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

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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.

Original languageEnglish
Article numbere023663
Number of pages10
JournalBMJ Open
Volume9
DOIs
Publication statusPublished - 29 Jan 2019

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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/.

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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)

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