ORCID Profile
0000-0002-1289-174X
Current Organisation
Institute for Social Science Research
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Publisher: Elsevier BV
Date: 11-2018
Publisher: National Institute for Health and Care Research
Date: 11-2020
DOI: 10.3310/PHR08150
Abstract: Young people report higher levels of unsafe sex and have higher rates of sexually transmitted infections than any other age group. Schools are well placed to facilitate early intervention, but more effective approaches are required. Peer-led approaches can augment school-based education, but often fail to capitalise on mechanisms of social influence. The potential of using social media in sexual health has not been tested in school settings. Finalise the design of the Sexually Transmitted infections And Sexual Health (STASH) intervention assess the recruitment and retention of peer supporters, and acceptability to participants and stakeholders assess the fidelity and reach, in addition to the barriers to and facilitators of, implementation refine programme theory understand the potential of social media determine design parameters for a future randomised controlled trial, including economic evaluation and establish whether or not progression criteria were met. This was a feasibility study comprising intervention development and refinement of the STASH pilot and non-randomised feasibility trial in six schools. Control data were provided by students in the year above the intervention group. Secondary schools in Scotland. Students aged 14–16 years, teachers and intervention delivery partners. The STASH intervention was adapted from A Stop Smoking In Schools Trial (ASSIST) (an effective peer-led smoking intervention). Based on diffusion of innovation theory, the STASH study involves peer nomination to identify the most influential students, with the aim of recruiting and training 15% of the year group as peer supporters. The peer supporters deliver sexual health messages to friends in their year group via conversations and use of Facebook ( www.facebook.com Facebook, Inc., Menlo Park, CA, USA) to share varied content from a curated set of web-based resources. Peer supporters are given support themselves via follow-up sessions and via trainer membership of Facebook groups. The primary outcome was whether or not progression criteria were met in relation to intervention acceptability and feasibility. The study also piloted indicative primary outcomes for a full-scale evaluation. Peer supporter questionnaire observations of activities interviews with trainers, teachers, peer supporters and students monitoring log of peer supporter activities (including on Facebook and meeting attendance) questionnaire to control year group (baseline characteristics, social networks, mediators and sexual health outcomes) baseline and follow-up questionnaire (approximately 6 months later) for intervention year group. A total of 104 students were trained as peer supporters (just over half of those nominated for the role by their peers). Role retention was very high (97%). Of 611 students completing the follow-up questionnaire, 58% reported exposure to STASH study activities. Intervention acceptability was high among students and stakeholders. Activities were delivered with good fidelity. The peer supporters were active, representative of their year group and well connected within their social network. Carefully managed social media use by peer supporters augmented conversations. A primary outcome of ‘always safer sex’ was identified, measured as no sex or always condom use for vaginal or anal sex in the last 6 months. The intervention cost £42 per student. Six progression criteria were met. A seventh criterion (regarding uptake of role by peer supporters) was not. Small feasibility study that cannot comment on effectiveness. The STASH intervention is feasible and acceptable within the context of Scottish secondary schools. The results support continuation to a full-scale evaluation. Small-scale improvements to the intervention, refinement to programme theory and funding sought for full-scale evaluation. Current Controlled Trials ISRCTN97369178. This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research Vol. 8, No. 15. See the NIHR Journals Library website for further project information.
Publisher: Springer Science and Business Media LLC
Date: 14-06-2021
DOI: 10.1186/S40814-021-00835-X
Abstract: Effective sex education is the key to good sexual health. Peer-led approaches can augment teacher-delivered sex education, but many fail to capitalise on mechanisms of social influence. We assessed the feasibility of a novel intervention (STASH) in which students (aged 14–16) nominated as influential by their peers were recruited and trained as Peer Supporters (PS). Over a 5–10-week period, they spread positive sexual health messages to friends in their year group, both in-person and via social media, and were supported to do so via weekly trainer-facilitated meetings. The aims of the study were to assess the feasibility of STASH (acceptability, fidelity and reach), to test and refine the programme theory and to establish whether the study met pre-set progression criteria for continuation to larger-scale evaluation. The overall design was a non-randomised feasibility study of the STASH intervention in 6 schools in Scotland. Baseline ( n =680) and follow-up questionnaires (approx. 6 months later n =603) were administered to the intervention year group. The control group (students in year above) completed the follow-up questionnaire only ( n =696), 1 year before the intervention group. The PS ( n =88) completed a brief web survey about their experience of the role researchers interviewed participants in key roles (PS ( n =20) PS friends ( n =22) teachers ( n =8) trainers ( n =3)) and observed 20 intervention activities. Activity evaluation forms and project monitoring data also contributed information. We performed descriptive quantitative analysis and thematic qualitative analysis. The PS role was acceptable on average across schools % of students nominated as influential by their friends, signed up and were trained ( n =104). This equated to 13% of the year group. Trained PS rarely dropped out (97% completion rate) and 85% said they liked the role. Fidelity was good (all bar one trainer-led activity carried out PS were active). The intervention had good reach PS were reasonably well connected and perceived as ‘a good mix’ and 58% of students reported exposure to STASH. Hypothesised pre-conditions, contextual influences and mechanisms of change for the intervention were largely confirmed. All bar one of the progression criteria was met. The weight of evidence supports continuation to full-scale evaluation. Current controlled trials ISRCTN97369178
Publisher: Springer Science and Business Media LLC
Date: 10-06-2021
DOI: 10.1038/S41598-021-90852-W
Abstract: There is growing interest in social network-based programmes to improve health, but rigorous methods using Social Network research to evaluate the process of these interventions is less well developed. Using data from the “STis And Sexual Health” (STASH) feasibility trial of a school-based, peer-led intervention on sexual health prevention, we illustrate how network data analysis results can address key components of process evaluations for complex interventions— implementation , mechanisms of impacts , and context. STASH trained students as Peer Supporters (PS) to diffuse sexual health messages though face-to-face interactions and online Facebook (FB) groups. We applied a Multilevel Exponential Random Graph modelling approach to analyse the interdependence between offline friendship relationships and online FB ties and how these different relationships align. Our results suggest that the creation of online FB communities mirrored offline adolescent groups, demonstrating fidelity of intervention delivery. Data on informal friendship networks related to student’s in idual characteristics (i.e., demographics, sexual health knowledge and adherence to norms, which were included for STASH), contributed to an understanding of the social relational ‘building’ mechanisms that sustain tie-formation. This knowledge could assist the selection of opinion leaders, improving identification of influential peers situated in optimal network positions. This work provides a novel contribution to understanding how to integrate network research with the process evaluation of a network intervention.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Chiara Broccatelli.