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

Sue Eaton; Deborah Biggerstaff; Stavros Petrou; Leeza Osipenko; Jo Gibbs; Claudia S Estcourt; Tariq Sadiq; Ala Szczepura

doi:10.1136/bmjopen-2018-023663

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

Sue Eaton, Deborah Biggerstaff , Stavros Petrou, Leeza Osipenko, Jo Gibbs, Claudia S Estcourt, Tariq Sadiq, Ala Szczepura

Coventry University

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

23 Downloads (Pure)

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.

Original language	English
Article number	e023663
Number of pages	10
Journal	BMJ Open
Volume	9
DOIs	https://doi.org/10.1136/bmjopen-2018-023663
Publication status	Published - 29 Jan 2019

Bibliographical note

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/.

Copyright © and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.

Keywords

Sexually transmitted infections
Chlamydia trachomatis
Patient preferences
Discrete choice experiment
Online clinical care pathway
Digital health

ASJC Scopus subject areas

Economics, Econometrics and Finance(all)
Immunology and Microbiology(all)
Medicine(all)
Social Sciences(all)

Access to Document

10.1136/bmjopen-2018-023663Licence: CC BY

PublishedFinal published version, 0.99 MBLicence: CC BY

Cite this

Young people’s preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management : a discrete choice experiment in England. / Eaton, Sue; Biggerstaff , Deborah; Petrou, Stavros; Osipenko, Leeza; Gibbs, Jo; Estcourt, Claudia S; Sadiq, Tariq; Szczepura, Ala.

In: BMJ Open, Vol. 9, e023663, 29.01.2019.

Research output: Contribution to journal › Article › peer-review

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title = "Young people{\textquoteright}s preferences for the use of emerging technologies for asymptomatic regular chlamydia testing and management: a discrete choice experiment in England",

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.",

keywords = "Sexually transmitted infections, Chlamydia trachomatis, Patient preferences, Discrete choice experiment, Online clinical care pathway, Digital health",

author = "Sue Eaton and Deborah Biggerstaff and Stavros Petrou and Leeza Osipenko and Jo Gibbs and Estcourt, {Claudia S} and Tariq Sadiq and Ala Szczepura",

note = "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/. Copyright {\textcopyright} and Moral Rights are retained by the author(s) and/ or other copyright owners. A copy can be downloaded for personal non-commercial research or study, without prior permission or charge. This item cannot be reproduced or quoted extensively from without first obtaining permission in writing from the copyright holder(s). The content must not be changed in any way or sold commercially in any format or medium without the formal permission of the copyright holders.",

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AU - Osipenko, Leeza

AU - Gibbs, Jo

AU - Estcourt, Claudia S

AU - Sadiq, Tariq

AU - Szczepura, Ala

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N2 - 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.

AB - 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.

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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

Abstract

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Ala Szczepura

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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

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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Ala Szczepura

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