CT-SHIFT: De-implementing Chlamydia Testing: Doing Less for Better Health

Implementing or discontinuing healthcare policies requires change at multiple levels, including healthcare professionals, teams, organisations, and the wider healthcare system. Therefore, we study (de-)implementation from a systems perspective, with a focus on social context, environmental influences, and sustainable change.

CT-SHIFT is a study on the de-implementation of routine chlamydia testing among asymptomatic individuals. Since 1 January 2025, Sexual Health Centres (Centra Seksuele Gezondheid, CSG) in the Netherlands have adopted this new policy. CT-SHIFT examines how this policy can be sustainably implemented and what its impact is on healthcare utilisation and health equity.

We investigate:
• How healthcare professionals apply the policy in the short, medium, and long term, and which system-level factors influence implementation;
• Whether vulnerable groups continue to receive the care they need; and
• Which barriers emerge within the system, which persist over time, and how they can be addressed sustainably.

Using surveys, national surveillance data, and in-depth interviews, we evaluate the de-implementation process during the first 18 months after policy introduction. Together with Public Health Services (GGDs), the National Institute for Public Health and the Environment (RIVM), general practitioners, laboratories, and community partners, we translate findings directly into policy and practice. The knowledge generated will not only be relevant for Dutch STI care, but also for international efforts aimed at sustainable de-implementation and effective prevention.

Rearchers: Sarah Dako, Zoie Alexiou, Sanne Gerards, Birgit van Benthem (RIVM) en Nicole Dukers (PI)

Funded by: ZonMW

Start: 2026 (lopend)