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How online sexual health services could work; generating theory to support development

Research output: Contribution to journalArticlepeer-review

Paula Baraitser, Jonathan Syred, Vicki Spencer-Hughes, Chris Howroyd, Caroline Free, Gillian Holdsworth

Original languageEnglish
Article number540
JournalBMC Health Services Research
Accepted/In press30 Nov 2015
Published5 Dec 2015


  • art_3A10.1186_2Fs12913_015_1200_x

    art_3A10.1186_2Fs12913_015_1200_x.pdf, 1.25 MB, application/pdf

    Uploaded date:08 Jan 2016

    Version:Final published version

    Licence:CC BY

King's Authors


Background: Online sexual health services are an emerging area of service delivery. Theory of change critically analyses programmes by specifying planned inputs and articulating the causal pathways that link these to anticipated outcomes. It acknowledges the changing and contested nature of these relationships. Methods: We developed two versions of a theory of change for an online sexual health service. The first articulated the theory presented in the original programme proposal and the second documented its development in the early stages of implementation through interviews with key programme stakeholders. Results: The programme proposal described an autonomous and empowered user completing a sexual health check using a more convenient, accessible and discreet online service and a shift from clinic based to online care. The stakeholder interviews confirmed this and described new and more complex patterns of service use as the online service creates opportunities for providers to contact users outside of the traditional clinic visit and users move between online and clinic based care. They described new types of user/provider relationships which we categorised as: those influenced by an online retail culture; those influenced by health promotion outreach and surveillance and those acknowledging the need for supported access. Conclusions: This analysis of stakeholder views on the likely the impacts of online sexual health services suggests three areas for further thinking and research. 1. Co-development of clinic and online services to support complex patterns of service use.

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