Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT

Background: People with serious mental illness have sexual health needs, but there is limited evidence regarding effective interventions to promote their sexual health. Objectives: To develop a sexual health promotion intervention for people with serious mental illness, and to conduct a feasibility...

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Main Authors: Elizabeth Hughes, Natasha Mitchell, Samantha Gascoyne, Thirimon Moe-Byrne, Amanda Edmondson, Elizabeth Coleman, Lottie Millett, Shehzad Ali, Ceri Dare, Catherine Hewitt, Sonia Johnson, Carrie Llewellyn, Catherine Mercer, Fiona Nolan, Charlotte Walker, Judith Watson
Format: Article
Language:English
Published: NIHR Journals Library 2019-12-01
Series:Health Technology Assessment
Subjects:
Online Access:https://doi.org/10.3310/hta23650
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author Elizabeth Hughes
Natasha Mitchell
Samantha Gascoyne
Thirimon Moe-Byrne
Amanda Edmondson
Elizabeth Coleman
Lottie Millett
Shehzad Ali
Ceri Dare
Catherine Hewitt
Sonia Johnson
Carrie Llewellyn
Catherine Mercer
Fiona Nolan
Charlotte Walker
Judith Watson
author_facet Elizabeth Hughes
Natasha Mitchell
Samantha Gascoyne
Thirimon Moe-Byrne
Amanda Edmondson
Elizabeth Coleman
Lottie Millett
Shehzad Ali
Ceri Dare
Catherine Hewitt
Sonia Johnson
Carrie Llewellyn
Catherine Mercer
Fiona Nolan
Charlotte Walker
Judith Watson
author_sort Elizabeth Hughes
collection DOAJ
description Background: People with serious mental illness have sexual health needs, but there is limited evidence regarding effective interventions to promote their sexual health. Objectives: To develop a sexual health promotion intervention for people with serious mental illness, and to conduct a feasibility trial in order to establish the acceptability and parameters for a fully powered trial. Design: A two-armed randomised controlled, open feasibility study comparing usual care alone with usual care plus the adjunctive intervention. Setting: Five community mental health providers in Leeds, Barnsley, Brighton and London. Participants: Adults aged ≥ 18 years with serious mental illness and receiving care from community mental health teams. Interventions: A remote, web-based computer randomisation system allocated participants to usual care plus the RESPECT (Randomised Evaluation of Sexual health Promotion Effectiveness informing Care and Treatment) intervention (three sessions of 1 hour) (intervention arm) or usual care only (control arm). The intervention was an interactive manualised package of exercises, quizzes and discussion topics focusing on knowledge, motivation and behavioural intentions to adopt safer sexual behaviours. Main outcome measures: Feasibility parameters including establishing the percentage of people who were eligible, consented and were retained in each arm of the trial, retention for the intervention, as well as the completeness of the data collection. Data were collected on knowledge, motivation to adopt safer sexual behaviour, sexual behaviour, sexual stigma, sexual health service use and quality of life. Data were collected at baseline and then at 3 months and 6 months post randomisation. Results: Of a target of 100 participants, 72 people participated in the trial over 12 months. Of the 36 participants randomised to the intervention arm, 27 received some of the intervention (75.0%). At 3 months, 59 of the 72 participants completed follow-up questionnaires (81.9%) (30 participants from the intervention arm and 29 participants from the control arm). Only the first 38 participants were followed up at 6 months. However, data were collected on 29 out of 38 participants (76.3% retention): 13 in the intervention arm and 16 in the control arm. No adverse events were reported. Participant feedback confirmed that both the design and the intervention were acceptable. The economic analysis indicated high completion rates and completeness of data among participants who continued the trial. Conclusions: Despite the limitations, the findings suggest that it is both acceptable and feasible to undertake a sexual health promotion study for people with serious mental illness. Future work: A fully powered randomised controlled trial would be required to establish the clinical effectiveness of the intervention. Trial registration: Current Controlled Trials ISRCTN15747739. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 65. See the NIHR Journals Library website for further project information.
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spelling doaj.art-17e609afe67a4f34ad14f9f1ccc5db432022-12-21T21:43:39ZengNIHR Journals LibraryHealth Technology Assessment1366-52782046-49242019-12-01236510.3310/hta2365014/172/01Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCTElizabeth Hughes0Natasha Mitchell1Samantha Gascoyne2Thirimon Moe-Byrne3Amanda Edmondson4Elizabeth Coleman5Lottie Millett6Shehzad Ali7Ceri Dare8Catherine Hewitt9Sonia Johnson10Carrie Llewellyn11Catherine Mercer12Fiona Nolan13Charlotte Walker14Judith Watson15Centre for Applied Research in Health, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UKDepartment of Health Sciences, University of York, York, UKDepartment of Health Sciences, University of York, York, UKDepartment of Health Sciences, University of York, York, UKCentre for Applied Research in Health, School of Human and Health Sciences, University of Huddersfield, Huddersfield, UKDepartment of Health Sciences, University of York, York, UKDivision of Psychiatry, University College London, London, UKDepartment of Health Sciences, University of York, York, UKExpert by experience, UKDepartment of Health Sciences, University of York, York, UKDivision of Psychiatry, University College London, London, UKDepartment of Primary Care and Public Health, University of Sussex, Brighton, UKInstitute for Global Health, University College London, London, UKSchool of Health and Social Care, University of Essex, Colchester, UKExpert by experience, UKDepartment of Health Sciences, University of York, York, UKBackground: People with serious mental illness have sexual health needs, but there is limited evidence regarding effective interventions to promote their sexual health. Objectives: To develop a sexual health promotion intervention for people with serious mental illness, and to conduct a feasibility trial in order to establish the acceptability and parameters for a fully powered trial. Design: A two-armed randomised controlled, open feasibility study comparing usual care alone with usual care plus the adjunctive intervention. Setting: Five community mental health providers in Leeds, Barnsley, Brighton and London. Participants: Adults aged ≥ 18 years with serious mental illness and receiving care from community mental health teams. Interventions: A remote, web-based computer randomisation system allocated participants to usual care plus the RESPECT (Randomised Evaluation of Sexual health Promotion Effectiveness informing Care and Treatment) intervention (three sessions of 1 hour) (intervention arm) or usual care only (control arm). The intervention was an interactive manualised package of exercises, quizzes and discussion topics focusing on knowledge, motivation and behavioural intentions to adopt safer sexual behaviours. Main outcome measures: Feasibility parameters including establishing the percentage of people who were eligible, consented and were retained in each arm of the trial, retention for the intervention, as well as the completeness of the data collection. Data were collected on knowledge, motivation to adopt safer sexual behaviour, sexual behaviour, sexual stigma, sexual health service use and quality of life. Data were collected at baseline and then at 3 months and 6 months post randomisation. Results: Of a target of 100 participants, 72 people participated in the trial over 12 months. Of the 36 participants randomised to the intervention arm, 27 received some of the intervention (75.0%). At 3 months, 59 of the 72 participants completed follow-up questionnaires (81.9%) (30 participants from the intervention arm and 29 participants from the control arm). Only the first 38 participants were followed up at 6 months. However, data were collected on 29 out of 38 participants (76.3% retention): 13 in the intervention arm and 16 in the control arm. No adverse events were reported. Participant feedback confirmed that both the design and the intervention were acceptable. The economic analysis indicated high completion rates and completeness of data among participants who continued the trial. Conclusions: Despite the limitations, the findings suggest that it is both acceptable and feasible to undertake a sexual health promotion study for people with serious mental illness. Future work: A fully powered randomised controlled trial would be required to establish the clinical effectiveness of the intervention. Trial registration: Current Controlled Trials ISRCTN15747739. Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 65. See the NIHR Journals Library website for further project information.https://doi.org/10.3310/hta23650severe mental illnesssexual healthfeasibility randomised controlled trialqualitative research
spellingShingle Elizabeth Hughes
Natasha Mitchell
Samantha Gascoyne
Thirimon Moe-Byrne
Amanda Edmondson
Elizabeth Coleman
Lottie Millett
Shehzad Ali
Ceri Dare
Catherine Hewitt
Sonia Johnson
Carrie Llewellyn
Catherine Mercer
Fiona Nolan
Charlotte Walker
Judith Watson
Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT
Health Technology Assessment
severe mental illness
sexual health
feasibility randomised controlled trial
qualitative research
title Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT
title_full Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT
title_fullStr Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT
title_full_unstemmed Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT
title_short Sexual health promotion in people with severe mental illness: the RESPECT feasibility RCT
title_sort sexual health promotion in people with severe mental illness the respect feasibility rct
topic severe mental illness
sexual health
feasibility randomised controlled trial
qualitative research
url https://doi.org/10.3310/hta23650
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