Evidence map›Paper›PMID 34686552›Full record

ArticleBMJ open2021

What can be learnt from a qualitative evaluation of implementing a rapid sexual health testing, diagnosis and treatment service?

Ava Lorenc, Emer Brangan, Joanna M Kesten, Paddy J Horner, Michael Clarke, Megan Crofts, Jonathan Steer, Jonathan Turner, Peter Muir, Jeremy Horwood

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 3 countries.

Ava LorencPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0003-1132-4601
Emer BranganDepartment of Nursing and Midwifery, University of the West of England, Bristol, UK.ORCID 0000-0002-1288-0960
Joanna M KestenPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID 0000-0002-3674-6045
Paddy J HornerNIHR Health Protection Research Unit in Behavioural Science and Evaluation, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Michael ClarkeUnity Sexual Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Megan CroftsUnity Sexual Health, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Jonathan SteerSouth West Regional Laboratory, National Infection Service, Public Health England, Bristol, UK.
Jonathan TurnerSouth West Regional Laboratory, National Infection Service, Public Health England, Bristol, UK.
Peter MuirSouth West Regional Laboratory, National Infection Service, Public Health England, Bristol, UK.
Jeremy HorwoodPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK j.horwood@bristol.ac.uk.
National Institute for Health Research · GBPublic Health England · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity of the West of England · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo investigate experiences of implementing a new rapid sexual health testing, diagnosis and treatment service.

designA theory-based qualitative evaluation with a focused ethnographic approach using non-participant observations and interviews with patient and clinic staff. Normalisation process theory was used to structure interview questions and thematic analysis.

settingA sexual health centre in Bristol, UK.

participants26 patients and 21 staff involved in the rapid sexually transmitted infection (STI) service were interviewed. Purposive sampling was aimed for a range of views and experiences and sociodemographics and STI results for patients, job grades and roles for staff. 40 hours of observations were conducted.

resultsImplementation of the new service required co-ordinated changes in practice across multiple staff teams. Patients also needed to make changes to how they accessed the service. Multiple small 'pilots' of process changes were necessary to find workable options. For example, the service was introduced in phases beginning with male patients. This responsive operating mode created challenges for delivering comprehensive training and communication in advance to all staff. However, staff worked together to adjust and improve the new service, and morale was buoyed through observing positive impacts on patient care. Patients valued faster results and avoiding unnecessary treatment. Patients reported that they were willing to drop-off self-samples and return for a follow-up appointment, enabling infection-specific treatment in accordance with test results, thus improving antimicrobial stewardship.

conclusionsThe new service was acceptable to staff and patients. Implementation of service changes to improve access and delivery of care in the context of stretched resources can pose challenges for staff at all levels. Early evaluation of pilots of process changes played an important role in the success of the service by rapidly feeding back issues for adjustment. Visibility to staff of positive impacts on patient care is important in maintaining morale.

Indexed as

Sexual HealthSexually Transmitted DiseasesAppointments and SchedulesHumansMaleQualitative ResearchSexual Behaviorchange managementCOVID-19organisational developmentqualitative researchsexual medicine

Identifiers

PMID34686552
PMCPMC8543645
OpenAlexW3204458039

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.