Table 3

Potential implementation strategies: policy categories and illustrative quotations to support intervention functions and overcome barriers to chlamydia testing in general practice

Policy categoriesThemes and subthemesIllustrative quotations
Communication and marketing
Using print, electronic, telephonic, or broadcast media
Circulating information on chlamydiaCommunity advertsQ3.1: ‘Increasing advertising, like at universities and things, increasing awareness of how you can get tested; just go along to your GP and get one.’ (P05, male, 23 years)
TV and radio advertisementsQ3.2: ‘I think TV adverts would actually get people to sign up, because then I think… it would suddenly cross their minds that they might have it… Because I think the main problem is that people don’t think, they just don’t think about it.’ (P18, male, 19 years)
General practice posters and leafletsQ3.3: ‘Put up posters in the place [general practice], give out a leaflet and then they can go and give it to their friends or whatever… Encourage them to get tested; pass it on.’ (P12, male, 23 years)
Social mediaQ3.4: ‘Well, looking at the sort of age range, you’ve obviously got to look at what they’re accessing, so social media.’ (P13, female, 22 years)
Reminder letterQ3.5: ‘Like how they send out letters for smear tests when you’re 25 - if they did something similar when you’re 16 or 17 or whatever, saying that you can at any time go and get a chlamydia test… or a yearly letter to people or a yearly phone call, just reminding people that they can go and get it done, I think that would help a lot.’ (P07, female, 20 years)
Clear instructions for self-sampling kitsQ3.6: ‘I think just make sure the instructions are really clear and provide reassurances, like, it’s really hard to do this wrong, don’t worry, with pictures and stuff… yeah, it’s very important to have clear instructions.’ (P11, female, 21 years)
Service provision
Delivering a service
GP offering testingQ3.7:‘If you were going to see your doctor about something and it was offered to you, I think far more people would be willing to take it. If it was something that someone said that you can also do this and have a test, then people would probably do it. But if it’s somebody going out of their own way to go and get themselves tested, then I think it’s actually just some people are, maybe even me, just lazy!’ (P14, male, 24 years)
Option of alternative staffStaff unknown to patientQ3.8: ‘You know your GP, so to have that embarrassment of going through that stuff with them, it can be a bit uncomfortable sometimes… Whereas if it’s just a nurse who you don’t really know that well or haven’t really met before, it’s kind of easier to deal with.’ (P15, female, 24 years)
Gender of staff (relatability)Q3.9: ‘This is a bit picky, but I will only go and see a female GP for anything I’ve got wrong with me… So maybe get someone like the same sex… or give them the option… because you sort of like think they understand more of what you’re going through, because obviously, you go to a male GP about summat [sic] and you just feel they don’t understand, so you can’t tell them everything.’ (P27, female, 16 years)
Alternative sampling methodsPreference for urine sampleQ3.10: ‘I think maybe if it was a swab test, if it’s just chlamydia, like I might be put off because that’s a bit intrusive as a test, but if you could just do the wee sample then I don’t think it would put me off, no.’ (P06, female, 24 years)
Preference for self swabQ3.11: ‘I think if it’s a swab one, then it’s definitely better to do it yourself. It’s sort of like quite a private thing that you can do yourself, yeah, privacy is important’ (P01, female, 24 years)
Preference for HCP swabQ3.12: ‘I always just want the nurse to do it, to do all the swabs and things just to make sure that it was done right’. (P08, female, 23 years)
Discreet systems in practiceDrop-boxQ3.13: ‘If they had like the tests in the toilets or something, people might just do it whilst they’re there. If there’s like a drop-box and then at least you don’t have to talk to somebody.’ (P06, female, 24 years)
Collection pointQ3.14: ‘Having them available for you to just pick up and take one, and do one whenever you want.’ (P22, male, 18 years)
Postal kitsQ3.15: ‘I actually thought the kits that you can do in the post are really good, if they still offer them, because then you don’t have to go anywhere. I think you could just put them in the letterbox as well, actually. Yes, you’d only have to go to the post office. (slight laugh) Yeah, I think that would be good for people who are too busy.’ (P07, female, 20 years)
Home self-samplingQ3.16: ‘Even those kind of home kits that you can just drop it into your doctor, I think that’s kind of good because people prefer to do it in their own home.’ (P03, female, 22 years) Q3.17: ‘I think it’s a pretty good option to have. I think you’ve got to give people the different options though, cos I personally wouldn’t like to do it that way, I wana get it done there and then. But we’re all different aren’t we.’ (P05, male, 23 years)
Online testing via GP websiteAlternative optionQ3.18: ‘I think the online thing is really good. I think if I was leaving, if I went to the doctor and if was on my way out and they said, ‘You can do this test online,’ that would be a real, like, oh, wow, that’s so good! I just think that’s a really, really good idea.’ (P23, male, 17 years)
Maintain in-person optionsQ3.19: ‘I think there’s something about going and speaking to a person, even if you do the test yourself, like if you have any questions about it, even just stupid questions like how likely am I to have this or when will I get the results back? I just like speaking to someone.’ (P11, female, 21 years)
Young person’s health checkQ3.20: ‘I think if it was generally like a sexual health thing, like when teenagers become sexually active, from like maybe the ages of 16 onwards, it just became a routine thing. You do a health check, check your lung functions, your physical health and then on top of that, as part of the natural process, you ask about kind of sexual health. You know, like an elderly person would get their prostate examined; a younger person could get a sexual health exam as part of it.’ (P16, male, 23 years)
Creating documents that recommend to mandate practice.
Offered in all consultationsOffer during every visitQ3.21: ‘The GP could just ask you every time you went, like, ‘Do you want one?’ you know, so they have a lot of questions, but your GP, you know, if they just said it every time, I’m sure they’d get quite a lot of people to take them regularly, you know, having your GP offering it to you as part of your check-up, that could be quite effective.’ (P17, male, 21 years)
Approach appropriatelyQ3.22: ‘I guess it would depend how they offered it. It might make me feel a bit worried, like they were implying that I had chlamydia.’ (P28, female, 16 years)
Non-judgmental communicationQ3.23: ‘You want someone with zero judgement who will just come and treat it like a normal thing. Otherwise people would be put off from going again if you get someone who makes a comment that you don’t really like.’ (P05, male, 23 years)
Standard questionQ3.24: ‘When you’re with the medical professional, and they propose it as a very commonplace and comfortable thing, and common and easy thing to do… If that [chlamydia test] became just a standard question to ask for a demographic that was particularly at risk, then at least it’s kind of like when you go to the supermarket and they ask if you want a bag, and you spend maybe three seconds thinking yes or no. So normalising it a bit more is very important.’ (P16, male, 23 years)
Do not single people outQ3.25: ‘I’d feel a bit weird if it felt like they were singling me out, but if they just kind of offered it as, hey, we’re just offering this for everyone type thing, I would feel absolutely fine about it.’ (P24, female, 22 years)
Personable, friendly staffQ3.26: ‘I think personally I would prefer someone quite outgoing, talkative, you know, calms you as soon as you step into the room, tell a joke maybe. I think that’s personally the way I would prefer it, rather than going in there and the person be massively serious and barely talk to you. It would definitely be better, and I’d be more likely to go back again if it was like that to be honest.’ (P26, male, 20 years)
  • GP(s), general practitioner(s); P, participant number; Q, Quote number.