{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T06:07:04Z","timestamp":1757311624207,"version":"3.37.3"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T00:00:00Z","timestamp":1586995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009128","name":"Research for Patient Benefit Programme","doi-asserted-by":"publisher","award":["PB-PG-1014-35007"],"award-info":[{"award-number":["PB-PG-1014-35007"]}],"id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Community-based screening may be one solution to increase testing and treatment of sexually transmitted infections in sexually active teenagers, but there are few data on the practicalities and cost of running such a service. We estimate the cost of running a \u2018Test n Treat\u2019 service providing rapid chlamydia (CT) and gonorrhoea (NG) testing and same day on-site CT treatment in technical colleges.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Process data from a 2016\/17 cluster randomised feasibility trial were used to estimate total costs and service uptake. Pathway mapping was used to model different uptake scenarios. Participants, from six London colleges, provided self-taken genitourinary samples in the nearest toilet. Included in the study were 509 sexually active students (mean 85\/college): median age 17.9\u2009years, 49% male, 50% black ethnicity, with a baseline CT and NG prevalence of 6 and 0.5%, respectively. All participants received information about CT and NG infections at recruitment. When the Test n Treat team visited, participants were texted\/emailed invitations to attend for confidential testing. Three colleges were randomly allocated the intervention, to host (non-incentivised) Test n Treat one and four months after baseline. All six colleges hosted follow-up Test n Treat seven months after baseline when students received a \u00a310 incentive (to participate).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The mean non-incentivised daily uptake per college was 5 students (range 1 to 17), which cost \u00a3237 (range \u00a31082 to \u00a388) per student screened, and \u00a34657 (range \u00a321,281 to \u00a31723) per CT infection detected, or \u00a313,970 (range \u00a363,842 to \u00a35169) per NG infection detected.<\/jats:p>\n<jats:p>The mean incentivised daily uptake was 19 students which cost \u00a391 per student screened, and \u00a31408\/CT infection or \u00a37042\/NG infection detected.<\/jats:p>\n<jats:p>If daily capacity for screening were achieved (49 students\/day), costs including incentives would be \u00a347 per person screened and \u00a3925\/CT infection or \u00a32774\/NG infection detected.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Delivering non-incentivised Test n Treat in technical colleges is more expensive per person screened than CT and NG screening in clinics. Targeting areas with high infection rates, combined with high, incentivised uptake could make costs comparable.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Trial registration<\/jats:title>\n<jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1186\/ISRCTN58038795\">ISRCTN58038795<\/jats:ext-link>, Assigned August 2016, registered prospectively.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12913-020-5062-5","type":"journal-article","created":{"date-parts":[[2020,4,16]],"date-time":"2020-04-16T10:02:49Z","timestamp":1587031369000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Near patient chlamydia and gonorrhoea screening and treatment in further education\/technical colleges: a cost analysis of the \u2018Test n Treat\u2019 feasibility trial"],"prefix":"10.1186","volume":"20","author":[{"given":"Sarah","family":"Kerry-Barnard","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2854-7441","authenticated-orcid":false,"given":"Susie","family":"Huntington","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Fleming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Reid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Tariq","family":"Sadiq","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vari M.","family":"Drennan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Adams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pippa","family":"Oakeshott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,4,16]]},"reference":[{"key":"5062_CR1","unstructured":"Public Health England. Infection Report - Sexually Transmitted Infections and Chlamydia Screening in England, 2015. 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Point-of-care management of urogenital chlamydia trachomatis via gram-stained smear analysis in male high-risk patients. Diagnostic accuracy and cost-effectiveness before and after changing the screening indication at the STI Clinic in Amsterdam. Sex Transm Infect. 2015;91(7):479\u201384.","journal-title":"Sex Transm Infect"},{"key":"5062_CR8","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1186\/1471-2334-13-485","volume":"13","author":"RJ Guy","year":"2013","unstructured":"Guy RJ, Natoli L, Ward J, Causer L, Hengel B, Whiley D, et al. A randomised trial of point-of-care tests for chlamydia and gonorrhoea infections in remote aboriginal communities: test, treat ANd GO- the \u2018TTANGO\u2019 trial protocol. 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Students provided written informed consent.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"N\/A","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors have completed the Unified Competing Interest Form. PO is a member of the NIHR South London Collaboration for Leadership in Applied Health Research and a member of the esti2 consortium funded under the UKCRC Translational Infection Research Initiative supported by the Medical Research Council (Grant Number G0901608) with contributions from the Biotechnology and Biological Sciences Research Council, the National Institute for Health Research. EA and SH are employed by Aquarius Population Health that receives grants and other funding to work on projects relating to STIs from Cepheid, Binx Health, and St George\u2019s, University of London. STS directs The Applied Diagnostic Research and Evaluation Unit, which has conducted diagnostic evaluations for rapid STI tests for a number of companies including Cepheid, Binx Health, Alere, TwistDx and SpeedDx.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"316"}}