Background The 24 Sexual Health Clinics (SHCs) at the municipal public health centres covering The Netherlands provide sexual health care for key-populations and provide about 150.000 consultations annually. Adolescents 12–25 years can anonymously contact the SHCs free-of-charge for personal consultations on sexual health subjects including STI-testing. However financial restrictions result in prolonged waiting times. Moreover, specific high-incidence populations (e.g. multicultural, low SES) are insufficiently reached. The SHCs and the national sexual health institutes developed and implemented eHealth interventions to increase the accessibility and efficiency of sexual health services and to stimulate self-care.
Approach A stepped care model (SCM) approach was used to reshape Dutch public sexual health care for young people (www.sense.info). Important principle is that clients do not receive more care than is necessary. Not all clients need the same type – or level – of care: some may be helped by a online self-assessment tool in combination with a home STI testing package, others need (immediate) support by a health professional.
Outcomes/Impact The SCM approach leads to a re-organization of public sexual health care in the Netherlands for young people. The steps in the cascade refer to different types of consultations: on- and off-line, including, video-consultations and referral to (commercial) self-testing. The SCM increased the accessibility of the health system by allocating the scarce capacity of medical professionals to those who really need it and stimulated eHealth support and self-care by others.
Innovation and Significance The SCM approach proves to decrease fragmentation of sexual youth services and eHealth solutions by offering one nationwide online sexual health platform. This increases the findability of the information, and greatly enhances efficiency. It promotes self-care and relieves the workload of public health care professionals. This systematic, efficient and blended approach provides a sound basis for cooperation between SHCs and national institutes and enables developing a strategical agenda for innovations and eHealth solutions.
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