The 130th Annual Meeting of APHA

Abstract #49850

Michelle Larro, MA¹, Rebecca Ledsky, MBA², Matthew Hogben, PhD³, C. Kevin Malotte, DrPH⁴, Susan Middlestadt, PhD², Janet S St. Lawrence, PhD⁵, Glen Olthoff, MHA, MA⁶, Robert H. Settlage, MD, MPH⁷, and Nancy L. VanDevanter, DrPH⁸. (1) Community Health and Social Epidemiology Programs, California State University, Long Beach, 5500 Atherton Street, Suite 400, Long Beach, CA 90815, 5629852178, mlarro@csulb.edu, (2) Center for Applied Behavioral and Evaluation Research, Academy for Educational Development, 1825 Connecticut Avenue, NW, Suite 800, Washington, DC 20009, (3) Behavioral Intervention and Research Branch, DSTDP, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-44, Altanta, GA 30333, (4) Health Science Department, California State University, Long Beach, 5500 Atherton Street, Suite 400, Long Beach, CA 90815, (5) Behavioral Interventions Research Branch, Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop E-44, Atlanta, GA 30333, (6) STD, Baltimore City Health Department, 5408 Silver Hill Rd, Suite 4100, Forestville, MD 20747, (7) Department of Health Services, Los Angeles County, PO Box 9, Los Angeles, CA 90815, (8) Center for Applied Public Health, Mailman School of Public Health, Columbia University, 722 W. 168 St, New York, NY 10032

Background: Persons infected with gonorrhea (GC) or chlamydia (CT) are at high risk for reinfection. Urine tests allow easy re-testing. Well-planned, brief counseling interventions have a positive behavioral impact on STD risk reduction and addictive behaviors. Monetary incentives have also been shown to increase return rates. Methods: Participants (n=420) treated for GC and/or CT at one of two public STD clinics (Prince George’s County, MD, Los Angeles County, CA) were randomly assigned to one of three interventions designed to encourage return for re-testing at three months. These were 1) brief recommendation to return (n=141), 2) intervention 1 plus $20 incentive paid at return visit (n=144), or 3) intervention 1 plus motivational interview at first visit and phone reminder at 3 months (n=135). Regardless of 3 month return, extensive efforts were made to encourage all participants to return for re-testing at 4 ˝ months. Results: Return rates at 3 months were 11.4%, 13.2%, and 23.9%, respectively. After controlling for demographics and clinic site using multivariate logistic regression, the odds ratios for interventions 2 and 3, respectively, compared to intervention 1 were 1.14 (95% CI 0.6-2.4) and 2.67 (95% CI 1.4-5.2). In LA, at 4 ˝ months, 12% of clients who returned for retesting (n=93) were reinfected. Conclusions: Contrary to expectations, a monetary incentive did not increase return rates compared to a brief recommendation. A motivational interview and phone call reminder did increase return. Further study is ongoing to investigate the separate effects of the interview and the reminder.

Learning Objectives:

At the conclusion of the session, participants will be able to
• describe three different approaches to encouraging return for STD re-testing, and
• be able to identify the most effective method found in this study.

Keywords: Health Behavior, STD Prevention

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.