ORCID Profile
0000-0002-4409-6601
Current Organisation
University of Glasgow
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Informa UK Limited
Date: 25-03-2019
Publisher: Cold Spring Harbor Laboratory
Date: 26-10-2021
DOI: 10.1101/2021.10.22.21264941
Abstract: Access to quality sexual and reproductive health (SRH) services remains imperative, even during a pandemic. Our objective was to understand experiences of delayed or unsuccessful access to SRH services in Britain during the early stages of COVID-19 pandemic. Semi-structured qualitative follow-up interviews were conducted in October-November 2020 (six months after the first UK lockdown) with participants of Natsal-COVID, a quasi-representative web-panel survey of sexual health and behaviour during COVID-19 (n=6654). Inductive thematic analysis was used to identify lessons for future SRH service access and quality. Telephone interviews with participants from the general population. 14 women and 6 men (24-47-years-old) reporting unmet need for SRH services and agreeing to recontact (n=311) were selected for interview using socio-demographic quotas. Participant experiences spanned ten different SRH services, including contraception and antenatal/maternity services. At interview, ten participants still experienced unmet need. Participants reported hesitancy and self-censorship of need. Accessing services required tenacity. Challenges included navigating inconsistent information and changing procedures perceptions of gatekeepers as obstructing access and inflexible appointment systems. Concerns about reconfigured services included reduced privacy decreased quality of interactions with professionals reduced informal support due to lone attendance and fewer routine physical checks. However, participants also described ex les of more streamlined services and staff efforts to compensate for disruptions. Many viewed the blending of telemedicine with in-person care as a positive development. COVID-19 impacted access and quality of SRH services. The accounts of those who struggled to access services revealed self-censorship of need, difficulty navigating shifting service configurations, and perceived reduction in quality due to a socially-distanced service model. Telemedicine offers potential for greater efficiency if blended intelligently with in-person care. We offer some initial data-based recommendations for promoting equitable access and quality in restoration and future adaption of SRH services. Access to quality sexual and reproductive health (SRH) services remains imperative, even during a pandemic. In response to the threat of COVID-19, SRH services limited in-person provision, introduced social distancing and mask wearing, and expanded remote consultations and postal services. There are no published qualitative community studies in Britain exploring service-user experiences of the rapid adaption and scaling-down of SRH services in response to COVID-19. This study provides important insights into how rapid contraction and adaptation of sexual and reproductive health services was experienced by service users. It adds the patient perspective to formal and informal learning and sharing of knowledge been practitioners and policy makers. The study highlights that difficulty accessing services, decreased quality of SRH interactions, reduced opportunity to receive informal support, and fewer routine physical checks were difficult for patients. Our data-driven recommendations – including cautious adoption of telemedicine and improving collaboration across services – have relevance across SRH services and may be useful to other primary and secondary care providers.
Publisher: National Institute for Health and Care Research
Date: 11-2020
DOI: 10.3310/PHR08150
Abstract: Young people report higher levels of unsafe sex and have higher rates of sexually transmitted infections than any other age group. Schools are well placed to facilitate early intervention, but more effective approaches are required. Peer-led approaches can augment school-based education, but often fail to capitalise on mechanisms of social influence. The potential of using social media in sexual health has not been tested in school settings. Finalise the design of the Sexually Transmitted infections And Sexual Health (STASH) intervention assess the recruitment and retention of peer supporters, and acceptability to participants and stakeholders assess the fidelity and reach, in addition to the barriers to and facilitators of, implementation refine programme theory understand the potential of social media determine design parameters for a future randomised controlled trial, including economic evaluation and establish whether or not progression criteria were met. This was a feasibility study comprising intervention development and refinement of the STASH pilot and non-randomised feasibility trial in six schools. Control data were provided by students in the year above the intervention group. Secondary schools in Scotland. Students aged 14–16 years, teachers and intervention delivery partners. The STASH intervention was adapted from A Stop Smoking In Schools Trial (ASSIST) (an effective peer-led smoking intervention). Based on diffusion of innovation theory, the STASH study involves peer nomination to identify the most influential students, with the aim of recruiting and training 15% of the year group as peer supporters. The peer supporters deliver sexual health messages to friends in their year group via conversations and use of Facebook ( www.facebook.com Facebook, Inc., Menlo Park, CA, USA) to share varied content from a curated set of web-based resources. Peer supporters are given support themselves via follow-up sessions and via trainer membership of Facebook groups. The primary outcome was whether or not progression criteria were met in relation to intervention acceptability and feasibility. The study also piloted indicative primary outcomes for a full-scale evaluation. Peer supporter questionnaire observations of activities interviews with trainers, teachers, peer supporters and students monitoring log of peer supporter activities (including on Facebook and meeting attendance) questionnaire to control year group (baseline characteristics, social networks, mediators and sexual health outcomes) baseline and follow-up questionnaire (approximately 6 months later) for intervention year group. A total of 104 students were trained as peer supporters (just over half of those nominated for the role by their peers). Role retention was very high (97%). Of 611 students completing the follow-up questionnaire, 58% reported exposure to STASH study activities. Intervention acceptability was high among students and stakeholders. Activities were delivered with good fidelity. The peer supporters were active, representative of their year group and well connected within their social network. Carefully managed social media use by peer supporters augmented conversations. A primary outcome of ‘always safer sex’ was identified, measured as no sex or always condom use for vaginal or anal sex in the last 6 months. The intervention cost £42 per student. Six progression criteria were met. A seventh criterion (regarding uptake of role by peer supporters) was not. Small feasibility study that cannot comment on effectiveness. The STASH intervention is feasible and acceptable within the context of Scottish secondary schools. The results support continuation to a full-scale evaluation. Small-scale improvements to the intervention, refinement to programme theory and funding sought for full-scale evaluation. Current Controlled Trials ISRCTN97369178. This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research Vol. 8, No. 15. See the NIHR Journals Library website for further project information.
Publisher: BMJ
Date: 16-12-2021
DOI: 10.1136/SEXTRANS-2021-055210
Abstract: Physical restrictions imposed to combat COVID-19 dramatically altered sexual lifestyles but the specific impacts on sexual behaviour are still emerging. We investigated physical and virtual sexual activities, sexual frequency and satisfaction in the 4 months following lockdown in Britain in March 2020 and compared with pre-lockdown. Weighted analyses of web panel survey data collected July/August 2020 from a quota-based s le of 6654 people aged 18–59 years in Britain. Multivariable regression took account of participants’ opportunity for partnered sex, gender and age, to examine their independent associations with perceived changes in sexual frequency and satisfaction. Most participants (86.7%) reported some form of sex following lockdown with physical activities more commonly reported than virtual activities (83.7% vs 52.6%). Altogether, 63.2% reported sex with someone (‘partnered sex’) since lockdown, three-quarters of whom were in steady cohabiting relationships. With decreasing relationship formality, partnered sex was less frequently reported, while masturbation, sex toy use and virtual activities were more frequently reported. Around half of all participants perceived no change in partnered sex frequency compared with the 3 months pre-lockdown, but this was only one-third among those not cohabiting, who were more likely to report increases in non-partnered activities than those cohabiting. Two-thirds of participants perceived no change in sexual satisfaction declines were more common among those not cohabiting. Relationship informality and younger age were independently associated with perceiving change, often declines, in sexual frequency and satisfaction. Our quasi-representative study of the British population found a substantial minority reported significant shifts in sexual repertoires, frequency and satisfaction following the introduction of COVID-19 restrictions. However, these negative changes were perceived by some more than others predominantly those not cohabiting and the young. As these groups are most likely to experience adverse sexual health, it is important to monitor behaviour as restrictions ease to understand the longer term consequences, including for health services.
Publisher: JMIR Publications Inc.
Date: 06-2020
Abstract: here is strong interest in the use of social media to spread positive sexual health messages through young people’s social networks. However, research suggests this potential may be limited by a reluctance to be visibly associated with sexual health content online, and by lack of trust in the veracity of peer sources. o investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of a secondary school-based and peer-led sexual health intervention (STASH Sexually Transmitted infections And Sexual Health). ollowing training, and as part of their role, student-nominated peer supporters (aged 14-16) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationships content within these groups. Data come from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component we used data from: 11 semi-structured paired and group interviews with peer supporters and their friends (collectively, ‘students’ n=42 aged 14-16) a web-based post-intervention questionnaire to peer supporters (n=88) and baseline and follow-up questionnaires to students in the intervention year group (n=680 and 603 respectively). We carried out thematic analysis of qualitative data and descriptive analysis of quantitative data. essage-sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends), and reassuring to peer supporters, but led to engagement that ran parallel to – rather than embedded in –their routine social media use. The offline context of a school-based intervention helped legitimate and augment the Facebook posts but even where friends were receptive to STASH messages, they did not necessarily engage visibly. Preferences for content design varied, but humor, color and text brevity were important. Preferences for online versus offline message-sharing varied. nvitation-only social media groups formed around peer supporters’ existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically, and the need for adult-oversight of activities for information accuracy and safeguarding. srctn97369178
Publisher: Springer Science and Business Media LLC
Date: 14-06-2021
DOI: 10.1186/S40814-021-00835-X
Abstract: Effective sex education is the key to good sexual health. Peer-led approaches can augment teacher-delivered sex education, but many fail to capitalise on mechanisms of social influence. We assessed the feasibility of a novel intervention (STASH) in which students (aged 14–16) nominated as influential by their peers were recruited and trained as Peer Supporters (PS). Over a 5–10-week period, they spread positive sexual health messages to friends in their year group, both in-person and via social media, and were supported to do so via weekly trainer-facilitated meetings. The aims of the study were to assess the feasibility of STASH (acceptability, fidelity and reach), to test and refine the programme theory and to establish whether the study met pre-set progression criteria for continuation to larger-scale evaluation. The overall design was a non-randomised feasibility study of the STASH intervention in 6 schools in Scotland. Baseline ( n =680) and follow-up questionnaires (approx. 6 months later n =603) were administered to the intervention year group. The control group (students in year above) completed the follow-up questionnaire only ( n =696), 1 year before the intervention group. The PS ( n =88) completed a brief web survey about their experience of the role researchers interviewed participants in key roles (PS ( n =20) PS friends ( n =22) teachers ( n =8) trainers ( n =3)) and observed 20 intervention activities. Activity evaluation forms and project monitoring data also contributed information. We performed descriptive quantitative analysis and thematic qualitative analysis. The PS role was acceptable on average across schools % of students nominated as influential by their friends, signed up and were trained ( n =104). This equated to 13% of the year group. Trained PS rarely dropped out (97% completion rate) and 85% said they liked the role. Fidelity was good (all bar one trainer-led activity carried out PS were active). The intervention had good reach PS were reasonably well connected and perceived as ‘a good mix’ and 58% of students reported exposure to STASH. Hypothesised pre-conditions, contextual influences and mechanisms of change for the intervention were largely confirmed. All bar one of the progression criteria was met. The weight of evidence supports continuation to full-scale evaluation. Current controlled trials ISRCTN97369178
Publisher: Informa UK Limited
Date: 08-06-2022
DOI: 10.1080/13691058.2022.2080866
Abstract: Sexting has generated considerable public and professional interest with concerns centring on young people, and potential harms to mental and sexual health. Little research thus far has explored the practice among adults and none has focused on the cultural norms relating to the emotional experience of sexting across different ages and genders. We conducted 40 semi-structured interviews with a erse s le of adults aged 18-59 years in Britain on the role of digital technologies in participants' sexual lives. In this paper, we draw on the accounts of 34 people with experience of sexting. We identified three main themes in participants' accounts related to the emotional aspects of sexting: (1) trust, (2) desire/intimacy and (3) shame. Under each theme, we identified motivations, 'feeling rules', and ex les of 'emotion work' relating to the self, the other and the dyad. We conclude that there are shared cultural norms that constitute what appropriate sexting should feel like. Interventions aiming to minimise harms arising from sexting need to build on commonly held cultural conventions regarding the 'rules of the game' concerning feelings as well as behaviours.
Publisher: Informa UK Limited
Date: 08-06-2022
DOI: 10.1080/13691058.2022.2078507
Abstract: Government controls over intimate relationships, imposed to limit the spread of Sars-CoV-2, were unprecedented in modern times. This study draws on data from qualitative interviews with 18 participants in Natsal-COVID, a quasi-representative web-panel survey of the British population (
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-055284
Abstract: Physical distancing as a non-pharmaceutical intervention aims to reduce interactions between people to prevent SARS-CoV-2 transmission. Intimate physical contact outside the household (IPCOH) may expand transmission networks by connecting households. We aimed to explore whether intimacy needs impacted adherence to physical distancing following lockdown in Britain in March 2020. The Natsal-COVID web-panel survey (July–August 2020) used quota-s ling and weighting to achieve a quasi-representative population s le. We estimate reporting of IPCOH with a romantic/sexual partner in the 4 weeks prior to interview, describe the type of contact, identify demographic and behavioural factors associated with IPCOH and present age-adjusted ORs (aORs). Qualitative interviews (n=18) were conducted to understand the context, reasons and decision making around IPCOH. Of 6654 participants aged 18–59 years, 9.9% (95% CI 9.1% to 10.6%) reported IPCOH. IPCOH was highest in those aged 18–24 (17.7%), identifying as gay or lesbian (19.5%), and in steady non-cohabiting relationships (56.3%). IPCOH was associated with reporting risk behaviours (eg, condomless sex, higher alcohol consumption). IPCOH was less likely among those reporting bad/very bad health (aOR 0.54 95% CI 0.32 to 0.93) but more likely among those with COVID-19 symptoms and/or diagnosis (aOR 1.34 95% CI 1.10 to 1.65). Two-thirds (64.4%) of IPCOH was reported as being within a support bubble. Qualitative interviews found that people reporting IPCOH deliberated over, and made efforts to mitigate, the risks. Given 90% of people did not report IPCOH, this contact may not be a large additional contributor to SARS-CoV-2 transmission, although heterogeneity exists within the population. Public health messages need to recognise how single people and partners living apart balance sexual intimacy and relationship needs with adherence to control measures.
Publisher: JMIR Publications Inc.
Date: 16-02-2021
DOI: 10.2196/20898
Abstract: There is a strong interest in the use of social media to spread positive sexual health messages through social networks of young people. However, research suggests that this potential may be limited by a reluctance to be visibly associated with sexual health content on the web or social media and by the lack of trust in the veracity of peer sources. The aim of this study was to investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of STASH (Sexually Transmitted Infections and Sexual Health), a secondary school-based and peer-led sexual health intervention. Following training, and as a part of their role, student-nominated peer supporters (aged 14-16 years) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationship content within these groups. Data came from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component, we used data from 11 semistructured paired and group interviews with peer supporters and their friends (collectively termed students n=42, aged 14-16 years), a web-based postintervention questionnaire administered to peer supporters (n=88), and baseline and follow-up questionnaires administered to students in the intervention year group (n=680 and n=603, respectively). We carried out a thematic analysis of qualitative data and a descriptive analysis of quantitative data. Message sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends) and reassuring to peer supporters but led to engagement that ran parallel to—rather than embedded in—their routine social media use. The offline context of a school-based intervention helped legitimate and augment Facebook posts however, even where friends were receptive to STASH messages, they did not necessarily engage visibly on social media. Preferences for content design varied however, humor, color, and text brevity were important. Preferences for social media versus offline message sharing varied. Invitation-only social media groups formed around peer supporters’ existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically and the need for adult oversight of activities for information accuracy and safeguarding.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2015
End Date: 2020
Funder: Medical Research Council
View Funded Activity