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

Background Middle-aged and older adults, including disabled people, are rarely engaged in helping to develop sexual health services to meet their needs. We used co-creation as a promising participatory strategy to develop ideas to inform more inclusive sexual health services for middle-aged and older adults in England. Methods During April and May 2023, we recruited participants to take part in our co-creation workshops and interviews. The research team partnered with active community leaders with lived experience to co-design and co-organise sessions. Discussion topics were developed iteratively, centred on participant input, to ensure the sessions were accessible and appropriate for the focus population. Implementation of the co-creation workshops and one-to-one interviews was evaluated by gathering community facilitators' reflections on how they felt about their experience as facilitators and the success of the workshops. Reflections Overall, co-creation activities are well-accepted and highly valuable means to engage middle-aged and older adults. We are identifying three strengths and four challenges worth noting. As for strengths, they entail: (1) shared informed decision-making; (2) co-leadership for conducting the research activities; and (3) importance of co-facilitation; and for challenges: (1) ensuring the venue/information is accessible to all; (2) recruitment of middle-aged and older adults for a stigmatised research topic; (3) need more time for co-creation sessions to make sure equal opportunity to contribute; and (4) integrating co-creation into existing community activities. Conclusion Co-creation is crucial for inclusive health services, but underexplored in sexual health research involving middle-aged, older and disabled individuals. This study emphasises shared ownership, which enables the offering of practical guidance for researchers and healthcare professionals.