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A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback

BACKGROUND: The incidence of sexually transmitted infections (STIs) is increasing in the United States. The COVID-19 pandemic resulted in significant reductions in access to health care services, including STI testing and treatment, leading to underreporting of STI cases and a need for alternatives...

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Autores principales: Edwards, Abagail, Nuño, Aries, Kemp, Christopher, Tillett, Emily, Armington, Gretchen, Fink, Rachel, Hamill, Matthew M, Manabe, Yukari C
Formato: Online Artículo Texto
Lenguaje:English
Publicado: JMIR Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520762/
https://www.ncbi.nlm.nih.gov/pubmed/37695644
http://dx.doi.org/10.2196/48670
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author Edwards, Abagail
Nuño, Aries
Kemp, Christopher
Tillett, Emily
Armington, Gretchen
Fink, Rachel
Hamill, Matthew M
Manabe, Yukari C
author_facet Edwards, Abagail
Nuño, Aries
Kemp, Christopher
Tillett, Emily
Armington, Gretchen
Fink, Rachel
Hamill, Matthew M
Manabe, Yukari C
author_sort Edwards, Abagail
collection PubMed
description BACKGROUND: The incidence of sexually transmitted infections (STIs) is increasing in the United States. The COVID-19 pandemic resulted in significant reductions in access to health care services, including STI testing and treatment, leading to underreporting of STI cases and a need for alternatives to clinic-based testing. Moreover, concerns around confidentiality, accessibility, and stigma continue to limit access to clinic-based STI testing, particularly for high-priority populations. IWantTheKit (IWTK) is a web-based platform that mails free, confidential, self-administered sample collection kits for testing for gonorrhea, chlamydia (both genital and extragenital sites), and vaginal trichomonas. Individuals visiting the IWTK website may select genital, pharyngeal, and rectal samples for chlamydia and gonorrhea testing. Vaginal samples are tested for trichomoniasis. Self-collected samples are processed in a College of American Pathologists–accredited laboratory, and results are posted to an individual’s secure digital account. OBJECTIVE: This study aimed to (1) describe users’ experience with the IWTK service through analysis of routine data and (2) optimize retention among current users and expand reach among high-priority populations by responding to user needs through programmatic and functional changes to the IWTK service. METHODS: Free-text entries were submitted by IWTK users via a confidential “Contact Us” page on the IWTK website from May 17, 2021, to January 31, 2022. All entries were deidentified prior to analysis. Two independent analysts coded these entries using a predefined codebook developed inductively for thematic analysis. RESULTS: A total of 254 free-text entries were analyzed after removing duplicates and nonsensical entries. Themes emerged regarding the functionality of the website and personal experiences using IWTK’s services. Users’ submissions included requests related to order status, address changes, replacement of old kits, clinical information (eg, treatment options and symptom reports), and reported risk behaviors. CONCLUSIONS: This analysis demonstrates how routine data can be used to propose potential programmatic improvements. IWTK implemented innovations on the website based on the study results to improve users’ experience, including a tracking system for orders, address verification for each order, a physical drop box, additional textual information, direct linkage to care navigation, and printable results. Web-based, mail-order STI testing programs can leverage user feedback to optimize implementation and retention among current users and potentially expand reach among high-priority populations. This analysis is supported by other data that demonstrate how comprehensive support and follow-up care for individuals testing positive are critical components of any self-testing service. Additional formal assessments of the IWTK user experience and efforts to optimize posttesting linkage to care may be needed.
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spelling pubmed-105207622023-09-27 A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback Edwards, Abagail Nuño, Aries Kemp, Christopher Tillett, Emily Armington, Gretchen Fink, Rachel Hamill, Matthew M Manabe, Yukari C JMIR Form Res Short Paper BACKGROUND: The incidence of sexually transmitted infections (STIs) is increasing in the United States. The COVID-19 pandemic resulted in significant reductions in access to health care services, including STI testing and treatment, leading to underreporting of STI cases and a need for alternatives to clinic-based testing. Moreover, concerns around confidentiality, accessibility, and stigma continue to limit access to clinic-based STI testing, particularly for high-priority populations. IWantTheKit (IWTK) is a web-based platform that mails free, confidential, self-administered sample collection kits for testing for gonorrhea, chlamydia (both genital and extragenital sites), and vaginal trichomonas. Individuals visiting the IWTK website may select genital, pharyngeal, and rectal samples for chlamydia and gonorrhea testing. Vaginal samples are tested for trichomoniasis. Self-collected samples are processed in a College of American Pathologists–accredited laboratory, and results are posted to an individual’s secure digital account. OBJECTIVE: This study aimed to (1) describe users’ experience with the IWTK service through analysis of routine data and (2) optimize retention among current users and expand reach among high-priority populations by responding to user needs through programmatic and functional changes to the IWTK service. METHODS: Free-text entries were submitted by IWTK users via a confidential “Contact Us” page on the IWTK website from May 17, 2021, to January 31, 2022. All entries were deidentified prior to analysis. Two independent analysts coded these entries using a predefined codebook developed inductively for thematic analysis. RESULTS: A total of 254 free-text entries were analyzed after removing duplicates and nonsensical entries. Themes emerged regarding the functionality of the website and personal experiences using IWTK’s services. Users’ submissions included requests related to order status, address changes, replacement of old kits, clinical information (eg, treatment options and symptom reports), and reported risk behaviors. CONCLUSIONS: This analysis demonstrates how routine data can be used to propose potential programmatic improvements. IWTK implemented innovations on the website based on the study results to improve users’ experience, including a tracking system for orders, address verification for each order, a physical drop box, additional textual information, direct linkage to care navigation, and printable results. Web-based, mail-order STI testing programs can leverage user feedback to optimize implementation and retention among current users and potentially expand reach among high-priority populations. This analysis is supported by other data that demonstrate how comprehensive support and follow-up care for individuals testing positive are critical components of any self-testing service. Additional formal assessments of the IWTK user experience and efforts to optimize posttesting linkage to care may be needed. JMIR Publications 2023-09-11 /pmc/articles/PMC10520762/ /pubmed/37695644 http://dx.doi.org/10.2196/48670 Text en ©Abagail Edwards, Aries Nuño, Christopher Kemp, Emily Tillett, Gretchen Armington, Rachel Fink, Matthew M Hamill, Yukari C Manabe. Originally published in JMIR Formative Research (https://formative.jmir.org), 11.09.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included.
spellingShingle Short Paper
Edwards, Abagail
Nuño, Aries
Kemp, Christopher
Tillett, Emily
Armington, Gretchen
Fink, Rachel
Hamill, Matthew M
Manabe, Yukari C
A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback
title A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback
title_full A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback
title_fullStr A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback
title_full_unstemmed A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback
title_short A Web-Based, Mail-Order Sexually Transmitted Infection Testing Program: Qualitative Analysis of User Feedback
title_sort web-based, mail-order sexually transmitted infection testing program: qualitative analysis of user feedback
topic Short Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520762/
https://www.ncbi.nlm.nih.gov/pubmed/37695644
http://dx.doi.org/10.2196/48670
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