Listening for commissioning: A participatory study exploring young people's experiences, views and preferences of school‐based sexual health and school nursing

Abstract

Funding informationThe paper draws on insights gained from engagement and participation activities, commissioned by an English Local Authority (LA) in 2015, which aimed to provide greater understanding of the views and experiences of young people in relation to health improvement services and initiatives. The LA developed the overall brief, main research questions and helped guide the work. The findings have been used by the LA to help inform service changes and develop a transformational health improvement programme in school settings. Aims and objectives:To explore the experiences, views and preferences of young people aged 11-19 years regarding school-based sexual health and school nursing to inform commissioning and delivery for one local authority area in England during 2015.Background: Promoting sexual health for young people remains a challenging, even controversial, but important public health issue. Concerns regarding accessibility, acceptability and efficacy in school-based sexual health and school nursing are evident in the literature. Additionally, a complex public health policy context now governs the funding, provision and delivery of sexual health and school nursing, which potentially presents further challenges.Design: A qualitative, participatory design was used to explore sexual health and school nursing. Data were generated from 15 focus groups (n = 74), with young people aged 11-19 years, in educational-based settings in one local authority area in England.Results: The resultant themes of visibility in relation to sexual health education and school nursing revealed both the complex tensions in designing and delivering acceptable and appropriate sexual health services for young people and the significance of participatory approaches. Conclusion:Our study shows the importance of participatory approaches in working with young people to clearly identify what they want and need in relation to sexual health. The findings also confirm the ways in which school-based sexual health remains challenging but requires a theoretical and conceptual shift. This we argue must be underpinned by participatory approaches.Relevance to clinical practice: School nurses have always had a significant role to play in promoting positive sexual health for young people and they are exceptionally well placed to challenge the risk-based cultures that frequently dominate schoolbased sexual health. A shift of debates and practices towards the promotion of positive sexual health cultures though previously argued for now requires the active engagement and involvement of young people. Sherriff et al., 2011; Attwood & Smith, 2014;Carroll, Lloyd-Jones, Cooke, & Owen, 2012;Hayter, Owen, & Cooke, 2012; Owen et al., 2010). In England, school nurses are qualified nurses with specialist training in the public health needs of school-aged children and young people (Department of Health, 2012a;Jenkins, 2016;Maughan, Bobo, Butler, Schantz, & Schoessler, 2015). The "School Health Service" aims to provide programmes and interventions to p...

‘We expected more about sex in the sex week’ - A qualitative study about students’ experiences with a sexual health education programme, from a health-promotion perspective

“…They are simply calling for a positive approach to sex and sexuality. The same wish is well documented in the previous research (Aranda et al, 2018 ; Berggrav, 2015 ; Denford et al, 2017 ; Mattebo et al, 2014 ; Pound et al, 2016 ).…”

“…They felt the focus was mainly negative and neglected aspects of sexuality such as pleasure and enjoyment. This is also shown in other studies (Aranda et al, 2018 ; Denford et al, 2017 ; Mattebo et al, 2014 ; Pound et al, 2016 ). As one of our informants so precisely expressed it: “Sex is not supposed to be a negative thing.…”

“…Adolescents wish for topics related to sexual health education to convey a positive view of sexuality and diversity. They wish adults to accept that young people have and desire sexual experiences and want to talk about what and how sex is (Aranda et al, 2018 ; Berggrav, 2015 ; Pound et al, 2016 ). Further, research shows that education focusing only on abstinence is ineffective in promoting positive changes in sexual behaviour (Denford et al, 2017 ).…”

“…Sexuality must be recognized as a special subject for the students and should not be taught like ordinary subjects (Pound et al, 2016 ). Sexual health education is successful when students participate, the environment feels safe, and the teacher has sufficient knowledge, uses humour, and is confident when talking about sexuality (Aranda et al, 2018 ; Denford et al, 2017 ; Mattebo et al, 2014 ; Pound et al, 2016 ). Peer-led interventions are considered a powerful tool in sexual health education regarding influencing students’ knowledge and attitudes (Sun et al, 2018 ).…”

School-Based Participatory Response for Reopening During the COVID-19 Pandemic: A Case Study of a Metropolitan High School Implementing the Health Promoting School

“…The school community prevention safety belt was developed in terms of physical and social environment, and personal prevention activities based on the six health promotion school indicators. In addition, formation of a student club to monitor whether major contents of the prevention safety belts were being followed at the individual level, had a positive effect on the fellow students; such an effect has also been shown in previous studies ( 10 , 11 ). Activating personal prevention safety belts by checking the symptoms of students when entering the school and during each class, and providing self-made disinfection products were cost-effective and sustainable methods that can be applied easily in other schools.…”