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    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

    Access Status
    Open access via publisher
    Authors
    Ward, J.
    McGregor, S.
    Guy, R.
    Rumbold, A.
    Garton, L.
    Silver, B.
    Taylor-Thomson, D.
    Hengel, B.
    Knox, J.
    Dyda, A.
    Law, M.
    Wand, H.
    Donovan, B.
    Fairley, C.
    Skov, S.
    Ah Chee, D.
    Boffa, John
    Glance, D.
    McDermott, R.
    Maher, L.
    Kaldor, J.
    Date
    2013
    Type
    Journal Article
    
    Metadata
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    Citation
    Ward, J. and McGregor, S. and Guy, R. and Rumbold, A. and Garton, L. and Silver, B. and Taylor-Thomson, D. et al. 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. 13 (1).
    Source Title
    BMC Infectious Diseases
    DOI
    10.1186/1471-2334-13-425
    School
    National Drug Research Institute (NDRI)
    URI
    http://hdl.handle.net/20.500.11937/33911
    Collection
    • Curtin Research Publications
    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. © 2013 Ward et al.; licensee BioMed Central Ltd.

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