A peer-led, school-based social network intervention for young people in the UK, promoting sexual health via social media and conversations with friends: intervention development and optimisation of STASH

Purcell, C. , McDaid, L. , Forsyth, R., Simpson, S. A. , Elliott, L., Bailey, J. V., Moore, L. and Mitchell, K. R. (2023) A peer-led, school-based social network intervention for young people in the UK, promoting sexual health via social media and conversations with friends: intervention development and optimisation of STASH. BMC Public Health, 23, 675. (doi: 10.1186/s12889-023-15541-x) (PMID:37041542) (PMCID:PMC10088210)

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Abstract

Background: The quality of school-based sex and relationships education (SRE) is variable in the UK. Digitally-based interventions can usefully supplement teacher-delivered lessons and positively impact sexual health knowledge. Designed to address gaps in core SRE knowledge, STASH (Sexually Transmitted infections And Sexual Health) is a peer-led social network intervention adapted from the successful ASSIST (A Stop Smoking in Schools Trial) model, and based on Diffusion of Innovation theory. This paper describes how the STASH intervention was developed and refined. Methods: Drawing on the Six Steps in Quality Intervention Development (6SQuID) framework, we tested a provisional programme theory through three iterative stages -: 1) evidence synthesis; 2) intervention co-production; and 3) adaptation - which incorporated evidence review, stakeholder consultation, and website co-development and piloting with young people, sexual health specialists, and educators. Multi-method results were analysed in a matrix of commonalities and differences. Results: Over 21 months, intervention development comprised 20 activities within the three stages. 1) We identified gaps in SRE provision and online resources (e.g. around sexual consent, pleasure, digital literacy), and confirmed critical components including the core ASSIST peer nomination process, the support of schools, and alignment to the national curriculum. We reviewed candidate social media platforms, ruling out all except Facebook on basis of functionality restrictions which precluded their use for our purposes. 2) Drawing on these findings, as well as relevant behaviour change theories and core elements of the ASSIST model, we co-developed new content with young people and other stakeholders, tailored to sexual health and to delivery via closed Facebook groups, as well as face-to-face conversations. 3) A pilot in one school highlighted practical considerations, including around peer nomination, recruitment, awareness raising, and boundaries to message sharing. From this, a revised STASH intervention and programme theory were co-developed with stakeholders. Conclusions: STASH intervention development required extensive adaptation from the ASSIST model. Although labour intensive, our robust co-development approach ensured that an optimised intervention was taken forward for feasibility testing. Evidencing a rigorous approach to operationalising existing intervention development guidance, this paper also highlights the significance of balancing competing stakeholder concerns, resource availability, and an ever-changing landscape for implementation. Trial registration: ISRCTN97369178.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McDaid, Professor Lisa and Purcell, Dr Carrie and Mitchell, Professor Kirstin and Moore, Professor Laurence and Simpson, Professor Sharon and Forsyth, Mr Ross
Authors: Purcell, C., McDaid, L., Forsyth, R., Simpson, S. A., Elliott, L., Bailey, J. V., Moore, L., and Mitchell, K. R.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN:1471-2458
ISSN (Online):1471-2458
Copyright Holders:Copyright © 2023 The Authors
First Published:First published in BMC Public Health 23: 675
Publisher Policy:Reproduced under a Creative Commons License
Data DOI:10.5525/gla.researchdata.1110

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
172849AN EXPLORATORY STUDY TO TEST STASH, A PEER-LED INTERVENTION TO PREVENT AND REDUCE STI TRANSMISSION AND IMPROVE SEXUAL HEALTH IN SECONDARY SCHOOLSLaurence MooreScottish Government (SCOTGOV)14/182/14SHW - MRC/CSO Social & Public Health Sciences Unit
3048230011Complexity in healthSharon SimpsonMedical Research Council (MRC)MC_UU_00022/1HW - MRC/CSO Social and Public Health Sciences Unit
3048230061Complexity in healthSharon SimpsonOffice of the Chief Scientific Adviser (CSO)SPHSU16HW - MRC/CSO Social and Public Health Sciences Unit
3048230031Relationships and healthKirstin MitchellMedical Research Council (MRC)MC_UU_00022/3HW - MRC/CSO Social and Public Health Sciences Unit
3048230081Relationships and healthKirstin MitchellOffice of the Chief Scientific Adviser (CSO)SPHSU18HW - MRC/CSO Social and Public Health Sciences Unit
168560MRC SPHSU/GU Transfer FellowshipsLaurence MooreMedical Research Council (MRC)MC_PC_13027SHW - MRC/CSO Social & Public Health Sciences Unit