A COMPARATIVE STUDY has found that patients with sexual health issues are more likely to complete self-reporting evaluations in a clinic setting than via a smartphone.
Digital self-reporting tools are increasingly used in sexual health clinics to obtain patient views and sensitive information, such as sexual history prior to appointments.
Sexual Health Clinic’s Smartphone Switch
Following this trend, in December 2023, the Melbourne Sexual Health Centre (MSHC) replaced its touchscreen kiosk system with a smartphone-enabled digital front door (DFD) platform for collecting computer-assisted self-interviewing (CASI) information.
The before-and-after study aimed to evaluate how this change at MSHC impacted response completeness.
Routine data were collected from patients aged 16 years of age and over who attended or were due to attend appointments at MSHC during the touchscreen period, January–June 2023. This was compared with the period January–June 2024 (when the switch to the DFD smartphone platform had been made).
The study compared the proportion of CASI questions that received a response against the total number they were expected to complete across the two periods.
Drop in CASI Completeness
Melbourne Sexual Health Centre’s transition from kiosks to smartphones for administering CASI was associated with a modest but consistent decline in data completeness.
Among 56,095 eligible consultations (28,093 via touchscreen kiosk) and 28,002 (via smartphone), the study found the mean questionnaire completeness was significantly lower in the smartphone group (35.6%) compared to the kiosk group (54%).
The number of sexual health clinic patients who did not respond to a single question increased from 45.1% during the kiosk period to 57.4% during the smartphone period.
Smartphone use was also associated with a 17.0 percentage point reduction in completeness (β: -16.96; 95% CI: -17.68 to -16.24) after adjustment for other confounding factors.
Reduced self-reporting completeness was independently associated with older age, indigenous identity, and living with HIV.
First-time sexual health centre attendees demonstrated substantially higher questionnaire completeness, the study found.
Impact of Reduced Self-Reporting
When CASI completeness declines, this can contribute to reduced sexual health clinic efficiency, the study warned, as clinicians would be required to collect missing information during consultations. This could pose challenges in high-demand clinical settings, they suggested.
Further research is needed to assess whether CASI response completeness improves as patients with sexual health issues become more familiar with digital smartphone systems.
Reference: Wijekoon D et al. Evaluating completion rates between kiosk and smartphone computer-assisted self-interviewing at a sexual health clinic in Melbourne: a before-and-after implementation study. Sex Health. 2025:SH25119.
Author
Emily Hayes, Freelance Writer and Editor
