Risk reduction as an accepted framework for safer-sex promotion among women who have sex with women

Sexual Health ◽  
2009 ◽  
Vol 6 (1) ◽  
pp. 15 ◽  
Author(s):  
Peta Cox ◽  
Ruth McNair
Keyword(s):  
Health Promotion ◽  
Mixed Methods ◽  
Focus Groups ◽  
Risk Reduction ◽  
Present Article ◽  
Health Professionals ◽  
Safer Sex ◽  
Low Risk ◽  
Sexually Transmissible Infections ◽  
Safer Sex Practices

Background: Safer-sex information for women who have sex with women (WSW) is often very difficult to locate. Girl2girl.info is one of the only websites focussed on safer sex for WSW. The present article describes the predevelopment consultation and evaluation of girl2girl.info. A risk-reduction framework was used to develop the website. Methods: Girl2girl.info was developed in 2004 using questionnaires and focus groups with 36 consumers who were WSW, largely based in Canberra, Australia. In 2006–2007 the site was evaluated using mixed methods of questionnaires with 74 WSW and interviews with 17 health professionals around Australia. Results: This research has identified some key attitudes toward safer sex of WSW participants, in particular a misperception that the majority of WSW are at low risk for sexually transmissible infections and a consistent aversion to using latex for safer sex. Conclusions: The article concludes that the promotion of a risk-reduction approach – including non-latex-based safer-sex practices – for WSW is both a theoretically appropriate and engaging form of health promotion for WSW.

Sex on premises venue (SOPV) health promotion project in response to sustained increases in HIV notifications

Sexual Health ◽  
2009 ◽  
Vol 6 (1) ◽  
pp. 41 ◽  
Author(s):  
Amy B. Mullens ◽  
Shaun Staunton ◽  
Joseph Debattista ◽  
Elisabeth Hamernik ◽  
Darren Gill
Keyword(s):  
Health Promotion ◽  
Safer Sex ◽  
Health Department ◽  
Health Issues ◽  
Private Industry ◽  
Sexual Behaviours ◽  
Time Period ◽  
Sexually Transmissible Infections ◽  
Bisexual And Transgender ◽  
Safer Sex Practices

Background: Due to increases in HIV notifications in Queensland, a health promotion outreach project was developed with sex on premises venues (SOPV) in Brisbane. Methods: A health promotion officer (HPO) promoted safer sex behaviours among SOPV patrons over 14 months, including providing information, counselling and skills to enhance safer sexual behaviours and providing referrals. Surveys were introduced to facilitate discussions regarding HIV/sexually transmissible infections, testing and safer sex practices. Results: The project demonstrated feasibility within this highly sexualised environment, and was enhanced by careful monitoring and revising the procedure to improve patron/staff responses to the project. The introduction of a survey instrument was a significant contributor to the project’s effectiveness, providing opportunities for patrons to discuss a variety of key sexual health issues. Conclusions: This initiative reflected effective partnering between the Health Department, a community HIV/lesbian, gay, bisexual and transgender organisation and private industry. Despite initial difficulties, the presence of a health worker within an SOPV was acceptable to patrons and allowed for brief interventions to be conducted. This project was deemed effective for a limited time period and within certain constraints.

scholarly journals Intelligent Structured Intermittent Auscultation (ISIA): A Mixed Methods Evaluation of an Informed Decision-Making Framework for Fetal Heart Rate Monitoring

2021 ◽  
Author(s):  
◽  
Robyn Mary Maude
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Knowledge Translation ◽  
Focus Groups ◽  
Medical Records ◽  
Fetal Heart ◽  
Informed Decision ◽  
Low Risk ◽  
Informed Decision Making ◽  
Low Risk Women

<p>Intermittent Auscultation (IA) of the fetal heart (FH) is a screening tool for the assessment of fetal well-being during labour; the detection of changes in the FH rate and rhythm may signal fetal compromise. While the evidence reveals that IA is as effective as continuous cardiotocography (CTG) for FH monitoring for low-risk women, current practitioners favour the use of continuous CTG despite the risk of significantly increased maternal and fetal morbidity. Translating the knowledge of the effectiveness of IA into practice became the primary aim of this study. While auscultation and palpation are essential midwifery skills, the teaching of IA does not go beyond simply outlining the protocol for frequency, duration, and timing and less is understood about the underlying physiology associated with what is heard and the reassurance of fetal wellbeing that this provides. A knowledge translation intervention, in the form of an evidence-based informed decision-making framework for Intelligent Structured Intermittent Auscultation (ISIA) and a comprehensive educational intervention were developed to enhance midwives‘ knowledge and awareness of IA and to influence decision-making and practice for FH monitoring for low-risk women. A mixed methods non-experimental pre- and post - intervention study design was used to evaluate the knowledge intervention. Pre measures included a retrospective review of 511 medical records to assess existing FH monitoring practices, and focus groups with 14 midwives explored barriers and facilitators to the use of IA. The intervention was then delivered to a mix of 33 midwives and doctors three months later, followed by a second review of 422 medical records and focus groups with seven midwives to determine any changes in practice and to evaluate outcomes. The findings revealed a statistically significant increase in the use of ISIA with improved documentation, and a relative decrease of 14% in the use an admission CTG for low risk women. The ISIA framework has wide applicability in all maternity settings. This research has illuminated the effects of culture, organisation and the socio-political context on the ability for midwives to utilise their fundamental midwifery skills to promote, facilitate and protect normal physiological birth in the institutional maternity care setting. Engagement with a Knowledge Translation project and the introduction of the ISIA framework for FHR monitoring for low risk women has given midwives voice to generate change.</p>

scholarly journals Patients’ and health professionals’ perceptions of the LoDED (limit of detection and ECG discharge) strategy for low-risk chest pain management: a qualitative study

2020 ◽  
pp. emermed-2020-209539
Author(s):  
Lucy Beasant ◽  
Edward Carlton ◽  
Gareth Williams ◽  
Jonathan Benger ◽  
Jenny Ingram
Keyword(s):  
Chest Pain ◽  
Qualitative Study ◽  
Focus Groups ◽  
Health Professionals ◽  
Limit Of Detection ◽  
High Sensitivity ◽  
Patient Discharge ◽  
Information Provision ◽  
Structured Interview ◽  
Low Risk

BackgroundRapid discharge strategies for patients with low-risk chest pain using high-sensitivity troponin assays have been extensively evaluated. The adherence to, and acceptability of such strategies, has largely been explored using quantitative data. The aims of this integrated qualitative study were to explore the acceptability of the limit of detection and ECG discharge strategy (LoDED) to patients and health professionals, and to refine a discharge information leaflet for patients with low-risk chest pain.MethodsPatients with low-risk chest pain who consented to a semi-structured interview were purposively sampled for maximum variation from four of the participating National Health Service sites between October 2018 and May 2019. Two focus groups with ED health professionals at two of the participating sites were completed in April and June 2019.ResultsA discharge strategy based on a single undetectable hs-cTn test (LoDED) was acceptable to patients. They trusted the health professionals who were treating them and felt reassured by other tests, (ECG) alongside blood test(s), even when the clinical assessment did not provide a firm diagnosis. In contrast, health professionals had reservations about the LoDED strategy, including concern about identifying low-risk patients and a shortened patient observation period. Findings from 11 patient interviews and 2 staff focus groups (with 20 clinicians) centred around three overarching themes: acceptability of the LoDED strategy, perceptions of symptom severity and uncertainty, and patient discharge information.ConclusionRapid discharge for low-risk chest pain is acceptable to patients, but clinicians reported some reticence in implementing the LoDED strategy. Further work is required to optimise discharge discussions and information provision for patients.

When online becomes offline: attitudes to safer sex practices in older and younger women using an Australian internet dating service

Sexual Health ◽  
2012 ◽  
Vol 9 (2) ◽  
pp. 152 ◽  
Author(s):  
Deborah J. Bateson ◽  
Edith Weisberg ◽  
Kirsten J. McCaffery ◽  
Georgina M. Luscombe
Keyword(s):  
Older Women ◽  
Safer Sex ◽  
Sexual Partners ◽  
The Internet ◽  
Internet Dating ◽  
Younger Women ◽  
Factors Associated ◽  
Sexually Transmissible Infections ◽  
Safer Sex Practices ◽  
Sex Practices

Background The prevalence of sexually transmissible infections (STIs) is increasing among older Australian women, partly due to re-partnering after divorce or death of a spouse. Older women may be less likely to use condoms with new sexual partners, exposing themselves to STIs. An online survey compared characteristics of internet dating women aged 40 and above with 18 to 39 year olds, and determined the factors associated with protective safer sex attitudes. Methods: An email directed women who had logged onto the internet dating service ‘RSVP’ in the previous 6 months to a survey hosted by Family Planning New South Wales. The survey explored demographic factors, STI-related knowledge and attitudes towards safer sex practices. Factors associated with discussing STIs before sex and refusing sex without a condom with a new partner were analysed using logistic regression. Results: The questionnaire was completed by 1788 women. Almost two-thirds (62.2%) were aged 40 or over. The majority (64.8%) were seeking a long-term partner. In the previous year, 41.5% of all women met a new sexual partner via the internet. Women aged >40 years were significantly more likely to discuss STIs with a new partner but less likely to refuse sex without a condom compared with younger women. Conclusions: The internet is a useful venue for women of all ages to meet new sexual partners. Older women are vulnerable to STI acquisition through failure to use condoms with a new partner. Research is needed to determine effective interventions to increase condom use in this age group.

scholarly journals Do women use dental dams? Safer sex practices of lesbians and other women who have sex with women

Sexual Health ◽  
2010 ◽  
Vol 7 (2) ◽  
pp. 165 ◽  
Author(s):  
Juliet Richters ◽  
Garrett Prestage ◽  
Karen Schneider ◽  
Stevie Clayton
Keyword(s):  
Sexual Risk ◽  
Safer Sex ◽  
Oral Sex ◽  
Mardi Gras ◽  
Latex Gloves ◽  
Sexually Transmissible Infections ◽  
Lesbian Community ◽  
Safer Sex Practices ◽  
Group Sex ◽  
The Relationship

Dental dams are distributed and promoted in some safer sex campaigns for use in oral sex. However, whether and how often dams are used for sex between Australian women remains unknown. We investigated the use of dental dams for sex by lesbians and other women who have sex with women, and the relationship between dam use and sexual risk for this group. In 2004, a self-completion questionnaire was distributed to women attending the Sydney Gay and Lesbian Mardi Gras Fair Day and lesbian community venues and health services in Sydney (n = 543). Among the 330 women who had had oral sex with a woman in the previous 6 months, 9.7% had used a dental dam and 2.1% had used one ‘often’. There was little evidence of dam use for prevention of sexually transmissible infections. Although women who practised rimming (oral–anal contact) or had fetish sex involving blood were more likely to have used a dam, dam use was not significantly more common among women who had more partners, or had casual or group sex. Some women avoided oral sex during menstruation or had oral sex with a tampon in place. Latex gloves and condoms were used by more women and more often than dams.

scholarly journals The role of Allied Health Professions and Nursing Research Internships in developing a research culture: a mixed-methods exploration of stakeholder perspectives

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
J. Nightingale ◽  
S. Fowler-Davis ◽  
K. Grafton ◽  
S. Kelly ◽  
C. Langham ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Focus Groups ◽  
Health Professionals ◽  
Online Survey ◽  
Allied Health ◽  
Academic Career ◽  
Evaluation Framework ◽  
Clinical Activity ◽  
Allied Health Professionals ◽  
Stakeholder Perspectives

Abstract Background Developing research capability and capacity within the healthcare professions is a challenge throughout diverse international settings. Within England, the National Institute for Health Research aimed to address these challenges through the Integrated Clinical Academic (ICA) research careers escalator for nurses, midwives and allied health professionals. Poor academic progression has been identified in the advanced stages of the pathway, though progression from the earlier entry point (Internship) has not previously been investigated. A national evaluation of four completed Internship cohorts was undertaken to explore stakeholder perspectives and progression beyond the Internship programme. Methods A mixed methods project used sequential qualitative and quantitative data collection phases commencing with two stakeholder focus groups (n = 10); the findings informed the development of an online survey distributed to previous cohorts of interns (n = 104), their managers (n = 12) and academic mentors (n = 36). Eight semi-structured interviews subsequently explored the challenges and opportunities afforded by the internships. Thematic analysis was used to review qualitative data from focus groups and interviews, with survey data analysed and displayed using descriptive statistics. Synthesis of data from each phase is displayed within the four level evaluation framework outlined within the New World Kirkpatrick® Training Evaluation Model. Results Important regional differences exist yet the internships are highly valued by all stakeholders. Representation varied between different professions, with nursing and some service-based professions poorly represented. All interns successfully completed the programme (n = 104), with evidence of positive impacts on interns, colleagues and patient care. Balancing research commitments with clinical activity was challenging; middle managers were seen as gatekeepers to programme success. Progression to the next stage of the ICA pathway is highly competitive and was achieved by only a quarter of interns; access to mentors outside of the funded programme is vital for a successful transition. Conclusions The Internship programme succeeds in providing a range of important early experiences in research, though progression beyond the programme is challenging due, in part, to a widening gap between Internship and the next level of the ICA framework. Vital mentorship support to bridge this gap is threatened by a lack of time and funding; therefore, the pursuit of a clinical-academic career will continue to be elusive for many nurses and allied health professionals. A partnership approach to clinical academic support at institutional level is needed with several international models offering alternative strategies for consideration.

scholarly journals Intelligent Structured Intermittent Auscultation (ISIA): A Mixed Methods Evaluation of an Informed Decision-Making Framework for Fetal Heart Rate Monitoring

2021 ◽  
Author(s):  
◽  
Robyn Mary Maude
Keyword(s):  
Decision Making ◽  
Mixed Methods ◽  
Knowledge Translation ◽  
Focus Groups ◽  
Medical Records ◽  
Fetal Heart ◽  
Informed Decision ◽  
Low Risk ◽  
Informed Decision Making ◽  
Low Risk Women

<p>Intermittent Auscultation (IA) of the fetal heart (FH) is a screening tool for the assessment of fetal well-being during labour; the detection of changes in the FH rate and rhythm may signal fetal compromise. While the evidence reveals that IA is as effective as continuous cardiotocography (CTG) for FH monitoring for low-risk women, current practitioners favour the use of continuous CTG despite the risk of significantly increased maternal and fetal morbidity. Translating the knowledge of the effectiveness of IA into practice became the primary aim of this study. While auscultation and palpation are essential midwifery skills, the teaching of IA does not go beyond simply outlining the protocol for frequency, duration, and timing and less is understood about the underlying physiology associated with what is heard and the reassurance of fetal wellbeing that this provides. A knowledge translation intervention, in the form of an evidence-based informed decision-making framework for Intelligent Structured Intermittent Auscultation (ISIA) and a comprehensive educational intervention were developed to enhance midwives‘ knowledge and awareness of IA and to influence decision-making and practice for FH monitoring for low-risk women. A mixed methods non-experimental pre- and post - intervention study design was used to evaluate the knowledge intervention. Pre measures included a retrospective review of 511 medical records to assess existing FH monitoring practices, and focus groups with 14 midwives explored barriers and facilitators to the use of IA. The intervention was then delivered to a mix of 33 midwives and doctors three months later, followed by a second review of 422 medical records and focus groups with seven midwives to determine any changes in practice and to evaluate outcomes. The findings revealed a statistically significant increase in the use of ISIA with improved documentation, and a relative decrease of 14% in the use an admission CTG for low risk women. The ISIA framework has wide applicability in all maternity settings. This research has illuminated the effects of culture, organisation and the socio-political context on the ability for midwives to utilise their fundamental midwifery skills to promote, facilitate and protect normal physiological birth in the institutional maternity care setting. Engagement with a Knowledge Translation project and the introduction of the ISIA framework for FHR monitoring for low risk women has given midwives voice to generate change.</p>

Facilitation as a vital skill in mental health promotion: findings from a mixed methods evaluation

2018 ◽  
Vol 13 (4) ◽  
pp. 238-247 ◽  
Author(s):  
Margaret McAllister ◽  
Cathie Withyman ◽  
Bruce Allen Knight
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mixed Methods ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Mental Health Promotion ◽  
First Century ◽  
Content Type ◽  
Twenty First Century ◽  
Century Health

PurposeThe implementation of mental health promotion is a core part of the role for all mental health professionals. This involves working with individuals and groups to facilitate the uptake and application of new knowledge, skills and personal attributes. Recently, an Australian intervention that included teaching nurses and educators the skills of mental health promotion was implemented and evaluated. The purpose of this paper is to report the findings of the qualitative evaluation and explore specific attributes of this facilitation, which helps to clarify and articulate a hidden, and taken-for-granted practice.Design/methodology/approachA qualitative mixed-methods study was designed to evaluate the perceived skills and attributes necessary for effective facilitation of a mental health promotion program in schools.FindingsThis evaluation revealed that facilitation is more than simply allowing free-flowing discussion amongst participants. For mental health promotion to be effective, the leader needs to be able to balance content delivery with flexibility, to use interpersonal behaviors that support and empower, and be willing to see the self as always learning and growing.Practical implicationsWithout explicit training or discussion of facilitation, it is possible that mental health professionals may slip into teaching didactically. Didactic teaching may not empower learners to articulate their own views, or internalize and demonstrate new skills. A facilitative approach is more fitting to the values of twenty-first-century health promotion. Facilitation is a skill that deserves to be taught explicitly within all mental health promotion courses, so that mental health professionals are inspired to teach in ways that are transactional, and empowering.Originality/valueA facilitative approach is more fitting to the values of twenty-first-century health promotion. This study confirms that facilitation is a skill that deserves to be taught explicitly to all mental health professionals so they are inspired to implement effec"tive mental health promotion.

Māori Research(er) in Three Poems

2018 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Jacquie Kidd
Keyword(s):  
Palliative Care ◽  
Health Literacy ◽  
Cultural Identity ◽  
Focus Groups ◽  
Health Professionals ◽  
Bell Hooks ◽  
Face To Face ◽  
The Third ◽  
Ruth Behar ◽  
Seeking Help

These three poems re-present the findings from a research project that took place in 2013 (Kidd et al. 2018, Kidd et al. 2014). The research explored what health literacy meant for Māori patients and whānau when they accessed palliative care. Through face-to-face interviews and focus groups we engaged with 81 people including patients, whānau, bereaved loved ones, support workers and health professionals. The poems are composite, written to bring some of our themes to life. The first poem is titled Aue. This is a Māori lament that aligns to English words such as ‘oh no’, or ‘arrgh’, or ‘awww’. Each stanza of the poem re-presents some of the stories we heard throughout the research. The second poem is called Tikanga. This is a Māori concept that encompasses customs, traditions and protocols. There are tikanga rituals and processes that guide all aspects of life, death, and relationships. This poem was inspired by an elderly man who explained that he would avoid seeking help from a hospice because ‘they leave tikanga at the door at those places’. His choice was to bear his pain bravely, with pride, within his cultural identity. The third poem is called ‘People Like Me’. This is an autoethnographical reflection of what I experienced as a researcher which draws on the work of scholars such as bell hooks (1984), Laurel Richardson (1997) and Ruth Behar (1996). These and many other authors encourage researchers to use frustration and anger to inform our writing; to use our tears to fuel our need to publish our research.

Physical activity promotion in primary health care in Slovenia

2014 ◽  
Vol 62 (2) ◽  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Health Promotion ◽  
Health Professionals ◽  
Healthy Lifestyle ◽  
Graduate Nurses ◽  
Primary Health ◽  
The Family ◽  
Prevention Of Cardiovascular Disease

In Slovenia, the role of general practitioners in counselling physical activity for prevention of cardiovascular disease (CVD) is well recognized. The role of general practitioners in advising healthy lifestyle for individuals who are at risk of developing CVD is formally defined in the National Program for Primary Prevention of Cardiovascular Disease, which has been running since 2001. Part of the program is counselling on healthy lifestyle including physical activity, performed in all health centres across the country. First a screening and medical examination is performed. In case of higher risk for CVD (>20%) the physician should give advice on the particular risk factor and direct patients to health-education centres, where they can participate in healthy lifestyle workshops lead by health professionals. Physicians and other health professionals who are involved in the implementation of prevention activities within the program need knowledge and skills that are crucial for successful counselling on healthy lifestyle. The educational program “basic education in health promotion and prevention of chronic non-communicable diseases in primary health care/family medicine” consists of two parts. The first part of the training is open to all health professionals working within the program. The second part is intended for health professionals working in health-education workshops. In the last few years a new family practice model has been introduced and disseminated. Some duties of the family physician, including health promotion and counselling, are being transferred to graduate nurses who become part of the family practice team. This new division of work undoubtedly brings many advantages, both in terms of the work organization, and of high-quality patient care. Nevertheless preventive action cannot be fully passed on to graduate nurses. Careful planning and education are needed to ensure a comprehensive approach in healthy life style counselling.

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