Table 2 Programme differentiation: “key” components identified, without which, the intervention may not have its intended effect
Components of the intervention that were not implemented as intended | Importance of the component | Recommendations for improvements |
|---|---|---|
Whole practice attendance at the educational workshops | If everyone understands what the 3Cs offer is and how it works in their practice, it makes a huge difference in increasing successful outcomes | Make the 3Cs and HIV training mandatory and offer more frequent educational workshops. In the meantime, continue working with the practice manager to find an appropriate time when as many people as possible can attend. |
Age-based prompt as well as addition to templates | A prompt solely on the contraception template will not target young men [4] and therefore a prompt is needed for all patients aged 15–24 years old to ensure that clinicians are reminded to offer the 3Cs to everyone in this age group [33]. | Be more specific in the educational workshop and facilitate by providing a manual on how to add the prompt; or train the trainer on how to add this prompt to the system, and have the trainer set up the prompt at the first educational workshop. |
Complete screening kits in all clinicians’ rooms | Screening kits at the clinician’s fingertips act as a reminder and facilitates ease of testing, which saves time and will facilitate completion of the tests on-site | Be more specific in the educational workshop and ensure a detailed action plan including who makes up kits is completed in the workshop. Liaise with the commissioners to suggest provision of complete kits as this would facilitate chlamydia testing. Encourage all staff to attend the training so that the whole team: is committed; are clear on their roles; and understand the testing process in their practice. |
Reminders and feedback on progress of testing and diagnosis rates | Regular feedback ensures that: 3Cs is not forgotten; staff remain focussed on any targets; and 3Cs are kept as a high priority. | Identify a sexual health champion during the educational workshop ensures that the champion is clear on their role of feeding back and discussing staff’s progress of 3Cs in team meetings. A locally enhanced service (LES) should increase the priority of 3Cs in the CCG and the GP surgery. LES financial incentives, in themselves, may not be a driver, but CCG reminders that coincide may improve chlamydia screening rates [50, 51]. |