Sam Miles
I am a social scientist with an interest in mobile digital technologies and how these technologies impact, enhance or impair social and sexual practices.
I am a Reader in Medical Sociology at Queen Mary University of London. I teach Medical degree students, the intercalated BSc and MSc in Medical Education.
In my previous post as an Assistant Professor in Social Sciences at London School of Hygiene & Tropical Medicine, I researched sexual and reproductive health & rights (SRHR) in settings around the world, with an emphasis on digital lives and wellbeing. Before this, my focus as a Research Fellow at LSHTM included patient-public involvement in health, transitions from child to adult health services for young people with chronic illness, and family planning and sexual health.
My ESRC-funded PhD at Queen Mary, University of London brought together work in digital space and queer theory to map possibilities for locative media on queer space-making practices in the city.
You can find my LSHTM staff profile at www.lshtm.ac.uk/aboutus/people/miles.sam, my ResearchGate profile at www.researchgate.net/profile/Sam_Miles4, and my blog at www.sexualityandthecityblog.wordpress.com. My twitter handle is @SamMiles87.
Address: London
I am a Reader in Medical Sociology at Queen Mary University of London. I teach Medical degree students, the intercalated BSc and MSc in Medical Education.
In my previous post as an Assistant Professor in Social Sciences at London School of Hygiene & Tropical Medicine, I researched sexual and reproductive health & rights (SRHR) in settings around the world, with an emphasis on digital lives and wellbeing. Before this, my focus as a Research Fellow at LSHTM included patient-public involvement in health, transitions from child to adult health services for young people with chronic illness, and family planning and sexual health.
My ESRC-funded PhD at Queen Mary, University of London brought together work in digital space and queer theory to map possibilities for locative media on queer space-making practices in the city.
You can find my LSHTM staff profile at www.lshtm.ac.uk/aboutus/people/miles.sam, my ResearchGate profile at www.researchgate.net/profile/Sam_Miles4, and my blog at www.sexualityandthecityblog.wordpress.com. My twitter handle is @SamMiles87.
Address: London
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Many people refuse vaccination and it is important to understand why. Here we explore the experiences of individuals from Gypsy, Roma, and Traveller groups in England to understand how and why they decided to take up or to avoid COVID-19 vaccinations.
Methods
We used a participatory, qualitative design, including wide consultations, in-depth interviews with 45 individuals from Gypsy, Roma, and Traveller, communities (32 female, 13 male), dialogue sessions, and observations, in five locations across England between October 2021 and February 2022.
Findings
Vaccination decisions overall were affected by distrust of health services and government, which stemmed from prior discrimination and barriers to healthcare which persisted or worsened during the pandemic. We found the situation was not adequately characterised by the standard concept of “vaccine hesitancy”. Most participants had received at least one COVID-19 vaccine dose, usually motivated by concerns for their own and others’ health. However, many participants felt coerced into vaccination by medical professionals, employers, and government messaging. Some worried about vaccine safety, for example possible impacts on fertility. Their concerns were inadequately addressed or even dismissed by healthcare staff.
Interpretation
A standard "vaccine hesitancy" model is of limited use in understanding vaccine uptake in these populations, where authorities and health services have been experienced as untrustworthy in the past (with little improvement during the pandemic). Providing more information may improve vaccine uptake somewhat; however, improved trustworthiness of health services for GRT communities is essential to increase vaccine coverage.
Keywords
Vaccination; COVID-19; Gypsy; Roma; Traveller; Discrimination; Qualitative; England; Vaccine hesitancy; Trust; Trustworthiness; Inequality; Inequity
commissioned the Dialogue, Evidence, Participation, and Translation for Health (DEPTH) research group to explore the impact of COVID-19 in Gypsy, Roma and Traveller communities, and among migrant workers. We undertook participatory qualitative research with members of these communities to co-produce insights into COVID-19 and public health responses, particularly focusing on testing, contact tracing, and vaccination.
Methods We searched for and synthesised clinical and programmatic guidelines for the provision of cervical screening for transmasculine patients.
Findings The guidelines offer recommendations addressing: (1) reception, check-in and clinic facilities; (2) patient data and invitation to screening; (3) improving inclusion in screening programmes; and (4) sexual history taking, language and identity. Guidelines offer strategies for alleviating physical and psychological discomfort during cervical screening and recommendations on what to do if the screening procedure cannot be completed. Most of the guidelines were from and for high-income countries.
Discussion The evidence base is limited, but existing guidelines provide recommendations to ensure life-saving screening services are available to all who need them. We were only able to identify one set of guidelines for a middle-income country, and none for low-income countries. We encourage the involvement of transmasculine people in the development of future guidelines.
Objective:
This study aimed to explore whether and how participation in a self-help group intervention affected vulnerable young mothers’ experiences and perceptions of mental health stressors.
Methods:
Self-help groups received 12 participatory sessions over 6 months. Eighteen semi-structured interviews and three focus group discussions were held with participants and drop-outs. Before and after the intervention, participants completed the locally validated 14-item Shona Symptom Questionnaire tool to indicate the probable prevalence of common mental health disorders.
Results:
Adolescent girls described mutually reinforcing stressors in their lives and reported low self-esteem and anxiety. Key themes emerging from qualitative data centred around girls’ struggles with adverse life events, the burden of new motherhood, social isolation related to sex work and self-help groups as a source of hope. Participants joined groups to obtain support and felt their mental well-being improved due to new social networks, feelings of solidarity with peers, and increased confidence for positive action, that is, seeking health services for themselves and their babies. Prior to enrolment 16% showed signs of possible common mental disorders falling to 2% at follow-up.
Conclusions:
Participants believed involvement in interactive self-help groups improved their mental health by strengthening peer support and engendering hope for the future. Although reduced mental distress cannot be attributed to the programme, the pilot intervention offers a low-cost approach that could be rigorously tested and adapted to a wide range of community settings.
Methods: We conducted a co-produced longitudinal qualitative study, including 80 interviews in 2016-2017 with young people with SCD aged 13-21 (mean age 16.6) across two cities in England. We recruited 48 participants (30 female, 18 male): 27 interviews were one-off, and 53 were repeated 2-3 times over approximately 18 months. We used an inductive analytical approach, combining elements of Grounded Theory and thematic analysis.
Results: Participants reported significant problems with the care they received in A&E during painful episodes, and in hospital wards as inpatients during unplanned healthcare. They experienced delays in being given pain relief and their basic care needs were not always met. Participants said that non-specialist healthcare staff did not seem to know enough about SCD and when they tried to work with staff to improve care, staff often seemed not prepared to listen to them or act on what they said. Participants said they felt out of place in adult wards and uncomfortable with the differences in adult compared with paediatric wards. Because of their experiences, they tried to avoid being admitted to hospital, attempting to manage their painful episodes at home and accessing unplanned hospital care only as a last resort. By contrast, they did not report having problems within SCD specialist services during planned, routine care.
Conclusions: Our study underscores the need for improvements to make services youth-friendly and youth-responsive, including training staff in SCD-specific care, compassionate care and communication skills that will help them elicit and act on young people's voices to ensure they are involved in shaping their own healthcare. If young people are prevented from using transition skills (self-management, self-advocacy), or treated by staff who they worry do not have enough medical competency in their condition, they may well lose their trust in services, potentially compromising their own health.
Many people refuse vaccination and it is important to understand why. Here we explore the experiences of individuals from Gypsy, Roma, and Traveller groups in England to understand how and why they decided to take up or to avoid COVID-19 vaccinations.
Methods
We used a participatory, qualitative design, including wide consultations, in-depth interviews with 45 individuals from Gypsy, Roma, and Traveller, communities (32 female, 13 male), dialogue sessions, and observations, in five locations across England between October 2021 and February 2022.
Findings
Vaccination decisions overall were affected by distrust of health services and government, which stemmed from prior discrimination and barriers to healthcare which persisted or worsened during the pandemic. We found the situation was not adequately characterised by the standard concept of “vaccine hesitancy”. Most participants had received at least one COVID-19 vaccine dose, usually motivated by concerns for their own and others’ health. However, many participants felt coerced into vaccination by medical professionals, employers, and government messaging. Some worried about vaccine safety, for example possible impacts on fertility. Their concerns were inadequately addressed or even dismissed by healthcare staff.
Interpretation
A standard "vaccine hesitancy" model is of limited use in understanding vaccine uptake in these populations, where authorities and health services have been experienced as untrustworthy in the past (with little improvement during the pandemic). Providing more information may improve vaccine uptake somewhat; however, improved trustworthiness of health services for GRT communities is essential to increase vaccine coverage.
Keywords
Vaccination; COVID-19; Gypsy; Roma; Traveller; Discrimination; Qualitative; England; Vaccine hesitancy; Trust; Trustworthiness; Inequality; Inequity
commissioned the Dialogue, Evidence, Participation, and Translation for Health (DEPTH) research group to explore the impact of COVID-19 in Gypsy, Roma and Traveller communities, and among migrant workers. We undertook participatory qualitative research with members of these communities to co-produce insights into COVID-19 and public health responses, particularly focusing on testing, contact tracing, and vaccination.
Methods We searched for and synthesised clinical and programmatic guidelines for the provision of cervical screening for transmasculine patients.
Findings The guidelines offer recommendations addressing: (1) reception, check-in and clinic facilities; (2) patient data and invitation to screening; (3) improving inclusion in screening programmes; and (4) sexual history taking, language and identity. Guidelines offer strategies for alleviating physical and psychological discomfort during cervical screening and recommendations on what to do if the screening procedure cannot be completed. Most of the guidelines were from and for high-income countries.
Discussion The evidence base is limited, but existing guidelines provide recommendations to ensure life-saving screening services are available to all who need them. We were only able to identify one set of guidelines for a middle-income country, and none for low-income countries. We encourage the involvement of transmasculine people in the development of future guidelines.
Objective:
This study aimed to explore whether and how participation in a self-help group intervention affected vulnerable young mothers’ experiences and perceptions of mental health stressors.
Methods:
Self-help groups received 12 participatory sessions over 6 months. Eighteen semi-structured interviews and three focus group discussions were held with participants and drop-outs. Before and after the intervention, participants completed the locally validated 14-item Shona Symptom Questionnaire tool to indicate the probable prevalence of common mental health disorders.
Results:
Adolescent girls described mutually reinforcing stressors in their lives and reported low self-esteem and anxiety. Key themes emerging from qualitative data centred around girls’ struggles with adverse life events, the burden of new motherhood, social isolation related to sex work and self-help groups as a source of hope. Participants joined groups to obtain support and felt their mental well-being improved due to new social networks, feelings of solidarity with peers, and increased confidence for positive action, that is, seeking health services for themselves and their babies. Prior to enrolment 16% showed signs of possible common mental disorders falling to 2% at follow-up.
Conclusions:
Participants believed involvement in interactive self-help groups improved their mental health by strengthening peer support and engendering hope for the future. Although reduced mental distress cannot be attributed to the programme, the pilot intervention offers a low-cost approach that could be rigorously tested and adapted to a wide range of community settings.
Methods: We conducted a co-produced longitudinal qualitative study, including 80 interviews in 2016-2017 with young people with SCD aged 13-21 (mean age 16.6) across two cities in England. We recruited 48 participants (30 female, 18 male): 27 interviews were one-off, and 53 were repeated 2-3 times over approximately 18 months. We used an inductive analytical approach, combining elements of Grounded Theory and thematic analysis.
Results: Participants reported significant problems with the care they received in A&E during painful episodes, and in hospital wards as inpatients during unplanned healthcare. They experienced delays in being given pain relief and their basic care needs were not always met. Participants said that non-specialist healthcare staff did not seem to know enough about SCD and when they tried to work with staff to improve care, staff often seemed not prepared to listen to them or act on what they said. Participants said they felt out of place in adult wards and uncomfortable with the differences in adult compared with paediatric wards. Because of their experiences, they tried to avoid being admitted to hospital, attempting to manage their painful episodes at home and accessing unplanned hospital care only as a last resort. By contrast, they did not report having problems within SCD specialist services during planned, routine care.
Conclusions: Our study underscores the need for improvements to make services youth-friendly and youth-responsive, including training staff in SCD-specific care, compassionate care and communication skills that will help them elicit and act on young people's voices to ensure they are involved in shaping their own healthcare. If young people are prevented from using transition skills (self-management, self-advocacy), or treated by staff who they worry do not have enough medical competency in their condition, they may well lose their trust in services, potentially compromising their own health.
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