Use of GetCheckedOnline, a comprehensive web-based testing service for sexually transmitted and blood-borne infections

Mark Gilbert, Travis Salway, Devon Haag, Christopher K. Fairley, Jason Wong, Troy Grennan, Zhaida Uddin, Christopher S. Buchner, Tom Wong, Mel Krajden, Mark Tyndall, Jean Shoveller, Gina Ogilvie

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). Objective: The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. Methods: We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Results: Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis). Conclusions: Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings.

Original languageEnglish
Article numbere81
JournalJournal of Medical Internet Research
Volume19
Issue number3
DOIs
Publication statusPublished - 1 Mar 2017

Keywords

  • Diagnostic tests
  • Health care delivery
  • Health services research
  • Internet
  • Intervention study
  • Sexually transmitted diseases

Cite this

Gilbert, Mark ; Salway, Travis ; Haag, Devon ; Fairley, Christopher K. ; Wong, Jason ; Grennan, Troy ; Uddin, Zhaida ; Buchner, Christopher S. ; Wong, Tom ; Krajden, Mel ; Tyndall, Mark ; Shoveller, Jean ; Ogilvie, Gina. / Use of GetCheckedOnline, a comprehensive web-based testing service for sexually transmitted and blood-borne infections. In: Journal of Medical Internet Research. 2017 ; Vol. 19, No. 3.
@article{9a0fbb81edd34e1fbc1d61c63d2fe708,
title = "Use of GetCheckedOnline, a comprehensive web-based testing service for sexually transmitted and blood-borne infections",
abstract = "Background: The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). Objective: The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. Methods: We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Results: Of 868 clients creating accounts, 318 (36.6{\%}) submitted specimens, of whom 96 (30.2{\%}) tested more than once and 10 (3.1{\%}) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5{\%}) were MSM, 89 (17.6{\%}) were symptomatic, 47 (9.3{\%}) were STI contacts, 232 (45.8{\%}) reported condomless sex, 146 (28.9{\%}) reported ≥4 partners in the past 3 months, and 76 (15.0{\%}) reported a recent STI. A total of 63 (12.5{\%}) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8{\%}) were by clinic invitations (0 diagnoses), 298 (34.3{\%}) were by deferred testers (6 diagnoses), 194 (22.4{\%}) were by promotional campaign (3 diagnoses), and 39 (4.5{\%}) were by other means (1 diagnosis). Conclusions: Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings.",
keywords = "Diagnostic tests, Health care delivery, Health services research, Internet, Intervention study, Sexually transmitted diseases",
author = "Mark Gilbert and Travis Salway and Devon Haag and Fairley, {Christopher K.} and Jason Wong and Troy Grennan and Zhaida Uddin and Buchner, {Christopher S.} and Tom Wong and Mel Krajden and Mark Tyndall and Jean Shoveller and Gina Ogilvie",
year = "2017",
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Gilbert, M, Salway, T, Haag, D, Fairley, CK, Wong, J, Grennan, T, Uddin, Z, Buchner, CS, Wong, T, Krajden, M, Tyndall, M, Shoveller, J & Ogilvie, G 2017, 'Use of GetCheckedOnline, a comprehensive web-based testing service for sexually transmitted and blood-borne infections' Journal of Medical Internet Research, vol. 19, no. 3, e81. https://doi.org/10.2196/jmir.7097

Use of GetCheckedOnline, a comprehensive web-based testing service for sexually transmitted and blood-borne infections. / Gilbert, Mark; Salway, Travis; Haag, Devon; Fairley, Christopher K.; Wong, Jason; Grennan, Troy; Uddin, Zhaida; Buchner, Christopher S.; Wong, Tom; Krajden, Mel; Tyndall, Mark; Shoveller, Jean; Ogilvie, Gina.

In: Journal of Medical Internet Research, Vol. 19, No. 3, e81, 01.03.2017.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Use of GetCheckedOnline, a comprehensive web-based testing service for sexually transmitted and blood-borne infections

AU - Gilbert, Mark

AU - Salway, Travis

AU - Haag, Devon

AU - Fairley, Christopher K.

AU - Wong, Jason

AU - Grennan, Troy

AU - Uddin, Zhaida

AU - Buchner, Christopher S.

AU - Wong, Tom

AU - Krajden, Mel

AU - Tyndall, Mark

AU - Shoveller, Jean

AU - Ogilvie, Gina

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Y1 - 2017/3/1

N2 - Background: The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). Objective: The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. Methods: We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Results: Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis). Conclusions: Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings.

AB - Background: The British Columbia Centre for Disease Control implemented a comprehensive Web-based testing service GetCheckedOnline (GCO) in September 2014 in Vancouver, Canada. GCO's objectives are to increase testing for sexually transmitted and blood-borne infections (STBBIs), reach high-prevalence populations facing testing barriers, and increase clinical STI service capacity. GCO was promoted through email invitations to provincial STI clinic clients, access codes to clients unable to access immediate clinic-based testing (deferred testers), and a campaign to gay, bisexual, and other men who have sex with men (MSM). Objective: The objective of the study was to report on characteristics of GCO users, use and test outcomes (overall and by promotional strategy) during this pilot phase. Methods: We used GCO program data, website metrics, and provincial STI clinic records to describe temporal trends, progression through the service pathway, and demographic, risk, and testing outcomes for individuals creating GCO accounts during the first 15 months of implementation. Results: Of 868 clients creating accounts, 318 (36.6%) submitted specimens, of whom 96 (30.2%) tested more than once and 10 (3.1%) had a positive STI diagnosis. The proportion of clients submitting specimens increased steadily over the course of the pilot phase following introduction of deferred tester codes. Clients were diverse with respect to age, gender, and ethnicity, although youth and individuals of nonwhite ethnicity were underrepresented. Of the 506 clients completing risk assessments, 215 (42.5%) were MSM, 89 (17.6%) were symptomatic, 47 (9.3%) were STI contacts, 232 (45.8%) reported condomless sex, 146 (28.9%) reported ≥4 partners in the past 3 months, and 76 (15.0%) reported a recent STI. A total of 63 (12.5%) GCO clients were testing for the first time. For 868 accounts created, 337 (38.8%) were by clinic invitations (0 diagnoses), 298 (34.3%) were by deferred testers (6 diagnoses), 194 (22.4%) were by promotional campaign (3 diagnoses), and 39 (4.5%) were by other means (1 diagnosis). Conclusions: Our evaluation suggests that GCO is an acceptable and feasible approach to engage individuals in testing. Use by first-time testers, repeated use, and STI diagnosis of individuals unable to access immediate clinic-based testing suggest GCO may facilitate uptake of STBBI testing and earlier diagnosis. Use by MSM and individuals reporting sexual risk suggests GCO may reach populations with a higher risk of STI. Motivation to test (eg, unable to access clinical services immediately) appears a key factor underlying GCO use. These findings identify areas for refinement of the testing model, further promotion, and future research (including understanding reasons for drop-off through the service pathway and more comprehensive evaluation of effectiveness). Increased uptake and diagnosis corresponding with expansion of the service within British Columbia will permit future evaluation of this service across varying populations and settings.

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KW - Health care delivery

KW - Health services research

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KW - Intervention study

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