Barriers and enablers to sexual health service use among university students: a qualitative descriptive study using the Theoretical Domains Framework and COM-B model

Abstract

BackgroundUniversity students are within the age group at highest risk for acquiring sexually transmitted infections and other negative health outcomes. Despite the availability of sexual health services at university health centres to promote sexual health, many students delay or avoid seeking care. This study aimed to identify the perceived barriers and enablers to sexual health service use among university undergraduate students.MethodsWe used a qualitative descriptive design to conduct semi-structured focus groups and key informant interviews with university students, health care providers, and university administrators at two university health centres in Nova Scotia, Canada. The semi-structured focus group and interview guides were developed using the Theoretical Domains Framework and COM-B Model. Data were analyzed using a directed content analysis approach, followed by inductive thematic analysis.ResultsWe conducted 6 focus groups with a total of 56 undergraduate students (aged 18–25) and 7 key informant interviews with clinicians and administrators. We identified 10 barriers and enablers to sexual health service use, under 7 TDF domains: knowledge; memory, attention and decision-making processes; social influences; environmental context and resources; beliefs about consequences; optimism; and emotion. Key linkages between students’ social opportunity and motivation were found to influence students’ access of sexual health services.ConclusionsWe identified barriers and enablers related to students’ capability, opportunity and motivation that influence sexual health service use. We will use these findings to design an intervention that targets the identified barriers and enablers to improve students’ use of sexual health services, and ultimately, their overall health and well-being.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3379-0) contains supplementary material, which is available to authorized users.

Improving case detection of tuberculosis in hospitalised Kenyan children– employing the Behaviour Change Wheel to aid intervention design and implementation

“…Behaviour Change Techniques are the active, observable and replicable components that make up an intervention. COM-B/BCW have been used successfully for behavioural analysis and to design interventions in both health and non-health-related elds [26,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55], but to our knowledge, has been used in only one study of TB on contact tracing in a low-resource setting, to identify barriers and facilitators and to tailor interventions to improve contact investigation in Kampala [26]. In the qualitative arm, to understand the challenges in recognising and testing for TB in admitted children we analysed data from: i) semi-structured interviews, small-group discussions and key informant interviews with front line health workers and mid-level managers; ii) observations of TB trainings, sensitisation meetings, policy meetings, and hospital practices, and iii) desk review of guidelines, job aides and policy documents, which have been reported elsewhere [31].…”

Cross cultural “behavioural diagnosis” examining the uptake of the MIND diet, using the COM-B model to inform an intervention.

“…The TDF [38], compromises 14 domains, each of which corresponds to a COM-B component and also representing a range of theory-based barriers and facilitators to behaviour [37]. The COM-B model and TDF have been used by several studies to explore barriers and facilitators to behaviour change in sexual health [42], physical activity in obese pregnant women [43] and reducing sugar [40]…”

“…To our knowledge, this is the first study investigating adherence to the MIND diet at midlife (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55) years old) in a Mediterranean and non-Mediterranean country. This study addresses this gap in the literature and highlights the perceived barriers and facilitators to adhering to a diet that may promote brain health at midlife and compares those barriers and facilitators to those living in Northern Ireland.…”

<p>Bleeding Management Practices of Australian Cardiac Surgeons, Anesthesiologists and Perfusionists: A Cross-Sectional National Survey Incorporating the Theoretical Domains Framework (TDF) and COM-B Model</p>

“…27 This combination of theoretical constructs has been used in a variety of settings to understand, explain and improve practice but not before in cardiac surgical bleeding management. 28,29 Current intra-operative bleeding management practice in Australian cardiac surgery units is not understood. The barriers and enablers to implementing effective bleeding management strategies, including the relationships between key stakeholders, and institutional support, likely impact on the uptake of evidence-based practice.…”