Identifying young people exposed to or at risk of sexual ill health: pilot implementation of an evidence-informed toolkit (SEXIT) at Swedish youth clinics

Abstract

Objectives: We aimed to develop and pilot-implement an evidence-informed toolkit (SEXual health Identification Tool; SEXIT) for identifying young people exposed to or at risk of sexual ill health, at Swedish youth clinics, and to investigate SEXIT's potential to identify young people in need of special care and monitoring. Methods: The SEXIT toolkit was developed, validated and pilot-implemented at three Swedish youth clinics. Pre-implementation staff readiness was assessed and youth clinic visitors' responses to SEXIT were analysed. Results: All staff perceived a need for screening for sexual risk-taking and exposure. The response rate from 268 youth clinic visitors (aged 15-24 years) was 86%. Half of the visitors had one or no variable associated with sexual ill health, a third had two or three, and 15% reported between four and seven variables. The most common variables were alcohol use, three or more sexual partners in the past year and previous chlamydia. Visitors rated SEXIT as important and not uncomfortable or difficult to answer. Conclusions: The SEXIT toolkit was found to be feasible and highly acceptable in a clinical setting. The use of SEXIT may facilitate important questions on sexual risk-taking and sexual ill health to be raised with youth clinic visitors.

Violence and sexual risk taking reported by young people at Swedish youth clinics

“…This study is based on quantitative results from a questionnaire belonging to the SEXIT 2.0 ( 32 ), within a framework of quality improvement (QI) and collaboration between youth clinics and the Knowledge Centre for Sexual Health in the southwest of Sweden. The QI involved implementation of SEXIT in clinical practice.…”

“…The development of SEXIT 2.0 was based on a previous pilot study ( 32 ) where the instrument was developed, validated and pilot-tested at three Swedish youth-clinics. Based on the results of the pilot implementation, the authors further developed SEXIT by including items regarding physical and emotional violence, witnessing violence, protection against STI and pregnancy and experience of STIs other than chlamydia, resulting in version 2.0.…”

“…The content validity of SEXIT 2.0 was established by an expert panel. Most of the variables in the questionnaire have been previously validated ( 32 ).…”

“…One study found that 16% of youths had visited a youth clinic in the past 3 months ( 31 ). In recent years, many youth clinics have introduced a tool, SEXIT (SEXual health Identification Tool), aiming to systematically address sexual risk taking, ill health and violence exposure with all visitors, through a questionnaire ( 32 ). This provides a unique opportunity to study a large sample of youth clinic visitors from different parts of Sweden, regarding multiple forms of violence and sexual risk taking.…”

An electronic patient-reported outcome created based on my needs is worth using: an explorative qualitative study investigating young people’s opinions for a health assessment tool

“…Young people have stated that using a PRO before a healthcare appointment allowed them more time to talk about what is most important to them during the appointment [ 10 ]. Examples of PROs for young people that are feasible, accepted, and used clinically are the SEXual health Identification Tool (SEXIT), developed to identify Swedish young people exposed to or at risk of poor sexual health [ 13 , 14 ], and YouthCHAT, with purpose to identify psychosocial and mental health issues in young people in New Zealand [ 11 , 15 , 16 ]. As PROs/ePROs are increasingly recognized for their utility, platforms of PROs/ePROs are being created, for example the Patient-Reported Outcome Measurement Information System® (PROMIS®) [ 7 ].…”