{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T10:37:37Z","timestamp":1770287857371,"version":"3.49.0"},"reference-count":32,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,1]]},"abstract":"\n OBJECTIVE:<\/jats:title>\n The Centers for Disease Control and Prevention recommend testing for Chlamydia trachomatis in sexually active female patients &lt;25 years old using nucleic-acid amplification tests (NAAT) from a vaginal swab. Our providers were typically testing using the less sensitive urine NAATs. We aimed to increase the percentage of urogenital C trachomatis NAATs performed by using vaginal swabs in adolescent female patients ages 10 through 20 years from 1.4% to 25%.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n We implemented 3 interventions at 3 pediatric practices over 12 months including education, process standardization, and cross-training. We used statistical process control to analyze the effect of interventions on our primary outcome: the percentage of urogenital C trachomatis tests performed with a vaginal swab. Our balance measure was the total number of urogenital C trachomatis tests.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n There were 818 urogenital C trachomatis tests performed: 289 before and 529 after the first intervention. Of urogenital C trachomatis tests in the preintervention time period, 1.4% were performed by using vaginal swabs. We surpassed our aim of 25% 6 weeks after the first intervention. We noted sustained improvement after the second intervention, with an average of 68.3% of tests performed by using vaginal swabs for the remaining postintervention period. There was no difference in the overall number of urogenital C trachomatis tests pre- and postintervention.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Using quality improvement methodology and implementing easily replicable interventions, we significantly and sustainably increased use of vaginal swabs. The interventions standardizing processes were associated with a higher impact than the educational intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2019-3028","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T12:25:16Z","timestamp":1594124716000},"source":"Crossref","is-referenced-by-count":1,"title":["Increasing Vaginal Chlamydia Trachomatis<\/i> Testing in Adolescent and Young Adults"],"prefix":"10.1542","volume":"146","author":[{"given":"Kathryn S.","family":"Brigham","sequence":"first","affiliation":[{"name":"MassGeneral Hospital for Children, Boston, Massachusetts; and"},{"name":"Division of Adolescent and Young Adult Medicine and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Peer","sequence":"additional","affiliation":[{"name":"Quality and Safety,"},{"name":"MassGeneral Hospital for Children, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian B.","family":"Ghoshhajra","sequence":"additional","affiliation":[{"name":"Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John Patrick T.","family":"Co","sequence":"additional","affiliation":[{"name":"Quality and Safety,"},{"name":"MassGeneral Hospital for Children, Boston, Massachusetts; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2020,8,1]]},"reference":[{"issue":"RR-03","key":"2021121013115449300_B1","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2015 [published correction appears in MMWR Recomm Rep. 2015;64(33):924]","volume":"64","author":"Centers for Disease Control and Prevention","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021121013115449300_B2","unstructured":"Centers for Disease Control and Prevention\n . 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