An exploratory study to test STASH, a peer-led intervention to prevent and reduce STI transmission and improve sexual health in secondary schools

Record ID 32016000566
Authors' objectives: Young people in the UK report higher levels of unsafe sex than any other age group. As a result, they are at highest risk of getting, and passing on, sexually transmitted infections. Young people often lack awareness of the risks or are unsure how to protect themselves. They are also vulnerable to social pressure from friends and peers who seem more sexually experienced, and to popular beliefs that safer sex behaviour is uncool . Youth peer-led interventions often involve peers 'teaching' friends or younger children. Peer educators often volunteer themselves for this role or are chosen by teachers; this type of selection tends to result in young people who are committed to school and who may find it difficult to relate to students who are disengaged and at highest risk. An alternative is to recruit young people from among those voted as most influential by their peers, and to train them not as peer educators but as peer supporters. These individuals then act as role models who change behavioural norms through social networks and other mechanisms of influence. This has been tried, with success, in a school-based anti-smoking intervention called ASSIST. Early research on the use of social media in promoting healthy behaviour is promising. Most UK teens are connected to online social networks; messages can spread rapidly; and social media provides an alternative to talking about sex directly, something many youth find embarrassing. The intervention: We will build on components found to work well in ASSIST: recruiting influential peers, allowing knowledge and attitudes to spread via social networks and using professionals to train peer supporters. However, this intervention focuses on sexual health, an older target group and utilises social media to spread messages. Students, experts in sexual health, teachers and parents will contribute to the intervention design. We will identify and recruit the most influential students in fourth year (S4) of secondary schools in Scotland. These students will attend a two-day training run by specialist trainers. Over a defined period (between 4 and 10 weeks) they will use social media and face-to-face interaction to influence sexual norms and behaviour among their peers. They will be supported through regular meetings and via social media by the professionals who trained them. Testing whether the intervention works: The main aim of the study is to find out whether the intervention is feasible, acceptable and implemented as intended. Following a pilot test in one school, we will implement the intervention in a further 6 schools, using the previous cohort of S4 students as controls; these students will move to S5 before the intervention starts and will therefore not be exposed to it. We will examine how the intervention was implemented by evaluating activities, and by talking to students, teachers and parents about their experience of being involved. We are interested in whether the intervention improves attitudes, knowledge, and risk-reduction skills, and whether these, in turn, delay first sex, increase condom use and improve the quality of sexual relationships. The study is not big enough to tell us whether the intervention worked, but will let us to assess whether it is worth doing a larger trial, and if yes, how we should go about doing this. Peer supporters will present the findings to their year group, teachers, and other professionals, and we will write up the results for academic and policy audiences. If the intervention is successful, we will seek funds for a full-scale trial.
Project Status: Ongoing
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Humans
  • Reproductive Health
  • Sex Education
  • Sexually Transmitted Diseases
  • Schools
  • Preventive Health Services
Organisation Name: NIHR Public Health Research programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
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