundIn The Netherlands, a national chlamydia screening program started in 2008, but the participation was low and the screening was not cost-effective. This study aimed to explore unconscious and conscious associations with chlamydia screening (16-29 year-olds). In addition, we examined whether information presented in chlamydia screening invitation letters had an effect on the evaluation of these determinants compared to a no-letter group.MethodsAn Internet survey was conducted that included self-report measures of attitude, susceptibility, severity, unrealistic optimism, subjective, moral, and descriptive norm, perceived behavioral control, outcome expectations, barriers, intention, and a response time measure to assess unconscious associations of chlamydia screening with annoyance, threat and reassurance.ResultsOn the unconscious level, participants (N?=?713) who received no information letter associated testing for chlamydia with annoyance and threat, but also with reassurance (all p's?<?.001). On the self-report measures, participants showed a low intention towards chlamydia screening (M?=?1.42, range 1-5). Subjective norm, moral norm, perceived susceptibility and attitude were the most important predictors of the intention to screen (R2?=?.56). Participants who rated their susceptibility as high also reported more risky behaviors (p?<?.001).In the groups that received a letter (N?=?735), a weaker unconscious association of chlamydia screening with annoyance was found compared with the no-letter group (p?<?.001), but no differences were found in reassurance or threat. Furthermore, the letters caused a higher intention (p?<?.001), but intention remained low (M?=?1.74). On a conscious level, giving information caused a more positive attitude, higher susceptibility, a higher subjective and moral norm, and more positive outcome expectations (all p's?<?.001).ConclusionSubjective norm, moral norm, susceptibility, and attitude towards chlamydia might be crucial targets to increase chlamydia screening behavior among sexually active young people. This study shows that informational invitation letters increase the intention and the intention-predicting variables. More evidence is needed on whether screening behavior can be increased by the use of an alternative information letter adapted to the specific unconscious and conscious determinants revealed in this study, or that we need other, more interactive behavior change methods.

Dataset Information

Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

Background

Methods and findings

Conclusions

Publications

Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets