(P87) IMPLEMENTATION OF A RAPID DIAGNOSTIC TOOL FOR SEXUALLY TRANSMITTED INFECTIONS IN A PEDIATRIC CARE NETWORK

Background:
Point of care testing (POCT) for sexually transmitted infections can address screening and treatment barriers and reduce loss to follow-up among adolescents. We assessed clinician attitudes regarding acceptability, feasibility, appropriateness, and usability of gonorrhea and chlamydia (GC/CT) POCT in adolescent clinics.

Methods:
This cross-sectional, multi-method implementation study assessed clinician attitudes toward and determinants of GC/CT POCT in four pediatric health system clinics (primary care, adolescent medicine, and adolescent HIV treatment and prevention) implementing POCT. Within six weeks of GC/CT POCT implementation using the Binx io®, clinical staff received survey weblinks containing the Acceptability and Feasibility of Intervention Measures, Intervention Appropriateness Measure, System Usability Scale (SUS), and additional open-ended questions assessing attitudes toward GC/CT POCT. A subsample completed semi-structured interviews exploring facilitators and barriers. We calculated median and interquartile range (IQR) scores for scaled items, with a threshold usability SUS score of 68. Two independent reviewers deductively coded interviews using the Consolidated Framework for Implementation Research (CFIR), categorizing responses within CFIR domains and identifying emerging themes.

Results:
The survey sample (n=33) consisted of physicians and nurse practitioners (70%), nurses (15%), medical assistants (6%), and other staff (9%); of which 71% had utilized GC/CT POCT. The median acceptability, feasibility, and appropriateness scores were 5 (IQR 4-5), 4 (IQR 3-5), and 5 (IQR 4-5), respectively. The median SUS score was 65 (IQR 57.5-75). In qualitative analysis (n=20), POCT implementation facilitators included ease of test administration and same-day test results, allowing for rapid directed care. Barriers included limited device availability and test duration (32 minutes), introducing workflow challenges.

Conclusion:
While we found high acceptability and appropriateness of GC/CT POCT, feasibility was variable, and usability scores were below accepted thresholds. Clinical staff identified workflow changes as modifiable factors to improve implementation. POCT can be beneficial in adolescent-serving clinics; however, workflow challenges should be addressed to improve intervention uptake.