Examining the implementation and engagement of reproductive and sexual health services for young people
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AbstractBackground and Rationale Young people are becoming more sexually active and are forming relationships during the early stages of their lives, sometimes engaging in sexual risk-taking, which contributes to high rates of conception and sexually transmitted infections (STIs). Findings from past studies have shown that young people, especially those at risk of STIs and unplanned pregnancy, are less likely to access reproductive and sexual health promotion programmes and services (RSHPPs) especially at mainstream clinics. This was attributed to concerns about judgemental attitudes of healthcare staff, confidentiality, fear of the unknown and worries about being seen entering venues providing RSHPPs. In the UK, the response to this is contained in the Government’s sexual health policy aimed at reducing the impact of poor reproductive and sexual health outcome in the population. There is the need to improve our understanding about how the voices of young people can be incorporated into the design and implementation of RSHPPs to better address their RSH needs. Study aim The aim of this research study is to examine the factors affecting the design, implementation, and engagement of RSHPPs for young people aged 16 - 25. Study design A mixed methods design was utilised to examine the design, implementation and engagement of RSHPPs for young people aged 16-25. Qualitative methods utilised two case studies involving four community-based organisations (CBOs) and two general practice surgeries (NHS-GP surgeries). Interviews and review of documentary evidence were utilised to explore the views and experiences of managers and health promotion workers (HPWs) regarding the design, implementation and engagement of RSHPPs for young people. A total of 25 managers and HPWs were interviewed across four community-based organisations and two GP surgeries. Qualitative data were analysed using the framework analysis. Similarly, quantitative methods utilised survey questionnaire involving 317 young people to examine their engagement with RSHPPs through six RSHPPs constructs, namely RSH knowledge, sexual behaviour, RSH seeking, attitude and expectation of RSHPPs, rating RSHPPs use and HPWs, barriers to accessing RSHPPs. SPSS was utilised to describe the data and to examine the association between the six RSHPPs constructs and demographic characteristics. Key findings The qualitative findings from the two case studies involving managers and HPWs indicate that RSHPPs afforded young people the opportunity to access RSE, chlamydia screenings and contraceptive services, especially within outreach settings as a first easy step to engaging with other RSHPPs. Quantitative findings from young people aged 16-25 indicate that the facilitators of RSHPPs include more frequent RSHPPs (35%), awareness of RSHPPs (31%) and the need for privacy (29%). Barriers to accessing RSHPPs include confidentiality (19.3%), embarrassment (19.1%) and was corroborated by managers and HPWs who reported that worries about confidentiality and embarrassment were the most cited barriers to accessing RSHPPs by young people. Implication for practice Addressing the local health priorities like reducing teenage pregnancies and STIs requires organisations to provide RSHPPs at both non-clinical and clinical settings to ensure that RSHPPs are accessible to young people. RSE should be tailored to meet the evolving RSH needs of young people before they initiate sexual activities to enable them to make informed decisions about their RSH. Embedding RSHPPs within youth related activities provide young people with some level of anonymity. Future evaluation of RSHPPs could explore the views and experiences of young people and service providers to understand how such collaboration could deliver better RSH outcomes for young people.
CitationAdakpa, I.T. (2022) 'Examining the implementation and engagement of reproductive and sexual health services for young people'. PhD thesis. University of Bedfordshire.
PublisherUniversity of Bedfordshire
TypeThesis or dissertation
DescriptionA thesis submitted to the University of Bedfordshire, in partial fulfilment of the requirements for the degree of Doctor of Philosophy.
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