Ruth Ponsford
Biographic Data
| ID | 161518 |
|---|---|
| NAME | Ruth Ponsford |
| GIVEN NAMES | Ruth |
| FAMILY NAME | Ponsford |
| SIGNATURE | PONSFORD R |
| AFFILIATIONS | London School of Hygiene & Tropical Medicine |
| ORCID | 0000-0003-2612-0249 |
| VERIFIED | Yes |
| TOTAL WORKS | 28 |
| TOTAL CITATIONS | 30 |
| WORKS AS AUTHOR | 28 |
| WORKS AS EDITOR | 0 |
| FIRST PUBLICATION YEAR | 2011 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Engagement with and Acceptability of a School-based Relationships and Sexual Health Intervention
Evidence suggests that school-based relationships and sex education plus school-level actions may be effective in promoting sexual health. We conducted a trial of a relationships and sexual-health intervention in English secondary schools. We draw on nested qualitative research to explore student engagement and acceptability. Twenty-four intervention schools participating in a randomised trial delivered a two-year programme aiming to comprise cla…
Decolonising global health evaluations
The field of global health evaluation is critiqued for its reliance on Eurocentric paradigms that perpetuate epistemic injustice. A rapidly evolving yet conceptually fragmented literature on decolonising evaluation has emerged in response. We conducted a scoping review to chart the nature and breadth of this literature and synthesise insights to guide future evaluation scholarship and practice. Academic database searches identified 1,024 records,…
The association of positive educational experiences with adolescents’ depressive symptoms
Introduction The school environment influences adolescent health through both individual experiences, such as one’s own engagement with school, and broader school-level factors, such as aggregate student levels of engagement, affecting all students. For mental-health outcomes, existing evidence more consistently supports individual-level influences than school-level effects. In relation to depression, negative student-level educational experience…
Factors affecting the implementation of a whole-school relationships and sexual health intervention
Whole-school relationships and sexual health interventions represent promising approaches to promoting healthy sexual development. However, data from a randomised controlled trial of the Positive Choices whole-school intervention demonstrate these may be challenging to implement in English secondary schools. We draw on qualitative data to examine staff perspectives on the implementation of the intervention and the factors affecting delivery. Inte…
Understanding the limited effectiveness of a whole-school relationships and sexual-health programme
Previous trials of whole-school relationships and sexual-health programmes have not reported on fidelity, reach or acceptability, despite the importance of these factors for interpreting outcomes. Our trial of the Positive Choices whole-school relationships and sexual-health programme found limited effectiveness in secondary schools in England. We aimed to understand whether sub-optimal fidelity, reach or acceptability might explain the results. …
Effects of a whole-school relationships and sexual health intervention on non-competent sexual debut
BACKGROUND: Relationships and sex education (RSE) impacts some sexual behaviours but could be strengthened by incorporating whole-school approaches (eg, building engagement, providing contraception). These can prevent pregnancies and sexually-transmitted infections but are unevaluated in UK schools. METHODS: A cluster-randomised trial of 'Positive Choices' compared it with usual practice in English secondary schools. Intervention comprised: RSE, …
The implementation of compulsory relationships and sex education in English secondary schools
The quality of sex education varies. In England from 2020, the government attempted to improve provision by making lessons a statutory requirement. We assessed implementation in 25 secondary schools in 2022–23, framed by May’s general theory of implementation. This identifies processes of sense-making, cognitive participation, collective action and reflexive monitoring, influenced by an intervention’s capability, stakeholder potential (individual…
Sexual Harassment in Early Adolescence
There is little research on sexual harassment among younger adolescents or on how rates vary by gender and other student/school characteristics. Drawing on data from 50 English schools, we explored the prevalence and patterning of victimization in the past year among students aged 12-13. Of 7,060 participants, almost a tenth had experienced sexual harassment. Girls, non-binary students, and sexual-minority students reported the highest rates. Stu…
The main thing I worry about is being approachable enough
The role of parents in communicating with their children about relationships and sex is receiving increasing attention from policy makers and commentators, both in respect of the recent introduction of statutory relationships and sex education in schools and of rising levels of violence against women in England. While a small body of literature has examined parent-child communication about relationships and sex from parents’ perspectives, this ar…
The mechanisms by which a whole-school intervention might improve sexual health
Whole-school interventions go beyond classroom education, promoting health by modifying school environments. These can be effective in delaying sexual debut and increasing contraception use but mechanisms are poorly understood. Qualitative research within realist evaluation can explore mechanisms via building 'context-mechanism-outcome configurations', describing how interventions trigger mechanisms that interact with context to generate outcomes…
Social norms relating to gender and dating and relationship violence in English secondary schools
Dating and relationship violence (DRV) among young people is widespread. DRV is associated with subsequent mental ill health, substance use and sexual risk among girls and boys and is a leading cause of morbidity and mortality among girls globally. Harmful social norms are widely recognised for their role in sustaining DRV, and interventions often seek to change these. However, little evidence is available to suggest which specific norms are most…
A thematic analysis of tobacco industry responses to the Scottish Government’s consultation on e-cigarette regulation
E-cigarette use is increasing rapidly across the world. Governments have begun to tighten regulation principally to prevent uptake by young people and non-smokers. As tobacco industry ownership of the e-cigarette market grows, it is important to be aware of how industry is seeking to influence the regulation of e-cigarettes. Using thematic analysis, this research examines the explicit arguments and implicit tactics used in responses from the toba…
Student-reported relationships and sex education coverage and knowledge among a diverse population of early adolescents
Student-reported quality and coverage of school-based relationships and sex education (RSE) vary, with gender/sexual-minority and disadvantaged students reporting poorer provision. Experience of RSE among younger adolescents is under-explored. We examined student-reported RSE coverage and priorities and how coverage, and sexual-health knowledge and awareness of services, varies between students and schools. The data came from a pre-intervention s…
Parental attitudes to school- and home-based relationships, sex and health education
Subsequent to the introduction of compulsory relationships and health education in primary schools and relationships and sex education and health education (RSHE) in secondary schools in England from 2020, this paper examines the attitudes of parents towards school-and home-based RSHE.Using data from a survey of parents (n = 849) of children at 37 independent schools in England and Wales, we analysed parental attitudes towards school-parent commu…
Central and Eastern European Migrants in the United Kingdom
Testing and refining middle-range theory in evaluations of public-health interventions
Evaluations of public-health interventions might potentially be used to test and refine middle-range theory (ie, theory about the mechanisms, which generate outcomes that is analytically generalisable enough to span a range of contexts, interventions or outcomes, but specific enough to be salient in a given application). This approach has been suggested as one means of developing more informed assessments of how different interventions work and w…
Whole-school interventions promoting student commitment to school to prevent substance use and violence
Objectives: Whole-school interventions and programmes aim to change school environments to promote health. Previous reviews suggest these are often inappropriately informed by individualistic psychological theories. We undertook a systematic review of whole-school interventions to prevent substance use and violence. This paper reports on a synthesis of theories of change, assessing whether these aligned with, and suggested refinements to, the the…
Enacting whole‐school relationships and sexuality education in England
Evidence from intervention evaluations suggests that achieving meaningful and lasting social, behavioural and attitudinal change from relationships, sex and health education (RSHE) in schools requires more than just a curriculum. Whole‐school approaches appear particularly promising since they work at multiple levels. For instance, they may: engage with carers, communities and local services; address iniquitous cultures and norms; change school p…
Dilemmas of school-based relationships and sexuality education for and about consent
In 2018, reflecting in this journal on the arrival of the ‘age of consent’ into sexuality education, Jen Gilbert questioned what would happen to a concept drawn in part from legal contexts, but partly also driven by the passion of feminist activists, when it met the demands and logics – the learning outcomes and lesson plans – of the classroom. This article offers one response, drawing on qualitative data from two whole-school sexual health progr…
Building collective control and improving health through a place-based community empowerment initiative
Both environmental improvement and collective agency over local decisions are recognised strategies for promoting health and health equity. However, both strategies have been critiqued for their association with policies that emphasise local resources and decision-making while the state disinvests in social and environmental determinants of health. This paper explores the role of place-based community empowerment initiatives in building collectiv…
Implementing a whole-school relationships and sex education intervention to prevent dating and relationship violence
Adolescent dating and relationship violence is associated with health harms and is an important topic for sex education. School-based interventions addressing this have been effective in the USA, but schools in England confront pressures that might hinder implementation. We assessed the feasibility of, and contextual enablers/barriers to implementing Project Respect, a whole-school intervention. We conducted a pilot trial with process evaluation …
A ‘strategy of resistance’? How can a place-based empowerment programme influence local media portrayals of neighbourhoods and what are the implications for tackling health inequalities
I realised it weren't about spending the money. It's about doing something together
Community initiatives aiming to reduce health inequalities are increasingly common in health policy. Though diverse many such initiatives aim to support residents of disadvantaged places to exercise greater collective control over decisions/actions that affect their lives - which research suggests is an important determinant of health - and some seek to achieve this by giving residents control over a budget. Informed by theoretical work in which …
Capturing complexity in the evaluation of a major area-based initiative in community empowerment
In recent years, there has been growing emphasis on the need to develop ways of capturing 'complexity' in the evaluation of health initiatives in order to produce better evidence about 'how' and under what conditions such interventions work. Used alone, conventional methods of evaluation that attempt to reduce intervention processes and outcomes to a small number of discrete and finite variables, are typically not well suited to this task. Among …
Reframing “participation” and “inclusion” in public health policy and practice to address health inequalities
There is a need for greater conceptual clarity in place-based initiatives that seek to give residents of disadvantaged neighbourhoods more control over action to address the social determinants of health inequalities at a local level. In this article, we address this issue as it relates to the concepts of participation and inclusion. We draw on qualitative data generated during the first phase of the Communities in Control Study, a longitudinal m…
Consumption, resilience and respectability amongst young mothers in Bristol
The progressive commercialisation of motherhood, babyhood and childhood means that consumption is becoming an increasingly important terrain through which maternal identity, style and parenting practices are displayed and ‘caring projects’ are enacted. Whilst all mothers may seek to act meaningfully by consuming for their children, this paper argues that aspects of material culture hold particular value for teenage mothers who are positioned outs…
Enacting whole‐school relationships and sexuality education in England
Evidence from intervention evaluations suggests that achieving meaningful and lasting social, behavioural and attitudinal change from relationships, sex and health education (RSHE) in schools requires more than just a curriculum. Whole‐school approaches appear particularly promising since they work at multiple levels. For instance, they may: engage with carers, communities and local services; address iniquitous cultures and norms; change school p…
A ‘strategy of resistance’? How can a place-based empowerment programme influence local media portrayals of neighbourhoods and what are the implications for tackling health inequalities
I realised it weren't about spending the money. It's about doing something together
Community initiatives aiming to reduce health inequalities are increasingly common in health policy. Though diverse many such initiatives aim to support residents of disadvantaged places to exercise greater collective control over decisions/actions that affect their lives - which research suggests is an important determinant of health - and some seek to achieve this by giving residents control over a budget. Informed by theoretical work in which …
Capturing complexity in the evaluation of a major area-based initiative in community empowerment
In recent years, there has been growing emphasis on the need to develop ways of capturing 'complexity' in the evaluation of health initiatives in order to produce better evidence about 'how' and under what conditions such interventions work. Used alone, conventional methods of evaluation that attempt to reduce intervention processes and outcomes to a small number of discrete and finite variables, are typically not well suited to this task. Among …
Reframing “participation” and “inclusion” in public health policy and practice to address health inequalities
There is a need for greater conceptual clarity in place-based initiatives that seek to give residents of disadvantaged neighbourhoods more control over action to address the social determinants of health inequalities at a local level. In this article, we address this issue as it relates to the concepts of participation and inclusion. We draw on qualitative data generated during the first phase of the Communities in Control Study, a longitudinal m…
Effects of a whole-school relationships and sexual health intervention on non-competent sexual debut
BACKGROUND: Relationships and sex education (RSE) impacts some sexual behaviours but could be strengthened by incorporating whole-school approaches (eg, building engagement, providing contraception). These can prevent pregnancies and sexually-transmitted infections but are unevaluated in UK schools. METHODS: A cluster-randomised trial of 'Positive Choices' compared it with usual practice in English secondary schools. Intervention comprised: RSE, …
Social norms relating to gender and dating and relationship violence in English secondary schools
Dating and relationship violence (DRV) among young people is widespread. DRV is associated with subsequent mental ill health, substance use and sexual risk among girls and boys and is a leading cause of morbidity and mortality among girls globally. Harmful social norms are widely recognised for their role in sustaining DRV, and interventions often seek to change these. However, little evidence is available to suggest which specific norms are most…
Fast-food, everyday life and health
Consumption, resilience and respectability amongst young mothers in Bristol
The progressive commercialisation of motherhood, babyhood and childhood means that consumption is becoming an increasingly important terrain through which maternal identity, style and parenting practices are displayed and ‘caring projects’ are enacted. Whilst all mothers may seek to act meaningfully by consuming for their children, this paper argues that aspects of material culture hold particular value for teenage mothers who are positioned outs…
Putting context centre stage
It is now widely accepted that context matters in evaluations of the health inequalities impact of community-based social initiatives. Systems thinking offers a lens for uncovering the dynamic relationship between such initiatives and their social contexts. However, there are very few examples that show how a systems approach can be applied in practice and what kinds of evidence are produced when this happens. In this paper, we use data from ethn…
Reframing “participation” and “inclusion” in public health policy and practice to address health inequalities
There is a need for greater conceptual clarity in place-based initiatives that seek to give residents of disadvantaged neighbourhoods more control over action to address the social determinants of health inequalities at a local level. In this article, we address this issue as it relates to the concepts of participation and inclusion. We draw on qualitative data generated during the first phase of the Communities in Control Study, a longitudinal m…
Fast-food, everyday life and health
Capturing complexity in the evaluation of a major area-based initiative in community empowerment
In recent years, there has been growing emphasis on the need to develop ways of capturing 'complexity' in the evaluation of health initiatives in order to produce better evidence about 'how' and under what conditions such interventions work. Used alone, conventional methods of evaluation that attempt to reduce intervention processes and outcomes to a small number of discrete and finite variables, are typically not well suited to this task. Among …
Implementing a whole-school relationships and sex education intervention to prevent dating and relationship violence
Adolescent dating and relationship violence is associated with health harms and is an important topic for sex education. School-based interventions addressing this have been effective in the USA, but schools in England confront pressures that might hinder implementation. We assessed the feasibility of, and contextual enablers/barriers to implementing Project Respect, a whole-school intervention. We conducted a pilot trial with process evaluation …
A ‘strategy of resistance’? How can a place-based empowerment programme influence local media portrayals of neighbourhoods and what are the implications for tackling health inequalities
I realised it weren't about spending the money. It's about doing something together
Community initiatives aiming to reduce health inequalities are increasingly common in health policy. Though diverse many such initiatives aim to support residents of disadvantaged places to exercise greater collective control over decisions/actions that affect their lives - which research suggests is an important determinant of health - and some seek to achieve this by giving residents control over a budget. Informed by theoretical work in which …
Dilemmas of school-based relationships and sexuality education for and about consent
In 2018, reflecting in this journal on the arrival of the ‘age of consent’ into sexuality education, Jen Gilbert questioned what would happen to a concept drawn in part from legal contexts, but partly also driven by the passion of feminist activists, when it met the demands and logics – the learning outcomes and lesson plans – of the classroom. This article offers one response, drawing on qualitative data from two whole-school sexual health progr…
Building collective control and improving health through a place-based community empowerment initiative
Both environmental improvement and collective agency over local decisions are recognised strategies for promoting health and health equity. However, both strategies have been critiqued for their association with policies that emphasise local resources and decision-making while the state disinvests in social and environmental determinants of health. This paper explores the role of place-based community empowerment initiatives in building collectiv…
Whole-school interventions promoting student commitment to school to prevent substance use and violence
Objectives: Whole-school interventions and programmes aim to change school environments to promote health. Previous reviews suggest these are often inappropriately informed by individualistic psychological theories. We undertook a systematic review of whole-school interventions to prevent substance use and violence. This paper reports on a synthesis of theories of change, assessing whether these aligned with, and suggested refinements to, the the…
Enacting whole‐school relationships and sexuality education in England
Evidence from intervention evaluations suggests that achieving meaningful and lasting social, behavioural and attitudinal change from relationships, sex and health education (RSHE) in schools requires more than just a curriculum. Whole‐school approaches appear particularly promising since they work at multiple levels. For instance, they may: engage with carers, communities and local services; address iniquitous cultures and norms; change school p…
Testing and refining middle-range theory in evaluations of public-health interventions
Evaluations of public-health interventions might potentially be used to test and refine middle-range theory (ie, theory about the mechanisms, which generate outcomes that is analytically generalisable enough to span a range of contexts, interventions or outcomes, but specific enough to be salient in a given application). This approach has been suggested as one means of developing more informed assessments of how different interventions work and w…
A thematic analysis of tobacco industry responses to the Scottish Government’s consultation on e-cigarette regulation
E-cigarette use is increasing rapidly across the world. Governments have begun to tighten regulation principally to prevent uptake by young people and non-smokers. As tobacco industry ownership of the e-cigarette market grows, it is important to be aware of how industry is seeking to influence the regulation of e-cigarettes. Using thematic analysis, this research examines the explicit arguments and implicit tactics used in responses from the toba…
Student-reported relationships and sex education coverage and knowledge among a diverse population of early adolescents
Student-reported quality and coverage of school-based relationships and sex education (RSE) vary, with gender/sexual-minority and disadvantaged students reporting poorer provision. Experience of RSE among younger adolescents is under-explored. We examined student-reported RSE coverage and priorities and how coverage, and sexual-health knowledge and awareness of services, varies between students and schools. The data came from a pre-intervention s…
Parental attitudes to school- and home-based relationships, sex and health education
Subsequent to the introduction of compulsory relationships and health education in primary schools and relationships and sex education and health education (RSHE) in secondary schools in England from 2020, this paper examines the attitudes of parents towards school-and home-based RSHE.Using data from a survey of parents (n = 849) of children at 37 independent schools in England and Wales, we analysed parental attitudes towards school-parent commu…
Central and Eastern European Migrants in the United Kingdom
The implementation of compulsory relationships and sex education in English secondary schools
The quality of sex education varies. In England from 2020, the government attempted to improve provision by making lessons a statutory requirement. We assessed implementation in 25 secondary schools in 2022–23, framed by May’s general theory of implementation. This identifies processes of sense-making, cognitive participation, collective action and reflexive monitoring, influenced by an intervention’s capability, stakeholder potential (individual…
Sexual Harassment in Early Adolescence
There is little research on sexual harassment among younger adolescents or on how rates vary by gender and other student/school characteristics. Drawing on data from 50 English schools, we explored the prevalence and patterning of victimization in the past year among students aged 12-13. Of 7,060 participants, almost a tenth had experienced sexual harassment. Girls, non-binary students, and sexual-minority students reported the highest rates. Stu…
The main thing I worry about is being approachable enough
The role of parents in communicating with their children about relationships and sex is receiving increasing attention from policy makers and commentators, both in respect of the recent introduction of statutory relationships and sex education in schools and of rising levels of violence against women in England. While a small body of literature has examined parent-child communication about relationships and sex from parents’ perspectives, this ar…
The mechanisms by which a whole-school intervention might improve sexual health
Whole-school interventions go beyond classroom education, promoting health by modifying school environments. These can be effective in delaying sexual debut and increasing contraception use but mechanisms are poorly understood. Qualitative research within realist evaluation can explore mechanisms via building 'context-mechanism-outcome configurations', describing how interventions trigger mechanisms that interact with context to generate outcomes…
Social norms relating to gender and dating and relationship violence in English secondary schools
Dating and relationship violence (DRV) among young people is widespread. DRV is associated with subsequent mental ill health, substance use and sexual risk among girls and boys and is a leading cause of morbidity and mortality among girls globally. Harmful social norms are widely recognised for their role in sustaining DRV, and interventions often seek to change these. However, little evidence is available to suggest which specific norms are most…
Engagement with and Acceptability of a School-based Relationships and Sexual Health Intervention
Evidence suggests that school-based relationships and sex education plus school-level actions may be effective in promoting sexual health. We conducted a trial of a relationships and sexual-health intervention in English secondary schools. We draw on nested qualitative research to explore student engagement and acceptability. Twenty-four intervention schools participating in a randomised trial delivered a two-year programme aiming to comprise cla…
Decolonising global health evaluations
The field of global health evaluation is critiqued for its reliance on Eurocentric paradigms that perpetuate epistemic injustice. A rapidly evolving yet conceptually fragmented literature on decolonising evaluation has emerged in response. We conducted a scoping review to chart the nature and breadth of this literature and synthesise insights to guide future evaluation scholarship and practice. Academic database searches identified 1,024 records,…
The association of positive educational experiences with adolescents’ depressive symptoms
Introduction The school environment influences adolescent health through both individual experiences, such as one’s own engagement with school, and broader school-level factors, such as aggregate student levels of engagement, affecting all students. For mental-health outcomes, existing evidence more consistently supports individual-level influences than school-level effects. In relation to depression, negative student-level educational experience…
Sociology (17 works) · Political science (14 works) · Psychology (14 works) · Adolescent Sexual and Reproductive Health (12 works) · Medicine (12 works) · Public health (8 works) · Public relations (8 works) · Social Psychology (8 works) · Community Health and Development (7 works) · Gender Studies (7 works)