Adolescent Chlamydia Screening in Pediatric Primary Care: A Quality Improvement Project

Aim: To increase Chlamydia trachomatis screening in adolescents 15-19 years of age from 7.8% to 15% following a 6-week implementation of universal chlamydia screening at three paediatric primary care (PPC) sites.

Methods: Pre-implementation (1 January 2022-19 October 2022) and post-implementation (20 October 2022-1 June 2023) screening rates were tracked through run charts and compared via Chi-square testing. Universal opt-out chlamydia screening with universal urine collection for 15- to 19-year-old was implemented at well visits, along with patient and staff education, and sexually transmitted infection treatment protocols.

Results: Chlamydia trachomatis screening increased from 7.8% to 34.1% with implementation of universal opt-out chlamydia screening. Proportions of patients screened increased significantly among White individuals, males and privately insured individuals.

Conclusions: A universal C. trachomatis screening project can be feasibly implemented in pediatric primary care and successfully increase adolescent chlamydia screening rates.

Implications for the profession: Implementing a universal opt-out C. trachomatis screening project is feasible in PPC and can help achieve the public health goal of chlamydia identification and treatment.

Impact: These findings will be impactful for both paediatric primary care and adolescent patients. The universal, opt-out C. trachomatis screening approach facilitated screening increases, improved equity in screening and led to increased case detection and treatment which has vast significance for those patients.

Reporting method: This manuscript is submitted using the SQUIRE 2.0 guidelines for quality improvement reporting.

Patient contribution: Patient contribution included de-identified data collection of chlamydia screening rates of eligible adolescents 15-19 years old who attended routine well visits at the three PPC locations. The data were reviewed on a dashboard, then stratified by race, ethnicity, payor and sex assigned at birth.