Developed by North East Lincolnshire Care Trust Plus and NHS North Lincolnshire, the Chlamydia Outreach Advice Screening and Treatment (COAST) program offered free Chlamydia screening and treatment to sexually active Northern Lincolnshire residents aged 15-24. To kickoff program development, a COAST steering group was established and conducted research on barriers and motivators for their target audience, consulted with local health and wellbeing service providers to learn how to best engage with young people, and reviewed existing data on Chlamydia screening programs. Focus groups and one-on-one interviews were also conducted to help the team understand young people’s attitudes towards Chlamydia screening and get their thoughts on the most effective outreach strategies. COAST launched in 2007 and was guided by a program coordinator, three health advisors, and three administrator support positions. Stakeholders including screening sites and service providers that joined the program were viewed as a secondary target audience and were offered benefits to encourage continued participation. To make the screening process as simple as possible for healthcare professionals, COAST provided all of the necessary tools in a “clinic in a bag” package and used an existing electronic patient record system so general physicians could access all necessary patient information for free. To make the screening process easy and convenient for young people, COAST developed DIY testing kits that could be picked up from locations like youth centers and college campuses or requested online via COAST’s webpage. This allowed individuals to obtain a testing kit complete with a pictoral step-by-step guide and complete the Chlamydia test on their own, sending it and a completed lab form back via an anonymous pre-paid envelope. Results were then communicated electronically or via postal mail to individuals and those who tested positive were asked to contact COAST to receive free treatment. Nurses were then responsible for contacting the patients’ previous sexual partners, encouraging them to get tested as well. Outreach activities and tutorials were delivered at local colleges to raise awareness of the COAST program, and a local design company created COAST logos and images which were voted on by youth. Branded materials including posters, leaflets, and beermats were then distributed at locations frequently visited by the primary target audience. Targeted campaigns like “Get your tackle tested” and “Pee 4 Pants”, as well as competitions like “Wee for a Wii” were used to encourage Chlamydia testing among young people. Several methods were used to evaluate the COAST program. Screening data collected on a quarterly basis was compared to annual targets, user surveys were conducted to gather information on topics such as awareness of STIs and treatment preferences, and an audit tool was created to benchmark COAST’s work against other local screening programs. In year three of the program, North East Lincolnshire screened 26.4% (exceeding the 2010 target of 25%) and North Lincolnshire screened 20.4%.
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