Increasing physical activity and effectively managing stress can positively impact immunity and may reduce the duration of respiratory tract infections (RTIs). As part of a larger trial, participants accessed a digital behavioural change intervention that encouraged physical activity and stress management to reduce RTIs. We aimed to understand the barriers and facilitators to engaging in physical activity and stress reduction.

A qualitative process analysis from semistructured interviews of the behavioural intervention in a randomised control trial.

Primary care in the UK.

34 participants (aged 18–82 years) in the behavioural intervention arm.

The larger trial involved four interventions: a gel-based antiviral nasal spray; a saline water-based nasal spray; a behavioural intervention; usual care. In this study, we focused on participants allocated to the behavioural intervention. The behavioural intervention included two components: one to increase physical activity (getting active) and another for stress management techniques (healthy paths) to reduce RTIs.

We analysed the interviews using thematic analysis with a critical realist perspective (focusing on). We developed five themes: digital intervention engagement, views on intervention allocation, the role of getting active, the role of healthy paths and benefits reinforcing behaviour. Participants’ views on the relevance and benefit of the behavioural intervention shaped their engagement with the intervention website and behaviour. Facilitators of intervention engagement included awareness of inactivity, goal setting, increasing immunity, positive outcome expectations and benefits from changing behaviour. Barriers to engagement included negative outcome expectations, such as around efficacy of the behaviours.

Overall, the results highlighted the importance of positive expectations for a digital intervention promoting physical activity and stress management for RTI reduction. Future interventions should consider how to clearly communicate a broad range of perceived benefits to users.

The trial was prospectively registered with International Standard Randomized Controlled Trial Number (ISRCTN) registry (17936080).

In qualitative research, there are different approaches to defining and engaging with social reality. Epistemology, as the study of knowledge and knowledge creation, influences the methodologies and theories used by researchers. A growing literature questions the universality of Western-centric and Global North research methodologies and theories and highlights their Western epistemological roots. While Western frameworks are appropriate for Western contexts, it is a fallacy to assume that they represent global realities, thereby marginalising Global South knowledge systems. Thus, the aim of this scoping review is to analyse the underlying epistemologies, methodologies or theories that are evident in qualitative research conducted by researchers from the Global North in their research on, for or with people from the Global South.

The review will be conducted using the Joanna Briggs Institute framework for scoping reviews. A search strategy will be developed to identify published and unpublished literature in CINAHL, Embase, Google Scholar, MEDLINE, ProQuest, PsycINFO and Web of Science. All potential papers will be exported to the reference manager Zotero, and the results will be uploaded to Rayyan. Studies are selected using a three-step process and documented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. The abstracted studies will then be collated using the PAGER framework to identify the patterns, advances, gaps, evidence and recommendations that help to understand the review question.

As this is a secondary analysis, our research does not require ethical approval, but we will scrutinise all included studies for inclusion of an ethical approval statement. We intend to share our findings through peer-reviewed international journals and presentations at conferences, as well as collaborating with colleagues in related fields.

The protocol for this scoping review has been registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/5BUZX).

Most people who have experienced sexual violence (SV) will disclose the event(s) to someone. Key recipients of disclosure are those working in healthcare, and using sexual and reproductive health services can be an important step in accessing necessary medical care and being signposted to other services. Accessing this care and disclosing SV can be challenging. Evidence is lacking about how best to create a safe environment for disclosure to take place, how services can make changes to better facilitate this experience and what changes matter most.

Realist evaluation.

Sexual and reproductive health settings.

1-1 interviews with service users who have disclosed SV (n=18), three focus groups with healthcare professionals and survey respondents (n=2007).

Initial programme theories of what works, for whom and in what context were tested and refined with empirical data from a national survey, 1-1 interviews and focus groups. The final steps are presented here, bringing strands of the study together and informed using substantive theory.

The key steps in using healthcare on disclosure of SV relate to self-identification as a worthy candidate irrespective of background or presentation, ensuring empowerment during navigation of services, initial access to sexual healthcare made straightforward, validation by healthcare professionals when receiving disclosures, choice and control for service users during a collaborative interaction with healthcare professionals and aftercare that reflects needs particularly of minoritised groups.

We propose a novel way of considering Dixon-Woods’ candidacy theory seen through a trauma-informed lens for healthcare following SV, and how, by holding a trauma-informed lens to candidacy, steps of healthcare access and utilisation can be framed to ensure a safer environment for disclosure. This modified substantive theory marks the chosen endpoint of the realist evaluation and provides a transferable programme theory that can be considered in other settings.