Feasibility of Conducting a Large, Randomized Controlled Trial for STD Counseling in a Managed Care Setting

Background: Screening for, and prevention of, sexually transmitted diseases requires access to the adolescent, which is often difficult. The primary care visit can offer an opportunity to provide prevention counseling to adolescents. The objective of this study was to determine the feasibility of conducting a large randomized, controlled trial of sexually transmitted diseases counseling intervention in a managed care setting. Methods: A randomized, controlled trial of a counseling intervention was compared with usual care in a managed care organization in a southeastern United States urban area. Members aged 14- to 25-years old who tested positive for gonorrhea or chlamydia during the study period were randomized to receive either a two-part brief counseling intervention or usual care. Results: Among 93 members who tested chlamydia- or gonorrhea-positive and who were eligible to enroll, contact could not be made for 47 members, and only 12 of the remaining members enrolled in the study. Conclusions: It would be problematic to implement a full-scale trial of this intervention in this practice environment without significant changes in clinical and intervention processes. The need for counseling services for sexually transmitted diseases remains great.