ATSIHP-STRIVE



STRIVE: STI in Remote communities: ImproVed & Enhanced primary health care
A randomised community trial of STI quality improvement in 65 remote communities

Funding: National Health and Medical Research Council
Years: 2009-2013
Principal investigators: Kaldor J, Ward J, Rumbold A, Guy R, Law M, Donovan B, Maher L, McDermott R, Fairley C.
Chief of Operations: James Ward
National Study Coordinator: Linda Garton

L-R: Alice Rumbold, Rebecca Guy, Skye McGregor, Debbie Taylor, James Ward, Bronwyn Silver, John Kaldor
STRIVE is a randomised community trial to control sexually transmitted infections in remote Aboriginal communities in northern and central Australia.
Objectives of STRIVE
Primary:
(1) To determine whether targeted clinical review and support provided to health services can achieve substantive and sustained improvements in the provision of sexual health clinical services in remote Aboriginal communities.
(2) To determine whether the attainment of best practice levels in clinical activity can reduce the prevalence of STIs in these communities.
Secondary:
(1) To measure the impact of the STRIVE trial on health service staff.
(2) To measure other non-STRIVE activities which may influence sexual health service delivery

Study Design:
STRIVE is a randomised community trial with an intervention of a sexual health quality improvement program. The trial is being conducted in 65 remote communities comprised of 23 clusters of communities in northern and central Australia. The Sexual health Quality Improvement program comprises five main elements:
(i) quality improvement and trial coordinators based in each region
(ii) development of a set of agreed best practice targets in STI control such as coverage, interval time to treatment, retests for cure of infection, and contact tracing with clinic staff
(iii) modifications to patient information management systems
(iv) incentive payments to health services for reaching best practice targets and
(v) health promotion initiatives.
STRIVE will use a stepped wedge approach design meaning that over the next three years eight clusters of communities will be randomly assigned to receive the intervention. Currently the STRIVE team are collecting baseline prevalence data for chlamydia, gonorrhoea and trichomonas from each of the 65 clinics.
Collaborating institutions on STRIVE

• • National Centre in HIV Epidemiology and Clinical Research
• Menzies School of Health Research
• Northern Territory Department of Health and Families
• Aboriginal Medical Services Alliance of the Northern Territory
• University of Adelaide
• Central Australian Aboriginal Congress
• University of Melbourne
• Apunipima Cape York Health Council
• Kimberley Aboriginal Medical Services Council
• Western Australia Country Health Service

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