{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:44:39Z","timestamp":1762659879346,"version":"build-2065373602"},"reference-count":22,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":2046,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,23]]},"abstract":"<jats:p>Data from 110 primary healthcare clinics participating in two or more continuous quality improvement (CQI) cycles in preventive care, which included syphilis testing performance (STP) for Aboriginal and Torres Strait Islander people aged between 15 and 54 years, were used to examine whether the number of audit cycles including syphilis testing was associated over time with STP improvement at clinic level in this specific measure of public health importance. The number of cycles per clinic ranged from two to nine (mode 3). As shown by medical record audit at entry to CQI, only 42 (38%) clinics had tested or approached 50% or more of their eligible clients for syphilis in the prior 24 months. Using mixed effects logistic regression, it was found that the odds of a clinic\u2019s STP relative to its first cycle increased only modestly. Counterintuitively, clinics undertaking the most preventive health CQI cycles tended to have the lowest STP throughout. Participation in a general preventive care CQI tool was insufficient to achieve and sustain high rates of STP for Aboriginal and Torres Strait Islander people required for public health benefit. Improving STP requires dedicated effort and greater understanding of barriers to effective CQI within and beyond clinic control.<\/jats:p>","DOI":"10.1071\/py19070","type":"journal-article","created":{"date-parts":[[2020,2,2]],"date-time":"2020-02-02T19:17:53Z","timestamp":1580671073000},"page":"178-183","source":"Crossref","is-referenced-by-count":4,"title":["Syphilis testing performance in Aboriginal primary health care: exploring impact of continuous quality improvement over time"],"prefix":"10.1071","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0722-3293","authenticated-orcid":true,"given":"Armita","family":"Adily","sequence":"first","affiliation":[{"name":"AThe Kirby Institute, UNSW Sydney, Wallace Wurth Building, Sydney, NSW 2052, Australia."},{"name":"FCorresponding author. Email: Armita.Adily@unsw.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seham","family":"Girgis","sequence":"additional","affiliation":[{"name":"BS&K Girgis Medical Service, 1\/13\u201315 Kingsway, Cronulla, NSW 2230, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"D\u2019Este","sequence":"additional","affiliation":[{"name":"CNational Centre for Epidemiology and Population Health, The Australian National University, 62 Mills Road, Canberra, ACT 0200, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronica","family":"Matthews","sequence":"additional","affiliation":[{"name":"DUniversity Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW 2480, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanette E.","family":"Ward","sequence":"additional","affiliation":[{"name":"ENulungu Research Institute, University of Notre Dame, 88 Guy Street, Broome, WA 6725, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2020,2,3]]},"reference":[{"key":"2025110222281419500_R1","unstructured":"Australian Health Ministers\u2019 Advisory Council (AHMAC) (2017) Action plan: enhanced response to addressing sexually transmissible infections (and blood borne viruses) in Indigenous populations \u2013 November 2017. 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(Menzies School of Health Research: Darwin, NT, Australia) Available at https:\/\/www.menzies.edu.au\/icms_docs\/253996_Preventive_service_clincial_audit_protocol.pdf [Verified 5 February 2019]"},{"key":"2025110222281419500_R12","unstructured":"Menzies School of Health Research (2014) Sexual health (STI\/BBV) clinical audit tool. (Menzies School of Health Research: Darwin, NT, Australia) Available at https:\/\/www.menzies.edu.au\/icms_docs\/254003_2014_Release_Sexual_health_STI_BBV_clinical_audit_tool.pdf [Verified 5 February 2019]"},{"key":"2025110222281419500_R13","unstructured":"Multijurisdictional Syphilis Outbreak (MJSO) Working Group (2019) Surveillance report: March 2019. (MJSO, Australian Department of Health: Canberra, ACT, Australia) Available at http:\/\/www.health.gov.au\/internet\/main\/publishing.nsf\/Content\/ohp-infectious-syphilis-outbreak.htm [Verified 5 February 2019]"},{"key":"2025110222281419500_R14","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s12879-017-2241-z","article-title":"Wide variation in sexually transmitted infection testing and counselling at Aboriginal primary health care centres in Australia: analysis of longitudinal continuous quality improvement data.","volume":"17","author":"Nattabi","year":"2017","journal-title":"BMC Infectious Diseases"},{"key":"2025110222281419500_R15","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1071\/PY17148","article-title":"Clinic predictors of better syphilis testing in Aboriginal primary health care: a promising opportunity for primary health care service managers.","volume":"24","author":"Nattabi","year":"2018","journal-title":"Australian Journal of Primary Health"},{"issue":"4","key":"2025110222281419500_R16","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1108\/JHOM-02-2018-0056","article-title":"Impacts of continuous quality improvement in Aboriginal and Torres Strait Islander primary health care in Australia: a scoping systematic review.","volume":"32","author":"Sibthorpe","year":"2018","journal-title":"Journal of Health Organization and Management"},{"key":"2025110222281419500_R17","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1186\/1471-2334-13-425","article-title":"STI in remote communities: improved and enhanced primary health care (STRIVE) study protocol: a cluster randomised controlled trial comparing \u2018usual practice\u2019 STI care to enhanced care in remote primary health care services in Australia.","volume":"13","author":"Ward","year":"2013","journal-title":"BMC Infectious Diseases"},{"key":"2025110222281419500_R18","unstructured":"Ward J, Crooks L, Russell D (2016) High level summit on rising HIV, sexually transmissible infections (STI) and viral hepatitis in Aboriginal and Torres Strait Islander communities. 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