Program theory, that is, the specific idea about how a program causes the intended or observed outcomes, should be the central aspect of any realist evaluation or synthesis. The methods used for explicating or building initial rough program theories (IRPTs) in realist research are varied and arguably often underreported. In addition, preexisting psychological and sociological theories, at a higher level of abstraction, could be used to a greater extent to inform their development. This article illustrates a method for building IRPTs for use in realist research evaluation and synthesis. This illustration involves showing how the IRPTs were developed in a realist evaluation concerning sexual health services for young people. In this evaluation, a broad framework of abstract theories was constructed early in the process to support IRPT building and frame more specific program theories as they were developed. These abstract theories were selected to support theorizing at macro-, meso-, and microlevels of social structure. This article discusses the benefits of using this method to build initial theories for particular types of interventions that are large, complex, and messy. It also addresses challenges relating to the selection of suitable theories.Keywords realist, program theory, sexual health, young people, middle-range theory, adolescents, organizational change, conceptual framework What Is Already Known?Methods for developing initial theories in realist research are varied and underreported. Additionally, existing abstract theories are often used to substantiate rather than inform program theory development. What This Paper Adds?This paper provides an account of program theory development in a realist evaluation of positive comprehensive youth sexual health services. It offers a rationale for early development of a framework of abstract theories to improve coherence, quality, and transparency in realist research and a set of criteria for selecting abstract theories.

This document is the author deposited version. You are advised to consult the publisher's version if you wish to cite from it. HIRST, J. (2004). Researching young people's sexuality and learning about sex: experience, need, and sex and relationship education. Culture, health and sexuality, 6 (2), 115-129. This paper describes findings from an in-depth case study of young people's sexuality and learning about sex. Focus groups and unstructured interviews were conducted with young women and young men aged 15-16 years in a school in the north of England. Analysis focused on disjunctions between reported sexual behaviour in a park and in a bedsitting room, and the content of school sex and relationship education. Tensions between the accounts are considered for their impact on learning about sex, sexual negotiation, subjectivity and inter-generational understanding. Despite some negative experiences in sex education, the young people interviewed desired the affirmation and support of adults, and recommend sex and relationship education as the most appropriate vehicle for providing this. The value added outcomes of participation in the study, including consciousness and awareness raising, and the opportunity for reflection and debate and selves as 'experts', enhanced young people's view that non-judgemental and meaningful advice and guidance are possible in formal learning contexts. Implications for future forms of sex and relationship education are discussed. Published version Copyright and re-use policy

How to obtain copies of this and other HTA programme reports An electronic version of this title, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable DVD is also available (see below).Printed copies of HTA journal series issues cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our despatch agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per issue and for the rest of the world £3 per issue. How to order:-fax (with credit card details) -post (with credit card details or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you to either print out your order or download a blank order form. Contact details are as follows:Synergie UK (HTA Department) Digital House, The Loddon Centre Wade Road Basingstoke Hants RG24 8QW Email: orders@hta.ac.uk Tel: 0845 812 4000 -ask for 'HTA Payment Services' (out-of-hours answer-phone service) Fax: 0845 812 4001 -put 'HTA Order' on the fax header Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to University of Southampton and drawn on a bank with a UK address. Paying by credit cardYou can order using your credit card by phone, fax or post. SubscriptionsNHS libraries can subscribe free of charge. Public libraries can subscribe at a reduced cost of £100 for each volume (normally comprising 40-50 titles). The commercial subscription rate is £400 per volume (addresses within the UK) and £600 per volume (addresses outside the UK). Please see our website for details. Subscriptions can be purchased only for the current or forthcoming volume. How do I get a copy of HTA on DVD?Please use the form on the HTA website (www.hta.ac.uk/htacd/index.shtml). HTA on DVD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA School NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of ...

No abstract

Pleasure as a component of sexualities and relationships education has been much rehearsed recently. Arguably, theoretical debate and critique been more prominent than practitioner perspectives on how to persuade stakeholders of the value of implementing pleasure into learning about sexualities and relationships. This paper offers a rationale for positive SRE that includes pleasure. A series of theoretically and empirically supported suggestions are offered to encourage curriculum gatekeepers that SRE premised on a right to pleasure is warranted because of its potential to achieve safer sexual health outcomes and contribute to gender equality. Challenges faced by some sex educators are acknowledged by historicising the often uneasy associations between sexuality, education and youth in relation to some political and academic dimensions of debate, before offering a rationale on ways forward. Analysis focuses on young women. Policy developments relate to the UK but issues raised have relevance for SRE in other contexts.

Fathers in the UK are becoming more involved in the care of their infants and children. A constructivist grounded theory approach was adopted to explore men’s transition to fatherhood. This paper reports on one of the sub-categories derived from the data. First-time fathers with a child under two were recruited predominantly via social media. Audio-recorded semi-structured interviews were undertaken with an opening question asking men to tell their story of becoming a father. Interviews were transcribed and analysed using constructivist grounded theory methods. This paper reports one core aspect of the research findings which has particular relevance for healthcare professionals. The men in this study were highly appreciative of the care their partner and baby received but consistently reported a lack of father-specific support throughout their journey to fatherhood. This ranged from generally poor communication with healthcare professionals to being ignored and side-lined in maternity settings where they continued to be treated as visitors before, during and after the birth of their baby. Despite similar findings being reported over the last 30 to 40 years and policy directives emphasising the importance of working with fathers, change within healthcare services remains slow. Currently, fathers’ needs are not being adequately met by perinatal services.

This article offers an empirically grounded contribution to scholarship exploring the ways in which pleasure is 'put to work' in sex and sexuality education. Such research has cautioned against framing pleasure as a normative requirement of sexual activity and hence reproducing a 'pleasure imperative'. This paper draws on interviews with sexual health and education practitioners who engaged with Pleasure Project resources and training between 2007 and 2016. Findings suggest that practitioners tend to understand pleasure within critical frameworks that allow them to avoid normalising and (re)enforcing a pleasure imperative. Accounts also show negotiations with, and strategic deployments of, values surrounding sexual pleasure in society and culture. While some accounts suggest that a pleasure imperative does run the risk of being reproduced by practitioners, notably this is when discussing more 'contentious' sexual practices. Interviews also demonstrate that practitioners attempting to implement a pleasure agenda are faced with a range of challenges. While some positive, holistic, and inclusive practice has been afforded by a pleasure approach, we argue that the importance of a critical framework needs to be (re)emphasised. The paper concludes by highlighting areas for further empirical research.

This document is the author deposited version. You are advised to consult the publisher's version if you wish to cite from it. Published versionFORMBY, E., HIRST, J., OWEN, J., HAYTER, M. and STAPLETON, H. (2010). 'Selling it as a holistic health provision and not just about condoms ?' Sexual health services in school settings: current models and their relationship with sex and relationships education policy and provision. Sex education, 10 (4), 423-435. In this article we discuss the findings from a recent study of UK policy and practice in relation to sexual health services for young people, based in -or closely linked withschools. This study formed part of a larger project, completed in 2009, which also included a systematic review of international research. The findings discussed in this paper are based on analyses of interviews with 51 service managers and questionnaire returns from 205 school nurses. Four themes are discussed. First, we found three main service permutations, in a context of very diverse and uneven implementation. Second, we identified factors within the school context that shaped and often constrained service provision; some of these also have implications for SRE. Third, we found contrasting approaches to the relationship between SRE input and sexual health provision. Fourth, we identified some specific barriers that need to be addressed in order to develop "young people friendly" services in the school context. The relative autonomy available to school head teachers and governors can represent an obstacle to service provision -and interprofessional collaboration -in a climate where, in many schools, there is still considerable ambivalence about discussing "sex" openly. In conclusion, we identify areas worthy of further research and development, in order to address some obstacles to sexual health service and SRE provision in schools. Copyright and re-use policy