Question:

Define key terms which are relevant for your essay. Make sure the definitions are relevant and relevant to your essay content.

When using quantitative research, ensure that your definition is appropriate for the type of study or method you are discussing.

Critique the research document using the framework given by the module leader (see Below) to identify strengths and limitations in the study.

Answer to Question: HLST234 Nursing

Introduction

Controlling sexually transmitted illnesses (STI) is a priority in public health across the globe.

Although confidential and free services are available in the UK, many young people are not able to use them.

This study explored the acceptability, usability, and accessibility of STI testing toolskits among a younger population (16-24 years old).

Research in nursing is essential as it legitimizes and enriches the nursing profession’s knowledge base.

Criticizing research allows the robustness of the study’s findings to be evaluated. This allows anyone to validate the generalizability and validity of the results.

EBP is an evidence-based approach that uses well-designed research to solve health care problems.

EBP improves patient outcome and aims to decrease variation in patient outcome. Critique of a research article ensures that it can be used in any similar scenario with the best patient results as the final expectation.

This paper will discuss the findings of the Aicken et al (2016) research and highlight the strengths and limitations.

The paper will conclude with a critique of the study’s reliability.

Key terms: Sexually transmitted infections, validity of research, self testing.

These are the Key Points in The Research Paper

Aicken et.al. (2016) concluded that online self-testing and care pathways for STI are highly acceptable, provided privacy and accuracy concerns have been addressed.

The study also suggests that technology-related concerns must be included in the design and implementation of interventions.

Researchers must be aware that young people are more likely to keep their sexual healthcare secrets, which includes STI diagnosis.

Consideration should be given to the sender’s identity and message wording when sexual healthcare use evidence is displayed on Smartphones.

Additionally, you can use web-apps which are not downloaded or installed on the user’s smartphone instead of using native apps.

A self-testing Smartphone service with NHS branding should be available. This would help instill trustworthiness.

A self testing service that can be connected to e-prescriptions services with local pharmacies could offer a faster alternative to postal delivery. The nature of the STI as well as the treatment recommended will affect the speed and privacy.

There are many innovations in sexual clinics such as mute test, which allows patients to register electronically and provide clinical information on paper.

Aicken et.al. (2016) have shown that remote access to sexual care could overcome any barriers and help with STI detection.

If people can access the online treatment options quickly and easily, they will be able to reap the public health benefits.

It did not include gay men, which is a significant limitation of the study.

Because researchers were concerned about privacy, they did not include men who have sex in the study.

The participants were also all non-white.

This was almost inevitable due to the college being located where the majority of students are nonwhite. However, most of those who were approached declined participation for unknown reasons.

The study’s results are open to interpretation as the number of women required to fulfill the 20-24 sampling limit (n=2) was not met.

Research Study Belief

Author Credentials

The paper featured many authors, the most prominent being:

Catherine R. H. Aicken – MSc., BSc. University College Research Department of Infection and Population Health London.

Sebastian S. Fuller is a PhD. St,.

George’s University Institute for Infection and Immunity LondonLorna J. Sutcliffe: MSc.

Registered Nurse at Blizard Institution, Health Services Research(LSHTM), London and Barts School of Medicine and Dentistry Centre for Immunology and Infectious Diseases Queen Mary University of London

Others include Claudia S. Estcourt. Pippa oakeshott. Voula gkatzidou. Kate Hone. Pam Sonnenberg. S. Tariq Sadiq. Maryam Shahmanesh.

Writing style for authors

Active voice has been used to reference AMA in the paper.

The abstract summarises the key points within the body of the paper.

In-text citations use numerals in brackets to indicate each reference.

Title of The Study

The paper’s title reads: Young people’s perceptions on Smartphone-enabled self test and online care of sexually transmitted illnesses: qualitative interview study.

The title is clear as it represents the entire study.

Abstract Section of The Paper

The abstract summarizes the study by the researchers. It also includes details about the study such as the methodology used and the results.

It also contains six keywords, which correspond with the subject of the paper.

The Study is a powerful tool for learning.

Significance/ Research Problem

Research Problem: High STI prevalence among UK youth, more specifically at Further Education colleges in London

Study purpose: Provide information about the development the proposed eHealth intervention (Craig, Dieppe, & Macintyre,2008, p.1; Catwell & Sheikh,2009, p.1), whose objective it to be an addition to the existing services, rather than a replacement.

England’s high rate of sexually transmitted illnesses (STIs) is a concern for public health. This is due to the fact that young people are most at risk. (Sonnenberg, Clifton, & Beddows, 2013, p.1795; Public Health England,2015).

STI services help to diagnose, treat, and prevent asymptomatic infections.

Some people see attending an STI Clinic as a form or stigmatization.

An innovative intervention that combines STI self-testing with online clinical management is possible through a smartphone-enabled method.

While some STI services are available online at the moment (Woodhall Sile & Talebi et al., 2012, p.23), Richardson Maple & Perry, 2010, p.187, Huang, Gaydos & Barnes et al., 2013, p.108), this intervention goes beyond these options.

Home self-testing acceptability qualitative (Rompalo. Hsieh. & Hoganet., 2013, p.541) and the use and misuse of the internet in relation to STI testing are discussed (Friedman & Bloodgood 2013 p. 96. Hottes. Farrell. Bondyra et.al. 2012, p. 42. Shoveller. Knight. Davis et.al., 2102, p.14).

Because these studies were conducted in different countries (e.g., the US and Canada), it was not possible to transfer the results to the proposed intervention.

It was therefore necessary that the researchers conducted a formative study in order to gain information about the development process of the proposed eHealth intervention (Craig, Dieppe, & Macintyre,2008, p.1; Catwell & Sheikh,2009,). The objective of this study is to add to existing services, not replace them.

Aicken et.al. (2016) conducted a study to assess the acceptability and perceptions regarding remote self-testing for STIs. This was done among young people from Inner London, which has high rates of STIs (PHE (2013)) and large Black Caribbean and African communities.

The population under review is indicative of the fact urban youth populations could be early adopters for new technologies and may therefore be considered potential users of the service once it launches.

This research was carried out during the early stages in the development process of the intervention. It was part a formative program that provided information on the development and operation of the online self-testing STI service.

Another formative study considered design of the interface (Gkatzidou. Hone.& Sutcliffe.2015, p. 72) as well as clinical safety. Sadiq, Gibbs. Sutcliffe. (2014). This research, together with this study, led to a recent proof-ofconcept study of an online Chlamydia treatment pathway using mixed-method evaluations.

Aicken, Estcourt, & Johnson et. al., 2016, provided evidence that indicated user population. Device development for self-testing is ongoing.

Literature Review

This paper was lacking sufficient literature.

Researchers pointed out that no research had been done on remote self testing in relation to online STI management.

However, some elements of the proposed intervention have been evaluated in other studies.

One such study, which involved young women in the US, was qualitative and was completed between 2007 & 2008. It included reservations regarding STI testing using the internet. Other findings from similar studies among young Canadians were less clear (Shoveller et. al., 2015).

Aicken et. al. (2016) also found similar results when it came to wanting support from healthcare providers after a positive diagnosis.

Participants discussed privacy with family and peers in relation preference for self testing over going to a sexual clinic, and preference for discreet messaging. However, online security, confidentiality/privacy elicited fewer concerns.

This may be due to the number of Smartphones that the study sample owns, and the trust they have in NHS.

Study Design/Methodology

Study Population

The participants in this study were recruited at a Further Education college within Inner London.

FE colleges in England offer post-compulsory education, which is available to people 16 years of age and above. They often offer vocational training and are not like universities which offer higher academic qualifications.

There is a higher proportion of people from low socio-economic classes in FE colleges.

The study was open to students aged between 16 and 24 years old who self-reported having engaged in sexual activity at minimum once.

Methodology

Bryman (2008 p.6) suggests that research methodology could be understood as a strategy which shapes in a comprehensive way, our use and relationship of certain methods to expected outcomes. However (Noor, 2008 p. 1602), the research problem features and research methodology are the key factors.

Qualitative research methodology is best when you are trying to investigate a new subject or to determine pertinent issues (Creswell (2007), p. 23. Corbin &Strauss (2007), p.14).

Aicken et. al. (2016)’s research was suitable because it used in-depth interview techniques. In the 2012 study, participants were aged 16-24 and had reported that they had been sexually abused.

The participants were urban Further Education college students from areas where STI is common.

The study included a thematic assessment.Sampling

The participants were made up of 16 males as well as 9 females.

21 participants identified themselves as Black and one as Asian/Muslim. Three of the participants were from mixed ethnicities.

22 participants reported experiencing sexual activity. 2 people claimed to have been diagnosed with an STI. All participants also owned smartphones.

The sample used was valid because it represented the population being studied.

Ethical Considerations

The data collection method was valid because participants had signed a written consent to being interviewed.

Additionally, the University College London Ethics committee gave permission for the researchers to conduct interviews.

Researchers also included transcriptions from participants to aid understanding.

Data Collection

Semi-structured interviews require interviewees to respond in depth to open-ended, pre-set questions.

They are used for interviews with individuals and groups.

Data recording is made using audio or visual recording. At times, the researcher might choose to write down key points. This is more common than the rule.

Aicken, et al. (2016) used semi structured interviews that were recorded audio.

The data collection method was validated with the transcription of the interviews and the recording of the interviews.

Data Analysis

Thematic analysis was done to find the most important themes and recurring message. This was used to modify the questions and make the tool more useful and accurate.

Participants expressed enthusiasm about the proposed new services. They indicated that they would use the tool and tell their friends, as well as test it.

Online self-testing for STI clinical treatment was viewed as much more convenient and efficient than conventional methods. This allowed patients to conceal their test results from family and friends, which saved them from embarrassing consultations.

Despite these obvious privacy advantages, there are still privacy concerns regarding communication technology. The inherent risk of STI diagnosis, results being retrievable, or visible on the Smartphone is a major concern.

Another concern was raised regarding the accuracy of the test, the novelty and self-operation.

Some participants expressed concerns about possible diagnosis and treatment, even without any contact with a medical professional.

Study concluded that self-testing remotely via the internet was more appealing for young people than traditional STI services.

This could benefit the public health by providing early diagnosis and treatment.

This research supports online care options that are still in development stages.

Findings

Participants selected from high prevalence areas were comfortable with the proposal for a novel treatment. They also accepted an online self-testing STI method.

Participants considered three factors when deciding whether to use existing STI testing services or self-testing.

Participants believed privacy was maintained through remote self-testing. They avoided the need to visit a clinic or have to go to a healthcare consultation.

Once privacy concerns have been resolved and access to testing is made available, participants said they would test more often, or test once, if there was the possibility of them having to visit a sexual health clinic.

Participants were also alerted to other privacy concerns. These included sexual healthcare evidence, STI diagnosis evidence from their smartphones, online data security, treatment provision via the post and treatment provision via email.

Participants provided descriptions of the different risk management strategies they used and how the intervention could be designed to incorporate these suggestions. Others considered online data breach inevitable.

Participants expressed a mixed enthusiasm about the new technology. Some were skeptical of its accuracy, but others expressed confidence in conventional methods.

Some participants felt uncomfortable about the sexual health consultations. They were not able to anticipate their needs or receive positive results.

Online care and data security were two of the most important factors that increased self testing credibility.

But, as the STI self test device was not available or operating in the online care pathways at the time, the researchers had to rely upon the participants’ understanding of and engagement with a novel intervention, even though it was hypothetical.

Most participants felt that offering treatment to their partners was not an option. This could be due to the personal nature and abstract nature of this topic. Participants were asked imagine situations in which they might have to deal with infection.

Conclusion

This study has significant implications for policies, clinical practices, education, and research.

The study highlights the importance to provide interventions that are performed by healthcare professionals and nurses who can reach high-risk areas.

This study gave insight into the concerns of young people regarding STI. It also revealed their desire to keep their private information secure while still receiving support from a healthcare professional (in the case of a nurse).

Nurses can use the self testing device to improve their education and provide intervention tools for patients.

The device can be used by nurses to provide training on STI prevention and in removing stigmatization attitudes towards STI patients. (Cianelli et.al., 2011, p.3 and Norr et.al., 2012 p.73).

If nurses are taught how to use the self-testing tool, they will be able to better understand and manage their attitudes while using an efficient and non-threatening tool.

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