How can HMOs increase screening for Chlamydia trachomatis (CT), a readily treatable infection that affects an estimated 2.8 million Americans each year? Guidelines call for annual screening of all sexually active young females to combat this "silent epidemic," but physicians don't always adhere to the guidelines.

Findings: Doctors were more likely to screen if they had received training in the past, had received feedback from their contracted HMOs or had access to national CT screening guidelines. The study also revealed that other factors, such as a doctor's gender, specialty, or years of clinical experience, were related to how often the test was performed. The authors conclude that interventions tailored to physicians work best when they are noticed and acknowledged. In other words, interventions such as mailing of screening guidelines to physicians are more effective if combined with specific feedback on the physicians' screening rates.