Routine screening is essential to diagnosing chlamydia because if left untreated it can lead to pelvic inflammatory disease (PID), which could possibly lead to infertility. The American Congress of Obstetricians and Gynecologists (ACOG) recommends all sexually active adolescents and women aged 25 years or younger be screened for chlamydia annually. Despite recommendations from health care and government organizations to routinely screen for chlamydia of sexually active women aged 25 years and younger, chlamydia screening rates are suboptimal across the nation. Community health centers (CHCs) are an ideal setting for improving chlamydia screenings. They already serve as the medical home for a large and growing population of women, many who are uninsured and underserved minorities. This demographic of women are disproportionately affected by chlamydial infection and are in the greatest need for screening services. The purpose of this two-phase, sequential mixed methods study was to obtain statistical, quantitative results from a nationally representative sample of CHCs and then follow up with several CHC sites to explain those results more in depth using qualitative data. In the first phase, survey results were examined to address the relationship between barriers and characteristics of CHCs and routine chlamydia screening practice patterns at CHCs across the nation. In the second phase, case study interviews were used to probe the CHCs with various chlamydia screening frequency patterns to explore what the hindering (or facilitating) factors are to providing routine chlamydia screening at CHCs. The research findings inform policymaking on the national and state levels on how to address limitations to providing routine chlamydia screening at CHCs and potentially identify policy and practice recommendations for CHCs that could be shared among CHCs to improve access to chlamydia screenings to women age 25 and younger, which can improve their long-term fertility health.
|Advisor:||Wood, Susan F.|
|Commitee:||Goetz Goldberg, Deborah, Richard, Patrick|
|School:||The George Washington University|
|School Location:||United States -- District of Columbia|
|Source:||DAI-B 74/05(E), Dissertation Abstracts International|
|Subjects:||Womens studies, Public health|
|Keywords:||Chlamydia screening, Chlamydial infections, Community health centers, Fertility health, Mixed methods|
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