Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Public Health

Major Professor

Ellen M. Daley, Ph.D., M.P.H.

Co-Major Professor

Cheryl A. Vamos, Ph.D., M.P.H.

Committee Member

Joseph A. Puccio, M.D.

Committee Member

Kay M. Perrin, Ph.D., M.P.H.

Committee Member

Jason Beckstead, Ph.D.


sexually transmitted infections, sexually transmitted diseases


Background: Young adults are disproportionately burdened by sexually transmitted infections (STIs) such as chlamydia and gonorrhea; however, STI screening rates are low among this population. Given the barriers associated with screening, self-sampling methods used at home may be an innovative solution to improve STI screening rates.

Purpose: The purpose of this study was to explore factors influencing chlamydia and gonorrhea screening among college women. This study had two aims: (1) assess factors associated with STI screening among college women and (2) identify informational needs and key intervention characteristics to inform the development of a patient-centered STI screening intervention.

Methods: Guided by the Diffusion of Innovations (DOI), two secondary data analyses (nation-wide and college-wide) with sexually active college women (age 18-24) were analyzed. Primary data were collected and analyzed from sexually active college women, age 18-24 via an online survey and in-depth interviews. Results from the data sources were triangulated by salient themes and using DOI as a framework.

Results: Rates of screening and preferred information sources differed by race and ethnicity, and relative advantage characteristics were influential in the adoption of self-sampling methods. Individual-level factors, such as Black and Hispanic race and a higher number of partners were associated with an increased probability of STI screening. Preferred sources of information for traditional and innovative methods of STI screening differed by race, ethnicity, relationship status, housing status, and individual innovativeness. Key predictors of willingness to adopt self-sampling methods included relative advantage characteristics and low cost. Most women were not aware of self-sampling methods but felt that this method would be easy to use and was compatible with their needs, comfort level, and privacy concerns.

Conclusions: Results contribute to an understanding of the multi-level influences on traditional and innovative methods of STI screening among this population. The results can inform the development of a future innovative, theory-based, patient-centered intervention that promotes the use of self-sampling methods to improve STI screening rates, and ultimately decrease the burden of STI-related disease.

Included in

Public Health Commons