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Dive into the research topics where Makeda Gerressu is active.

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Featured researches published by Makeda Gerressu.


Sexually Transmitted Infections | 2008

Are one-stop shops acceptable? Community perspectives on one-stop shop models of sexual health service provision in the UK

Catherine Griffiths; Makeda Gerressu; Rebecca S French

Objectives: Traditionally, genitourinary medicine (GUM) and contraceptive services have been provided separately. Providing these services on one site, as a one-stop shop, has been suggested as a way of improving access to care. There is little evidence about the acceptability of such an approach. We aimed to assess acceptability of different one-stop shop models (a young peoples, an all ages (mainstream) and a general practice service) of sexual health provision among different community groups. Methods: Between April and December 2005, 19 semi-structured interviews and 14 focus groups were conducted with young heterosexual men (n = 48), men who have sex with men (MSM; n = 46) and minority ethnic men and women (n = 28) across England. Results: Knowledge of one-stop shops was limited. The concept was acceptable to participants (except MSM), although there was variation as to the preferred model. Young men and African individuals described distrust of general practice confidentiality, preferring young peoples or mainstream models, respectively. South Asians associated stigma with GUM, preferring instead a general practice one-stop shop. Regardless of model, respondents expressed preference for one provider/one session to provide GUM and contraceptive care. Conclusion: In terms of acceptability there can be no blue print one-stop shop model. Local assessments should determine whether a one-stop shop would have public health benefit and if so how best one should be set up to maximise access. To accommodate client preference for one provider/session for their sexual health needs it may be that the development of “integrated training” for providers across clinical specialities is a more realistic way forward.


Sexually Transmitted Infections | 2006

One stop shop versus collaborative integration: what is the best way of delivering sexual health services?

Rebecca S French; Cm Coope; Anna Graham; Makeda Gerressu; Chris Salisbury; Judith Stephenson

Objectives: To examine various models of integrated and/or one stop shop (OSS) sexual health services (including general practice, mainstream specialist services, and designated young people’s services) and explore their relative strengths and weaknesses. Methods: Literature review and interviews with key informants involved in developing the National Strategy for Sexual Health and HIV (n = 11). Results: The paper focuses on five broad perspectives (logistics, public health, users, staff, and cost). Contraceptive and genitourinary medicine issues are closely related. However, there is no agreement about what is meant by having “integrated” services, about which services should be integrated, or where integration should happen. There are concerns that OSSs will result in over-centralisation, to the disadvantage of stand alone and satellite services. OSS models are potentially more user focused, but the stigma that surrounds sexual health services may create an access barrier. From staff perspectives, the advantages are greater career opportunities and increased responsibility, while the disadvantages are concern that OSSs will result in loss of expertise and professional status. Cost effectiveness data are contradictory. Conclusion: Although there is a policy commitment to look at how integrated services can be better developed, more evidence is required on the impact and appropriateness of this approach.


BMJ Open | 2015

The Men's Safer Sex (MenSS) trial: protocol for a pilot randomised controlled trial of an interactive digital intervention to increase condom use in men

Julia Bailey; Rosie Webster; Rachael Hunter; Nick Freemantle; Greta Rait; Susan Michie; Claudia Estcourt; Jane Anderson; Makeda Gerressu; Judith Stephenson; Chee Siang Ang; G Hart; Sacha Dhanjal; Elizabeth Murray

Introduction Sexually transmitted infections (STI) are a major public health problem. Condoms provide effective protection but there are many barriers to use. Face-to-face health promotion interventions are resource-intensive and show mixed results. Interactive digital interventions may provide a suitable alternative, allowing private access to personally tailored behaviour change support. We have developed an interactive digital intervention (the Mens Safer Sex (MenSS) website) which aims to increase condom use in men. We describe the protocol for a pilot trial to assess the feasibility of a full-scale randomised controlled trial of the MenSS website in addition to usual sexual health clinical care. Methods and analysis Participants: Men aged 16 or over who report female sexual partners and recent unprotected sex or suspected acute STI. Participants (N=166) will be enrolled using a tablet computer in clinic waiting rooms. All trial procedures will be online, that is, eligibility checks; study consent; trial registration; automated random allocation; and data submission. At baseline and at 3, 6 and 12 months, an online questionnaire will assess condom use, self-reported STI diagnoses, and mediators of condom use (eg, knowledge, intention). Reminders will be by email and mobile phone. The primary outcome is condom use, measured at 3 months. STI rates will be recorded from sexual health clinic medical records at 12 months. The feasibility of a cost-effectiveness analysis will be assessed, to calculate incremental cost per STI prevented (Chlamydia or Gonorrhoea), from the NHS perspective. Ethics and dissemination Ethical approval: City and East NHS Research Ethics Committee (reference number 13 LO 1801). Findings will be made available through publication in peer-reviewed journals, and to participants and members of the public via Twitter and from the University College London eHealth Unit website. Raw data will be made available on request. Trial registration number Current Controlled Trials. ISRCTN18649610. Registered 15 October 2013 http://www.controlled-trials.com/ISRCTN18649610.


Current Opinion in Infectious Diseases | 2008

Sexual behaviour in young people.

Makeda Gerressu; Judith Stephenson

Purpose of review The purpose of this review was to synthesize major research findings in relation to young people and sexual behaviour from the period 2006–2007. Recent findings We found several key reviews that advance knowledge in the field of young people and sexual behaviour, including observational studies, both qualitative and quantitative, and intervention studies designed to reduce sexual transmission of HIV in both developed and developing countries. Other reviews focused on same-sex behaviours, victimization within relationships, HIV infection/sexually transmitted infection in travellers, prevention of HIV/sexually transmitted infection and the determinants of sexual behaviour in young people. Summary Powerful and consistent forces sustain gender differences in sexual behaviour. The design of interventions to reduce sexual risk behaviour should take account of these forces that help explain young peoples sexual behaviour. Knowledge about the kind of interventions that reduce risk behaviour and should be implemented has improved, although the impact on health outcomes such as pregnancy and HIV/sexually transmitted infection is often uncertain. Effective school sex education needs to be part of much broader strategies to improve sexual health, and there is an urgent need for better evaluation of interventions, especially community interventions. Further longitudinal studies are needed to provide insight into the development of relationships and sexual behaviour as well as the course of acculturation.


Sexually Transmitted Infections | 2009

Sexually transmitted infection risk exposure among black and minority ethnic youth in northwest London: findings from a study translating a sexually transmitted infection risk-reduction intervention to the UK setting

Makeda Gerressu; Gillian Elam; Rochelle N. Shain; Chris Bonell; Gary Brook; Jane Dimmitt Champion; Rebecca S French; Jonathan Elford; Graham Hart; Judith Stephenson; John Imrie

Objectives: Young black women are disproportionately affected by sexually transmitted infections (STI) in the UK, but effective interventions to address this are lacking. The Young Brent Project explored the nature and context of sexual risk-taking in young people to inform the translation of an effective clinic-based STI reduction intervention (Project SAFE) from the USA to the UK. Methods: One-to-one in-depth interviews (n  =  37) and group discussions (n  =  10) were conducted among men and women aged 15–27 years from different ethnic backgrounds recruited from youth and genitourinary medicine clinic settings in Brent, London. The interviews explored the context within which STI-related risks were assessed, experienced and avoided, the skills needed to recognise risk and the barriers to behaviour change. Results: Concurrent sexual partnerships, mismatched perceptions and expectations, and barriers to condom use contributed to STI risk exposure and difficulties in implementing risk-reduction strategies. Women attempted to achieve monogamy, but experienced complex and fluid sexual relationships. Low risk awareness, flawed partner risk assessments, negative perceptions of condoms and lack of control hindered condom use. Whereas men made conscious decisions, women experienced persuasion, deceit and difficulty in requesting condom use, particularly with older partners. Conclusions: Knowledge of STI and condom use skills is not enough to equip young people with the means to reduce STI risk. Interventions with young women need to place greater emphasis on: entering and maintaining healthy relationships; awareness of risks attached to different forms of concurrency and how concurrency arises; skills to redress power imbalances and building self-esteem.


Sex Education | 2004

Sex and relationship education and the media: an analysis of national and regional newspaper coverage in England

P Kingori; Kaye Wellings; Rebecca S French; Ros Kane; Makeda Gerressu; Judith Stephenson

Newspapers are recognised as a major source of factual information. The media representation of issues related to teenage pregnancy is important to policy makers and those delivering related interventions. This is particularly so in relation to issues which may be seen as sensitive by the public, such as sex and relationship education (SRE). Despite general recognition of the importance of the media in communicating to the public, there is an absence of satisfactory tools with which to evaluate newspaper reports, particularly so in the field of SRE. In this paper we present a systematic examination of newspaper articles related to SRE from September 2000 to September 2002, in the national and regional press in England. Our analysis has highlighted some important distinctions between newspaper type, spokesperson and region. This paper concludes that a pro‐active strategy of directly contacting high circulation newspapers with a view to positively influencing the tone of relevant articles and reports would be of considerable benefit to those involved in SRE, teenage pregnancy and related interventions.


Translational behavioral medicine | 2016

Increasing condom use in heterosexual men: development of a theory-based interactive digital intervention.

Rosie Webster; Susan Michie; Claudia Estcourt; Makeda Gerressu; Julia Bailey

Increasing condom use to prevent sexually transmitted infections is a key public health goal. Interventions are more likely to be effective if they are theory- and evidence-based. The Behaviour Change Wheel (BCW) provides a framework for intervention development. To provide an example of how the BCW was used to develop an intervention to increase condom use in heterosexual men (the MenSS website), the steps of the BCW intervention development process were followed, incorporating evidence from the research literature and views of experts and the target population. Capability (e.g. knowledge) and motivation (e.g. beliefs about pleasure) were identified as important targets of the intervention. We devised ways to address each intervention target, including selecting interactive features and behaviour change techniques. The BCW provides a useful framework for integrating sources of evidence to inform intervention content and deciding which influences on behaviour to target.


JMIR Research Protocols | 2015

Defining the Content of an Online Sexual Health Intervention: The MenSS Website

Rosie Webster; Makeda Gerressu; Susan Michie; Claudia Estcourt; Jane Anderson; Chee Siang Ang; Elizabeth Murray; Greta Rait; Judith Stephenson; Julia Bailey

Background Health promotion and risk reduction are essential components of sexual health care. However, it can be difficult to prioritize these within busy clinical services. Digital interventions may provide a new method for supporting these. Objective The MenSS (Men’s Safer Sex) website is an interactive digital intervention developed by a multidisciplinary team, which aims to improve condom use in men who have sex with women (MSW). This paper describes the content of this intervention, and the rationale for it. Methods Content was informed by a literature review regarding men’s barriers to condom use, workshops with experts in sexual health and technology (N=16) and interviews with men in sexual health clinics (N=20). Data from these sources were analyzed thematically, and synthesized using the Behavior Change Wheel framework. Results The MenSS intervention is a website optimized for delivery via tablet computer within a clinic waiting room setting. Key targets identified were condom use skills, beliefs about pleasure and knowledge about risk. Content was developed using behavior change techniques, and interactive website features provided feedback tailored for individual users. Conclusions This paper provides a detailed description of an evidence-based interactive digital intervention for sexual health, including how behavior change techniques were translated into practice within the design of the MenSS website. Triangulation between a targeted literature review, expert workshops, and interviews with men ensured that a range of potential influences on condom use were captured.


Journal of Public Health | 2012

The importance of distinguishing between black Caribbeans and Africans in understanding sexual risk and care-seeking behaviours for sexually transmitted infections: evidence from a large survey of people attending genitourinary medicine clinics in England

Makeda Gerressu; Catherine H Mercer; Jackie Cassell; Gary Brook; S. Dave

BACKGROUND In the UK, black Caribbean and African populations experience disproportionately high rates of sexually transmitted infections (STIs) and HIV. Often studies do not differentiate between these populations notwithstanding differences in STI epidemiology and sociodemographics. METHODS Patterns of care-seeking behaviour for STIs were explored separately for black Caribbean (n = 345), black African (n = 193) and white people through a cross-sectional survey of 2824 people attending five genitourinary medicine (GUM) clinics in England. RESULTS Black Caribbean men were least likely to use, or try to use, their general practice surgery prior to GUM clinic attendance (16.6%). Symptomatic black Caribbean and African men were least likely to delay seeking care (30.8 and 26.3%, respectively). Symptomatic black Caribbean men faced the least provider delay in accessing care (27.3%). Black Caribbean men and women were most likely, and black African men and women least likely, to be diagnosed with an STI (49.7 and 32.0% versus 26.8 and 16.3%, respectively). Among symptomatic women, black Caribbeans and, among symptomatic men, black Africans were most likely to report abstaining from sex (46.3 and 73.1%, respectively). CONCLUSIONS Our analyses highlight the importance of distinguishing between black ethnic groups and the need for future studies to ensure sufficiently large samples to permit such analyses.


Digital Health , 2 pp. 1-12. (2016) | 2016

The Men’s Safer Sex Trial: A feasibility randomised controlled trial of an interactive digital intervention to increase condom use in men:

Julia Bailey; Rosie Webster; Mark Griffin; Nick Freemantle; Rachael Hunter; Greta Rait; Claudia Estcourt; Jane Anderson; Makeda Gerressu; Judith Stephenson; Susan Michie; Elizabeth Murray

Objectives We aimed to determine the feasibility of an online randomised controlled trial (RCT) of the Men’s Safer Sex website, measuring condom use and sexually transmitted infection (STI). Methods For this study 159 men aged ≥16 with female sexual partners and recent condomless sex or suspected STI were recruited from three UK sexual health clinics. Participants were randomised to the intervention website plus usual clinic care (n = 84), or usual clinic care only (n = 75). Online outcome data were solicited at 3, 6, and 12 months. Results Men were enrolled via tablet computers in clinic waiting rooms. Software errors and clinic Wi-Fi access presented significant challenges, and online questionnaire response rates were poor (36% at 3 months with a £10 voucher; 50% at 12 months with £30). Clinical records (for STI diagnoses) were located for 94% of participants. Some 37% of the intervention group did not see the intervention website (n = 31/84), and (as expected) there was no detectable difference in condomless sex with female partners (IRR = 1.01, 95% CI 0.52 to 1.96). New acute STI diagnoses were recorded for 8.8% (7/80) of the intervention group, and 13.0% (9/69) of the control group over 12 months (IRR = 0.75, 95% CI 0.29 to 1.90). Conclusion It is likely to be feasible to conduct a future large-scale RCT to assess the impact of an online intervention using clinic STI diagnoses as a primary outcome. However, practical and technical challenges need to be addressed before the potential of digital media interventions can be realised in sexual health settings. Trial registration number: ISRCTN18649610

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Claudia Estcourt

Glasgow Caledonian University

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Rosie Webster

University College London

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Susan Michie

University College London

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