How can we make self-sampling packs for sexually transmitted infections and blood borne viruses more inclusive? A qualitative study with people with mild learning disabilities and low health literacy

摘要: Objectives1.5 million people in the UK have mild to moderate learning disabilities. Sexually transmitted infections (STIs) and blood borne viruses (BBVs) are over-represented experiencing broader health inequalities, which include those with Self-managed care, including self-sampling for STIs/BBVs, is increasingly commonplace, requiring agency literacy. To inform development of a partner notification trial, we explored barriers facilitators correct use an STI/BBV pack amongst MethodsUsing purposive convenience sampling conducted four interviews five gender-specific focus groups 25 (13 female, 12 male), disabilities (July-August 2018) Scotland. We balanced deductive inductive thematic analyses audio-transcripts explore issues associated pack. ResultsAll participants found at least one element challenging or impossible but welcomed opportunity undertake sexual screening without attending clinic inclusion condoms. Reported included perceived overly complex information instructions, feeling overwhelmed, manual dexterity required sampling. Many women struggled interpreting anatomical diagrams depicting vulvo-vaginal self-swabbing. Facilitators pre-existing knowledge, familiarity self-management, good social support, knowing that service afforded privacy. ConclusionIn first study usability packs disabilities, it Limiting minimum decision-making, "easy read" formats, simple language, large font sizes simpler could improve acceptability. However, some will remain unable engage all. avoid widening face-to-face options should continue be provided unwilling self-managed care. Key messagesO_LIPeople existing complex; many would not did feel able care C_LIO_LIMinimum "need know" information, very diagrams, formats specific needs C_LIO_LIAdoption other elements provision alternative models widen inequalities. C_LIO_LIFace-to-face need identifying limited literacy challenging. C_LI