Implementation of a Learning Collaborative Model Increases Chlamydia Screening at 37 Family Planning Clinics: Lessons Learned From 3 Cohorts.

Abstract

Chlamydia is the most commonly reported notifiable condition in the United States. Chlamydia disproportionately impacts young women and women of color. Annual screening of sexually active women 24 years and younger is recommended. Between 2016 and 2019, we facilitated 3 learning collaboratives to increase chlamydia screening at a combined 37 family planning clinics funded by the Planned Parenthood Federation of America, the Office of Population Affairs in the Department of Health and Human Services, and the New York State Department of Health. We applied a consistent learning collaborative approach across the 3 cohorts. Participating clinics sought to improve the proportion of clients screened for chlamydia each month, implemented a standard set of recommended practices, attended virtual learning sessions, reported updates on quality improvement efforts and chlamydia screening data monthly, and provided qualitative feedback in an online final assessment. Median screening rates increased by 11%, 22%, and 24% in the 3 collaboratives (P values of <0.01, 0.05, and 0.02, respectively). Increases were sustained after the collaboratives ended though the changes did not reach statistical significance. At least 75% of clinics increased screening rates in each collaborative. Clinics reported that adopting normalizing and opt-out language when counseling clients about screening was both feasible and effective, as was reducing missed opportunities for screening. Learning collaboratives consistently resulted in improvement across 3 cohorts and shed light on barriers and facilitators to screening in family planning settings. Public health practitioners are encouraged to draw on our results and lessons learned to promote screening.