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Background <p>Invasive group A streptococcal (iGAS) disease is a rare but serious bacterial infection affecting a broad cross-section of people. Public health advice is routinely provided to close contacts of iGAS cases to encourage early presentation to medical facilities, given the elevated risk of secondary transmission. Despite being at heightened risk, people experiencing homelessness (PEH) and people who inject drugs (PWID) have not been involved in developing the pre-existing public health materials, and therefore they may not be accessible, understandable, or actionable for these groups.</p> Objective <p>Coproduction is an approach in which people with lived experience work in partnership with researchers, in this case, to design and evaluate interventions intended for their use. This project (1) explored the experiences and communication needs of PEH and PWID; (2) coproduced iGAS factsheets with PEH and PWID; and (3) evaluated whether the coproduced materials were accessible, understandable, non-stigmatising, and actionable.</p> Methods <p>We used the Agile Co-production and Evaluation (ACE) framework to embed coproduction throughout the development and evaluation of iGAS public health materials, recognising the need for approaches tailored to the contexts and constraints faced by PEH and PWID. A multidisciplinary steering group including public health professionals, service providers, and researchers guided the study. The protocol was pre-registered (OSF: z4268) and the study is reported in accordance with GRIPP2 long-form guidelines for public involvement.</p> Results <p>Coproduction activities informed factsheet modifications incorporating simplified language, visual cues, and content relevant to PEH and PWID. Coproducers described the new factsheet as eye-catching, easy to read, and person-centred whereas the original version was viewed as having limited relevance. In the evaluation survey, 32/39 responders preferred the coproduced factsheet, which was rated higher for readability and clarity. Symptoms of iGAS were correctly identified and responders reported they would follow the advice.</p> Conclusions <p>Coproduction can improve the design and evaluation of public health advice for underserved groups. Using the ACE framework, coproduced materials were clearer, more actionable, and better aligned with the needs of PEH and PWID. The process also identified practical considerations for health protection teams and future incident settings.</p>

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Co-production and co-evaluation of public health communication of invasive Group A Streptococcal infection (iGAS) for people experiencing homelessness and people who inject drugs

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Alex F. Martin,
  • Sarah Denford,
  • Libby Eastwood,
  • Lucy Yardley,
  • G. James Rubin,
  • Theresa Lamagni,
  • Richard Amlôt,
  • Nicky Wilsenham,
  • David J. Roberts

摘要

Background

Invasive group A streptococcal (iGAS) disease is a rare but serious bacterial infection affecting a broad cross-section of people. Public health advice is routinely provided to close contacts of iGAS cases to encourage early presentation to medical facilities, given the elevated risk of secondary transmission. Despite being at heightened risk, people experiencing homelessness (PEH) and people who inject drugs (PWID) have not been involved in developing the pre-existing public health materials, and therefore they may not be accessible, understandable, or actionable for these groups.

Objective

Coproduction is an approach in which people with lived experience work in partnership with researchers, in this case, to design and evaluate interventions intended for their use. This project (1) explored the experiences and communication needs of PEH and PWID; (2) coproduced iGAS factsheets with PEH and PWID; and (3) evaluated whether the coproduced materials were accessible, understandable, non-stigmatising, and actionable.

Methods

We used the Agile Co-production and Evaluation (ACE) framework to embed coproduction throughout the development and evaluation of iGAS public health materials, recognising the need for approaches tailored to the contexts and constraints faced by PEH and PWID. A multidisciplinary steering group including public health professionals, service providers, and researchers guided the study. The protocol was pre-registered (OSF: z4268) and the study is reported in accordance with GRIPP2 long-form guidelines for public involvement.

Results

Coproduction activities informed factsheet modifications incorporating simplified language, visual cues, and content relevant to PEH and PWID. Coproducers described the new factsheet as eye-catching, easy to read, and person-centred whereas the original version was viewed as having limited relevance. In the evaluation survey, 32/39 responders preferred the coproduced factsheet, which was rated higher for readability and clarity. Symptoms of iGAS were correctly identified and responders reported they would follow the advice.

Conclusions

Coproduction can improve the design and evaluation of public health advice for underserved groups. Using the ACE framework, coproduced materials were clearer, more actionable, and better aligned with the needs of PEH and PWID. The process also identified practical considerations for health protection teams and future incident settings.