Compliance strategies in a clinic for treatment of sexually transmitted diseases.

Two student interns in health education assessed provider-patient educational interactions in a public clinic for treatment of sexually transmitted diseases. Clear verbal instructions related to specific treatment behaviors were omitted in more than half of the interactions observed. Handout materials were above the probable reading level of most clinic patients. The students introduced informal contract pads and some simplified materials to enhance communication between health care providers and patients. While the students were present to monitor activities, return rates of women for gonorrhea test-of-cure cultures increased from 35.4% to 97.1%; rates for men increased from 32.5% to 67.2%. Return rates for women remained high (73.2%) after the students had left, but returned to near the levels before intervention (36.7%) for men. The results suggest that efforts to counsel patients ought to be studied and monitored with the same degree of rigor accorded other elements of a disease control program.