Health equity analysis of awareness of GetCheckedOnline in communities outside Vancouver, British Columbia
Bibliographic record
Abstract
Introduction: Digital interventions for sexually transmitted and blood-borne infections (STBBI) testing are one strategy to overcome barriers to accessing provider-based testing. Despite evidence of overall effectiveness, these interventions might replicate existing health inequities. Exploring awareness of services as an implementation outcome can assist in understanding differential uptake by potential users, yet few studies have assessed service awareness. GetCheckedOnline is a digital intervention for STBBI testing in British Columbia (BC), Canada. This study evaluates awareness of GetCheckedOnline in communities where it is available outside Vancouver from a health equity perspective. Methods: From July to September 2022, a survey evaluated awareness, reported use and intention to use GetCheckedOnline in Kamloops, Kimberley, Maple Ridge, Nelson and Greater Victoria, BC, using online and in-person recruitment and oversampling of populations known to face barriers to testing. The implementation outcome of awareness was analyzed through Directed-acyclic graphs (DAG) informed logistic regression modelling to examine differences according to age, gender identity, race/ethnicity, sexual identity, educational attainment, and income. Intersections between gender and race/ethnicity and sexual identity and ethnicity were also studied. Results: The final sample included 1,658 participants, of whom a large proportion comprised members of equity-owed populations. Overall awareness was 36%, with 56% of those aware having used the service (20% of the total sample). A higher likelihood of awareness was found in participants identifying outside the man/woman gender binary, transgender participants, non-heterosexual people, Indigenous individuals and People of Color. A lower likelihood of awareness was found in the lower income group and people aged outside the range of 25 to 29 years. Discussion: This health equity analysis showed that the overall proportion of 1 in 3 people surveyed being aware of the service is not equally distributed in the communities studied. The pattern of awareness distribution in the sample, in some cases, favoured equity-owed groups, while other observed differences favoured more privileged groups. These findings can provide guidance for service promotion, including the identification of populations for whom it is necessary to evaluate the appropriateness of GetCheckedOnline to ensure the service can be used to overcome barriers and meet population testing needs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".