Designing a sexual health risk assessment for young people
Two sexual health nurses working with teenagers from the black and minority ethnic community reflect on fieldwork undertaken for a Mary Seacole leadership award aimed at reducing inequalities.
Two sexual health nurses working with teenagers from the black and minority ethnic community reflect on fieldwork undertaken for a Mary Seacole leadership award aimed at reducing inequalities
The fieldwork we undertook aimed to design a sexual health risk assessment suitable for the needs of black and minority ethnic (BME) young people aged 16-17 (McGregor and Cannon 2016). People from BME groups report lower levels of health and well-being compared with their white counterparts which has a negative effect on health outcomes and longevity (Stevenson and Rao 2014). Research also indicates that young people are more likely to be diagnosed with a sexually transmitted infection than older age groups (Public Health England 2015).
A purposive approach was taken to design a sexual health risk assessment among young people. Following ethical approval for the project, email invitations to participate were sent out to 16-17 year olds by the youth leader at a youth centre in a deprived area of London.
Qualitative methodology was chosen to gain insights from two focus groups made up of 14 young people. A semi-structured topic outline guided the discussions allowing participants to share personal opinions on how sexual health risk assessments could be approached.
Anonymity was observed, transcripts analysed and themes identified.
The overarching finding was that the young people preferred to build trusting relationships before disclosing personal information. If this was done, the structure of the risk assessment was immaterial.
Planning the project required considerable time, commitment and background research. The ethical implications for working with this group of young people who may be vulnerable needed careful consideration.
Using a forum approach can present the potential for disclosures which may require safeguarding action. This was discussed at ethical committee meetings. It required guidelines to be established which were made clear in the consent process and at the opening of each focus group.
It was difficult to ascertain which members of the multidisciplinary team should be included in setting up and conducting the study.
However, the importance of good networking skills and the ability to identify and establish effective working relationships with the team was imperative. In this case, it enabled access to this particularly hard-to-reach group.
Conducting the focus groups was a learning experience. Some of the pitfalls of this method became apparent when listening to the recording of the first group. It was difficult to bring discussions back on track once the young people started responding to one another, and it was hard to decipher comments when they talked over each other or mumbled.
In response, we considered strategies to maintain control over turn taking when speaking, while maintaining good rapport with the young people, and an extra person took notes during the second focus group. Another lesson learned during the first focus group was the effect of extraneous noise, such as outside traffic, on the recordings. This was addressed in the second set of focus groups, but contributed to some of the study’s limitations.
Implications for future research
This research has offered opportunities for linking and working with the multidisciplinary team for the benefit of young people. It has also enabled better understanding between staff and clients and the need to relate to each other in a trusting manner. Future research should include inviting young people to take part in training health professionals in communication skills.
Implications for practice when planning a similar research project
- Thorough preparation is needed with special attention to ethical issues and safeguarding.
- Ensure early collaboration with all relevant members of the multidisciplinary team.
- Establish good working relationships with all the people involved in the research project.
- Consider a trial run when recording groups of young people.
This is the first in a series featuring reflections on research projects undertaken by nurses working in a variety of specialties in children’s nursing.
- McGregor F, Cannon E (2016) Assessing sexual health risk for young black and minority ethnic people. Primary Health Care. 26, 2,18-23.
- Public Health England (2015) Health Protection Report. Sexually transmitted infections and chlamydia screening in England, 2015. Public Health England, London.
- Stevenson J, Rao M (2014) Explaining Levels of Wellbeing in BME Populations in England. University of East London, London.
About the authors
Fiona McGregor is a PhD student at Surrey University and a specialist sexual health nurse at Archway Centre, Central and North West London NHS Foundation Trust. In 2016 she received a research grant awarded by Nursing Children and Young People for her work on improving the sexual health of homeless young people living in hostels
Elissa Cannon is a charge nurse in sexual health, Archway Centre, Central and North West London NHS Foundation Trust
Written on behalf of the RCN’s Research in Child Health community