Chlamydia Screening of Adolescent Females: A Survey of Providers in Hawaii

Abstract

Hawaii currently ranks first among states for chlamydia screening of young women based on recent Healthcare Effectiveness Data and Information Set (HEDIS) measures and has consistently ranked in the top ten states in the US for annual reported chlamydia rates since 2002. A statewide provider survey was conducted in October 2007 and March 2008 to assess chlamydia screening practices and beliefs and identify potential barriers to screening. The overall reported screening rate for 15-19 year old females was 66.9% with significant differences by practice specialty (obstetrician/gynecologists were more likely to screen than family practitioners or pediatricians) and practice setting (higher rates of screening in non-private practice settings). Providers who were unaware of health plan reimbursement for screening and those who targeted screening only for clients perceived to be at "high risk" were significantly less likely to routinely provide screening. The Hawaii State Department of Health is currently working in consort with health care providers and the state's dominant health insurance carriers to address these issues through targeted provider educational interventions.

Sexually Transmitted Disease Prevention Policies in the United States

“…[30] An evaluation of the HEDIS chlamydia measure among providers in Hawaii found that a lack of awareness of reimbursement for screening was a barrier to following the recommendation. [31] Finally, it is possible that some policy changes do not have an impact on screening. For instance, changes in insurance coverage for chlamydia screening in two states did not appear to impact screening rates [32]; and, syphilis screening among pregnant women has remained low even in an area of high incidence.…”

Adapting a Sexually Transmitted Infection Prevention Intervention Among Female Adolescents in Hawai‘i

“…These same trends are observed among Hawai‘i youth. Since 2002, Hawai‘i has ranked consistently in the top 10 states in chlamydia rates (McGrath, Katz, Lee, & Rochat, 2011), particularly among those aged 15 to 24 years. In 2004, 63% of reported cases of chlamydia and 50% of gonorrhea cases in Hawai‘i were among people in this age group (Advocates for Youth, 2008).…”