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Young people's preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management: a discrete choice experiment in England.

Eaton, S; Biggerstaff, D; Petrou, S; Osipenko, L; Gibbs, J; Estcourt, CS; Sadiq, T; Szczepura, A (2019) Young people's preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management: a discrete choice experiment in England. BMJ Open, 9 (1). e023663. ISSN 2044-6055 https://doi.org/10.1136/bmjopen-2018-023663
SGUL Authors: Sadiq, Syed Tariq

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Abstract

OBJECTIVE: To undertake a comprehensive assessment of the strength of preferences among young people for attributes of emerging technologies for testing and treatment of asymptomatic chlamydia. DESIGN: Discrete choice experiment (DCE) with sequential mixed methods design. A staged approach to selection of attributes/levels included two literature reviews, focus groups with young people aged 16-24 years (n=21), experts' review (n=13) and narrative synthesis. Cognitive testing was undertaken to pilot and adapt the initial questionnaire. Online national panel was used for final DCE survey to maximise generalisability. Analysis of questionnaire responses used multinomial logit models and included validity checks. SETTING: England. PARTICIPANTS: 1230 young people aged 16-24 from a national online panel (completion rate 73%). OUTCOME MEASURES: ORs for service attributes in relation to reference levels. RESULTS: The strongest attribute influencing preferences was chlamydia test accuracy (OR 3.24, 95% CI 3.13 to 3.36), followed by time to result (OR 1.81, 95% CI 1.71 to 1.91). Respondents showed a preference for remote chlamydia testing options (self-testing, self-sampling and postal testing) over attendance at a testing location. For accessing treatment following a positive test result, there was a general preference for online (OR 1.21, 95% CI 1.15 to 1.28) versus traditional general practitioner (OR 1.18, 95% CI 1.12 to 1.24) or pharmacy (OR 1.15, 95% CI 1.10 to 1.22) over clinic services. For accessing a healthcare professional and receipt of antibiotics, there was little difference in preferences between options. CONCLUSIONS: Both test accuracy and very short intervals between testing and results were important factors for young people when deciding whether to undergo a routine test for asymptomatic chlamydia, with test accuracy being more important. These findings should assist technology developers, policymakers, commissioners and service providers to optimise technology adoption in service redesign, although use of an online panel may limit generalisability of findings to other populations.

Item Type: Article
Additional Information: © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Keywords: Chlamydia trachomatis, digital health, discrete choice experiment, online clinical care pathway, patient preferences, sexually transmitted infections
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: BMJ Open
ISSN: 2044-6055
Language: eng
Dates:
DateEvent
29 January 2019Published
5 November 2018Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
UNSPECIFIEDWellcome Trusthttp://dx.doi.org/10.13039/100004440
G0501681Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
G0700452Medical Research Councilhttp://dx.doi.org/10.13039/501100000265
UNSPECIFIEDBiotechnology and Biological Sciences Research Councilhttp://dx.doi.org/10.13039/501100000268
UNSPECIFIEDChief Scientist Officehttp://dx.doi.org/10.13039/501100000589
UNSPECIFIEDDepartment of Healthhttp://dx.doi.org/10.13039/501100000276
PubMed ID: 30700477
Web of Science ID: WOS:000471116800123
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/111155
Publisher's version: https://doi.org/10.1136/bmjopen-2018-023663

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