Co-creating inclusive sexual health services for middle-aged and older adults, including disabled people, in England: an innovative participatory approach within the field of sexual health.
Conyers H, Sakuma Y, et al. • Sexual health • 2025
Co-creation is crucial for inclusive health services, but underexplored in sexual health research involving middle-aged, older and disabled individuals, and this study emphasises shared ownership which enables the offering of practical guidance for researchers and healthcare professionals.
Key Findings
Results
Co-creation activities were found to be well-accepted and highly valuable means to engage middle-aged and older adults in sexual health research.
Study conducted in England during April and May 2023
Methods included co-creation workshops and one-to-one interviews
Evaluation was based on community facilitators' reflections on their experience and the success of the workshops
The research team partnered with active community leaders with lived experience to co-design and co-organise sessions
Results
Three key strengths of the co-creation approach were identified in engaging middle-aged and older adults in sexual health service development.
First strength identified was shared informed decision-making among participants
Second strength was co-leadership for conducting the research activities
Third strength was the importance of co-facilitation in conducting sessions
Discussion topics were developed iteratively, centred on participant input, to ensure sessions were accessible and appropriate
Results
Four key challenges were identified in implementing co-creation for sexual health research with middle-aged, older, and disabled adults.
First challenge was ensuring the venue and information is accessible to all participants, including disabled people
Second challenge was recruitment of middle-aged and older adults for a stigmatised research topic
Third challenge was needing more time for co-creation sessions to ensure equal opportunity to contribute
Fourth challenge was integrating co-creation into existing community activities
Background
Middle-aged and older adults, including disabled people, are rarely engaged in helping to develop sexual health services to meet their needs.
This gap in engagement was identified as the primary motivation for the study
Co-creation was described as 'a promising participatory strategy' to address this gap
The study targeted the development of more inclusive sexual health services in England
The research is described as underexplored in sexual health research involving middle-aged, older and disabled individuals
Methods
The co-creation methodology emphasised shared ownership of the research process between researchers and community participants.
Community leaders with lived experience were recruited to co-design and co-organise sessions
The approach involved iterative development of discussion topics centred on participant input
Sessions were designed to be accessible and appropriate for the focus population
The study provides 'practical guidance for researchers and healthcare professionals' as an outcome of this approach
What This Means
This research suggests that older adults and disabled people are largely left out of the process of designing sexual health services, even though they have important needs and valuable perspectives to contribute. Researchers in England tested a 'co-creation' approach — where community members with lived experience work alongside researchers as partners, not just subjects — through workshops and interviews conducted in spring 2023. Community leaders helped plan and run the sessions, and discussion topics were shaped by participant input throughout the process.
The study found that this co-creation approach was well-received and identified three main strengths: participants were involved in shared decision-making, community members took on co-leadership roles, and having multiple facilitators working together was particularly valuable. However, the researchers also identified four practical challenges, including making venues and materials physically accessible, recruiting participants for a stigmatised topic, allowing enough time for everyone to contribute equally, and fitting these research activities into community groups' existing schedules.
This research suggests that involving older and disabled people as genuine co-creators — rather than passive research subjects — can help develop more inclusive sexual health services. The findings offer practical lessons for health researchers and service designers who want to meaningfully engage these often-overlooked groups, highlighting that while co-creation holds real promise, careful attention to accessibility and logistics is essential to make it work effectively.
Conyers H, Sakuma Y, Jannaway T, Cowan A, Tucker J, Kpokiri E, et al.. (2025). Co-creating inclusive sexual health services for middle-aged and older adults, including disabled people, in England: an innovative participatory approach within the field of sexual health.. Sexual health. https://doi.org/10.1071/SH25022