Identifying Solutions to Improve the Sexually Transmitted Infections Testing Experience for Youth Through Participatory Ideation

Abstract

Sexually transmitted infection (STI) services, including screening, treatment, and counseling among youth, remain suboptimal. In the midst of increasing incidence of bacterial STIs, alarming STI disparities, and persistently low testing rates among youth, solution-focused and action-oriented research with youth is needed. To identify solutions to STI testing barriers, we conducted three participatory ideation workshops with 18 youth, 10 key stakeholders who work with youth, and 8 social design graduate students. In response to prompt questions asking "How might we" address a testing barrier, participants generated as many ideas as they could on small pieces of paper. The brainstorming sessions produced 702 brainstorm idea sheets that were then qualitatively analyzed through pile sorting by three team members (including two youth) with each pile representing a priori themes (from the "How might we" probe) or emergent themes. Ten themes were identified corresponding to three domains: (1) improving the testing experience (improving transparency in the testing process, increasing trust in privacy, alternative testing options, and providing incentives/rewards for testing), (2) addressing the clinic space (multi-service spaces, appealing physical clinical space, and providing waiting room activities), and (3) reframing STI testing (normalizing STI testing, the clinic as a supportive environment, and youth leadership to promote and support STI testing). These findings move beyond identifying barriers and motivators to STI testing among youth and focus on the generation of possible solutions. By engaging youth in the development of solutions to STI testing, solutions that may be better-utilized and more acceptable to youth may be developed.

Recent trends in sexually transmitted infections among adolescents, Catalonia, Spain, 2012–2017

“…[21][22][23] The reported rates of CT infection and gonorrhoea cases in adolescents in our setting are below the European average, 15,16 reflecting not only the lack of an opportunistic or systematic screening programme for CT but also the barriers faced by adolescents seeking medical care. 24 Further studies are needed to investigate this in our setting. Although these three STIs have been nationally notifiable conditions since 2007, the implementation of electronic medical reporting in 2011 and electronic integration of SNM and MDO systems in 2014 have improved the under-reporting of cases to Catalan Mandatory Notifiable System.…”

Participatory approaches to delivering clinical sexually transmitted infections services: a narrative review

“…[30][31][32][33] Participatory methods have been shown to effectively elucidate key issues around STIs that are pertinent to communities related to the planning of clinical STIs services delivery. 17,35,36 For example, a study in the United States adopted a series of participatory ideation workshops with youth and other key stakeholders in STIs services. 35 The researchers found that such an approach led to identifying themes beyond general barriers and motivators to STIs testing and included relevant solutions as well.…”

“…17,35,36 For example, a study in the United States adopted a series of participatory ideation workshops with youth and other key stakeholders in STIs services. 35 The researchers found that such an approach led to identifying themes beyond general barriers and motivators to STIs testing and included relevant solutions as well. The same team also adopted creative visual mapping approaches to better understand the youth's experiences in clinical STIs services uptake, which helped to identify issues and solutions informed by their lived experiences of utilising such clinical STIs services.…”

“…70,71 Furthermore, a decline in the use of traditional social spaces (such as pubs and clubs) and the widespread use of online spaces for anonymity among key populations presents some challenges for existing traditional engagement methods such as community open forums. 35…”

Situated Vulnerabilities, Sexual Risk, and Sexually Transmitted Infections' Diagnoses in a Sample of Transgender Youth in the United States

“…1 Recent research has aimed to increase rates of STI testing among youth. 2 However, to our knowledge, no national data exist to characterize STIs 3 in transgender and other gender minority youth (TGMY) who have a gender identity that differs from their sex assigned at birth. This is because TGMY are not routinely ''counted'' in STI surveillance systems using a methodology that allows for disaggregation of results by gender identity.…”