Chapter One: Background and methods
The last decade has seen increasing efforts by central and local government to target sexual health services and initiatives at young people in order to improve their sexual health, culminating in the Sexual Health Strategy for Scotland. In order that the Strategy and associated initiatives are effectively implemented, more information is needed about children and young people's own views, concerns and experiences regarding their sexual health and well-being.
To this end, a research study was originally commissioned by the Pupil Support and Inclusion Division* of the Scottish Executive from ChildLine Scotland ( CLS), working collaboratively with academics at the Centre for Research on Families and Relationships ( CRFR). Calls to CLS about sexual health and well-being issues have increased steadily over the years; represent one of the top three concerns expressed by children and young people who call CLS; and are the primary reason for calling in approximately 18% of all calls. These calls reflect children's own agendas, supporting an approach which treats children and young people as competent reporters on their own lives.
1.2 The study: methods and analysis
This study focussed on calls received from children and young people aged 5 to 18 years who contacted CLS about concerns relating to their sexual health and wellbeing. Two years of data (2003 and 2004) were extracted from CLS's anonymised database for thematic qualitative analysis. This generated a data set of 14,244 call records. Quantitative data were extracted and reformatted for statistical analysis using the data analysis package STATA. As CLS's database does not support complex statistical analysis and the data contained within the database can not be readily transferred into statistical analysis software this process required assistance from information technology specialists at ChildLine headquarters in London and specialist support from the developer of the database. Additional support was also received from Dr Frank Popham, RUHBC, University of Edinburgh. Three months of the original written archived records of counsellors' call notes were also transcribed and transferred into QSR N6 for in-depth analysis.
Unique case identification numbers were generated and used to enable the call records contained in the three datasets to remain linked. This allowed the research staff to cross reference between the individual records contained in these sets, if required.
(*Now - Health Education Branch in Qualifications, Assessment and Curriculum Division)
1.3 Qualitative analysis
The narrative extracts of the anonymised calls records contained with CLS's database were manually transferred and further anonymised into the qualitative data analysis package QSR N6 for in-depth analysis, as were three months of written archived records of counsellor's call notes. In the first instance, the extracted data were coded thematically to reflect the research questions; narratives were grouped according to age, gender, year and concern category. This facilitated further thematic coding by the RF to be conducted whilst retaining a focus on analysing how concerns may or may not have differed according to age and gender. Complex coding and in-depth analysis was carried out on the entire qualitative data set of 14,244 call narratives.
Three months of the original written archived records of counsellors' call notes were also transcribed, further anonymised, and transferred into QSR N6 for in-depth analysis. The transcription process was assisted by administrative staff within CLS. These data were also subjected to in-depth analysis and complex coding processes. However, as agreed with the Executive at the presentation of interim findings, the extent of detail in the archived records meant that it was only possible to analyse two of these months, not three, as originally planned. Nevertheless, this greater in depth work enabled the analysis of the short narrative extracts in CLS's database to be strengthened and supplemented by archived material containing richer and more contextualised information on children and young people's concerns.
The whole team contributed to the analytical process. In the first instance, the RF accessed and read samples of the records, as described above. This analysis, and that of the quantitative data set, was shared and discussed at full team meetings. More detailed work, reading and discussing selections of these data in order to agree the coding frame and key emergent themes (presented in this report), was carried out at several analytical team meetings involving the academic team.
1.4 Quantitative analysis
ChildLine Scotland provided a dataset containing 14,244 records (separate rows of data that dealt with a particular concern). Records had been extracted on the basis that they featured, as the main problem, one of the five sexual health issues: facts of life, sexual abuse, pregnancy, relationships, and sexuality. However, the main quantitative analysis was conducted on the cases (10,716 in total); this seemed more meaningful as these featured individual young people who were identified in the database by a unique case reference number. For analysis, two datasets were constructed one retaining the records structure and one based on individual cases. Analysis, using Stata, was conducted on the case level dataset.
1.5 Structure of the report
The main quantitative results will be presented first to provide the background to the detailed qualitative findings. Additional quantitative material is presented in appendix II. The report will then consider in turn each of the 5 main sexual health categories that were identified in the CLS database. These will be discussed in rank order from the category which included the highest number of cases through to that with the lowest. Facts of life was the most common main problem, then sexual abuse, pregnancy, relationships and sexuality (table 1).
Table 1 Children and Young People's Concerns in Rank Order (Highest to Lowest) 2003 and 2004 inclusive
No of cases
% of total cases
Facts of life
Note. As a small number of cases had more than one main problem the percentage of cases sums to more than 100 and the sum of the number of cases will be more than the total number.
Each of the above categories will be discussed in turn to illuminate the research questions identified in the application. These were:
1. What are the concerns that children and young people themselves identify with regard to their sexual health and wellbeing?
2. How are these concerns presented?
3. What are the range and content of these concerns in calls to ChildLine Scotland from 5 to 18 year olds?
4. What are the key differences (if any) in the types of concerns presented across the age groups?
5. What strategies and sources of support do children and young people themselves identify to deal with issues affecting their sexual health and wellbeing?
6. What helps / hinders children and young people accessing and using other support structures regarding their sexual health?
From this analysis a range of cross cutting themes becomes evident and these are highlighted in the final chapter. Implications for policy and practice will be presented in the finally agreed report, following discussions at a feedback session at the Scottish Executive and a policy/practitioner seminar, conducted as part of the dissemination programme.