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Case Study: Behaviour Change Interventions

Chlamydia Screening for Under-25s in Devon

What was the Behaviour/Issue to Address:

• High rates of Chlamydia amongst young people.
• Low take up of Chlamydia screening and treatment.
• Gain better understanding of how Chlamydia services need to be developed to meet local need.
• Identify mechanisms to encourage young people to take up screening opportunities.

The Audience:

Sexually-active young people, aged 16-25, living in Devon. Specific focus was placed upon targeting young men from DE socio-economic groups in work or training.

Assumptions:

• Young people choose not to access Chlamydia screening due to a lack of understanding of the infection and its symptoms and consequences.
• Young people have a lack of understanding of the process involved in taking a Chlamydia test, and so attach negative preconceptions to it.
• Young people fear their parent/guardian will find out if they have Chlamydia and so choose not to take a test.
• Young people will only access screening services if they are available locally.
• Young people don’t want to discuss Sexually Transmitted Infections (STIs) or Chlamydia openly.

Audience Insight Revealed:

Quantitative data was collected through postal and online questionnaires returned by 671 respondents (40% male, 60% female, 60% 16-19). Qualitative data was gathered through six focus group consultations with members of the target group (totaling 64 individuals), as well as interviews with a sample of eleven service delivery agents from sexual health clinics and youth services.

Key findings included:

• 92% were aware of the term ‘Chlamydia’, but lower awareness of symptoms and treatment.
• Local GPs and sexual health and contraceptive clinics are preferred sources of information and screening. Pharmacies are less popular.
• Leaflets are the preferred format for information on Chlamydia and sexual health, closely followed by websites.
• Young people want to talk about sexual health with ‘experts’ and discuss their views.
• Low awareness of notification options for obtaining results.
• Face-to-face at the GP surgery or clinic is the preferred method of receiving results (42% overall, 50% male), usually at the same location as the test was taken. This enables the service delivery agent to explain the result and treatment if a result is positive.
• Letter (26%), text (21%) and email (10%) are also accepted options for receiving results, with a preference shown for email, as this requires a password to access.
• Low awareness of how Chlamydia is transmitted and the frequent absence of any symptoms.
• Partial awareness of long-term consequences of having Chlamydia, but only in terms of reduced fertility.
• Some awareness of the importance of testing and for treatment upon detection.
• High awareness of protection against sexually transmitted infections through correct condom-use.

Understanding the Situation:

• Although there is some understanding of what Chlamydia means, knowledge of the common lack of symptoms and consequences of not treating it is less prevalent.
• Awareness of the options for receiving test results needs be increased, to reinforce the message that testing is simple, straightforward and can fit in with a young person’s lifestyle.

Consumer Behaviour Drivers:

• Stigma attributed to taking a test.
• Preference for not knowing own Chlamydia status, being unaware of infection removes the need to worry about it.
• Carrying condoms or having screening leads to negative labeling.

Barriers to Change:

• Perceptions of others.
• Accessibility and availability of testing.

Campaign/Intervention Objectives:

• Raise self-esteem and encourage informed decision-making.
• Raise awareness of the long-term consequences of Chlamydia.
• Address myths surrounding testing methods.
• Boost knowledge of testing locations, particularly Pharmacies
• Increase number of young people, particularly young men to have screening.

Behaviour Change Objectives:

• Increase take-up of Chlamydia screening and treatment.
• Encourage condom-use to protect against sexually transmitted infections.
• Create a new social norm - remove the stigma and embarrassment factor from seeking a Chlamydia test and carrying condoms.

Campaign Core Products:

• Recognisable, young-person-friendly brand to ‘badge’ the Chlamydia screening programme as part of a wider sexual health service.
• Dedicated website for the campaign.
• Branded, consistent collateral to generate awareness of the Chlamydia screening programme and testing locations, including posters and leaflets.
• Wider availability of home testing kits to pharmacies, clinics etc.

Benefits:

• Co-ordinated information that young people recognise as part of sexual health services.
• Information and branding that appeals to young people and encourages them to visit screening locations and sexual health services in general.
• Less embarrassment associated with the issue, due to increased promotion in public locations.
• Accessible information in a format young people are receptive to.

Results:

The insight stage of the campaign has now been completed, with pre-testing work currently in progress.

Evaluation:

Data from service delivery agents will be collated on numbers of young people accessing screening and treatment and reviewed.

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