Improving the sexual health of homeless young people resident in hostels
This report traces the journey taken by the author during the second year of her full time PhD programme. The PhD study aims to improve the sexual health of homeless young people who are resident in hostel accommodation. The second year has been undertaken and completed as a result of the award of a Florence Nightingale Research Scholarship 2015/2016.
The report has been structured around the objectives set for the year. The main objectives were to
- Refine the literature review and prepare it for a stand-alone publication
- Complete the confirmation process for transfer PhD level study
- Finalise the philosophical approach to the study
- Ongoing review and examination of the ethical approval process
- Carry out fieldwork
Reflections have been conducted throughout which has assisted the reflexivity used in the overall research approach and process. The project was developed from the premise that little is known about the sexual health of young people who are homeless and resident in hostels. They are a vulnerable group, many of whom are in transition from the care system (Chatrick 2009), have a history of previous abuse (Ensign 2001), and require support to make the shift to adulthood and independent living (Barnardo’s 2014). Young people have the highest rates of sexually transmitted infections and unplanned pregnancy compared to any other group (British Association of Sexual Health and HIV 2014). Overall, long term general health outcomes and life expectancy for homeless people are poor (Homeless Link 2014).
The study to improve the sexual health of this population will ultimately develop a model of sexual health care through examination of the knowledge and attitudes concerning sexual health through their lived experiences.
Literature review
The literature review took a systematic approach in order to ensure it was as reproducible and valid. Five studies fulfilled the set criteria, and these were analysed using the CASP and MATT tools for quality. These studies were conducted in the USA, Canada and Australia only. No relevant studies were found from the UK. Papers were thematically analysed. Four recurring themes (which also included sub-themes) were identified:
The review concluded that there is a lack of tested models of care or policy which could address the particular needs of this vulnerable group
Philosophical approach
A qualitative methodology is used for the study, which necessitates a deep rich examination of the lives and perceptions of the study population together with identification of the researcher location. The study is being undertaken through the use of an ethnographic case study. It requires immersion in the study setting using a constructivist theoretical model.
Confirmation process.
The confirmation process was undertaken at the beginning of the scholarship year and resulted in an upgrade to PhD level. Recommendations for the ongoing project were given for the continuing development of the methodology, literature review, tools for analysis, and skills for conducing fieldwork.
Ethical process
The ethics process application, amendments, audit and ongoing examination of ethics principles throughout the duration of the project is highlighted and reflected upon.
Fieldwork
Fieldwork was undertaken over a period of five months and has been completed. It included 34 one to one interviews and reflections, and 19 site visits to settings where observational data was collected. The observations focussed on the settings and interactions therein, and on residents meetings within the settings. The cycle of reflection, reflexivity, feedback and further improvements has been examined and suggestions made for future practise. Reflections on fieldwork included experiences of disclosures and the safeguarding processes that this required, along with the management of feelings and concerns. Recommendations for research and clinical practice have been made.
Study analysis
The collected data has been prepared for analysis which will take place during the next academic year. It will use Vivo 10 software programme supplemented by traditional hand analysis for themes.
Study dissemination
Dissemination of the study to date has been commenced. This includes three poster presentations at conferences (local, national and international), one abstract submission for presentation at conference and one paper prepared for submission to academic journal. Further dissemination will take place as the project progresses and at completion.
Abstract conclusion
The report concludes by suggesting recommendations for practice and care based on the project undertaken so far. The outcomes of the study year are stated, and thanks given for the opportunity provided by the Florence Nightingale Foundation Research Scholarship for enabling this year’s work to be completed. Finally, plans for the full completion of the third year study and ultimate completion of the PhD are given.