{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T20:33:23Z","timestamp":1776890003511,"version":"3.51.2"},"reference-count":24,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T00:00:00Z","timestamp":1619481600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"crossref","award":["RP-PG-0614-20009"],"award-info":[{"award-number":["RP-PG-0614-20009"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2021,3,12]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>1.5\u2009million people in the UK have mild to moderate learning disabilities. STIs and bloodborne viruses (BBVs) are over-represented in people experiencing broader health inequalities, which include those with mild learning disabilities. Self-managed care, including self-sampling for STIs\/BBVs, is increasingly commonplace, requiring agency and health literacy. To inform the development of a partner notification trial, we explored barriers and facilitators to correct use of an STI\/BBV self-sampling pack among people with mild learning disabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using purposive and convenience sampling we conducted four interviews and five gender-specific focus groups with 25 people (13 women, 12 men) with mild learning disabilities (July\u2013August 2018) in Scotland. We balanced deductive and inductive thematic analyses of audio transcripts to explore issues associated with barriers and facilitators to correct use of the pack.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All participants found at least one element of the pack challenging or impossible, but welcomed the opportunity to undertake sexual health screening without attending a clinic and welcomed the inclusion of condoms. Reported barriers to correct use included perceived overly complex STI\/BBV information and instructions, feeling overwhelmed and the manual dexterity required for blood sampling. Many women struggled interpreting anatomical diagrams depicting vulvovaginal self-swabbing. Facilitators included pre-existing STI\/BBV knowledge, familiarity with self-management, good social support and knowing that the service afforded privacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the first study to explore the usability of self-sampling packs for STI\/BBV in people with learning disabilities, participants found it challenging to use the pack. Limiting information to the minimum required to inform decision-making, \u2018easy read\u2019 formats, simple language, large font sizes and simpler diagrams could improve acceptability. However, some people will remain unable to engage with self-sampling at all. To avoid widening health inequalities, face-to-face options should continue to be provided for those unable or unwilling to engage with self-managed care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2020-054869","type":"journal-article","created":{"date-parts":[[2021,4,27]],"date-time":"2021-04-27T14:35:15Z","timestamp":1619534115000},"page":"276-281","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["How can we make self-sampling packs for sexually transmitted infections and bloodborne viruses more inclusive? A qualitative study with people with mild learning disabilities and low health literacy"],"prefix":"10.1136","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9933-6318","authenticated-orcid":false,"given":"Alan","family":"Middleton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Pothoulaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvina","family":"Woode Owusu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Flowers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Mapp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Vojt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Laidlaw","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5523-5630","authenticated-orcid":false,"given":"Claudia S","family":"Estcourt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,27]]},"reference":[{"key":"2024092104001708000_97.4.276.1","unstructured":"Nuffield Trust, Health Foundation, Kings Fund . 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Local action on health inequalities improving health literacy to reduce health inequalities, 2015. Available: http:\/\/www.healthliteracyplace.org.uk\/media\/1239\/hl-and-hi-ucl.pdf [Accessed 27 Jul 2020]."},{"key":"2024092104001708000_97.4.276.12","unstructured":"HM Government . Valuing People Now: a new three-year strategy for people with learning disabilities \u2018Making it happen for everyone\u2019 2019, 290565a 1p 2k January 09 (CWP) Produced by COI for the Department of Health. Available: https:\/\/webarchive.nationalarchives.gov.uk\/20130105064234\/http:\/\/www.dh.gov.uk\/prod_consum_dh\/groups\/dh_digitalassets\/documents\/digitalasset\/dh_093375.pdf [Accessed 27 Jul 2020]."},{"key":"2024092104001708000_97.4.276.13","unstructured":"Scottish Government . The keys to life, improving quality of life for people with learning disabilities\u201d Produced for the Scottish Government by APS Group Scotland DPPAS14362 (06\/13), 2013. 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