Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial
Background: Younger people bear the heaviest burden of sexually transmitted infections (STIs). Partner notification, condom use and STI testing can reduce infection but many young people lack the knowledge, skills and confidence needed to carry out these behaviours. Text messages can provide effecti...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
NIHR Journals Library
2016-07-01
|
| Series: | Health Technology Assessment |
| Subjects: | |
| Online Access: | https://doi.org/10.3310/hta20570 |
| _version_ | 1818522306400485376 |
|---|---|
| author | Caroline Free Ona McCarthy Rebecca S French Kaye Wellings Susan Michie Ian Roberts Karen Devries Sujit Rathod Julia Bailey Jonathan Syred Phil Edwards Graham Hart Melissa Palmer Paula Baraitser |
| author_facet | Caroline Free Ona McCarthy Rebecca S French Kaye Wellings Susan Michie Ian Roberts Karen Devries Sujit Rathod Julia Bailey Jonathan Syred Phil Edwards Graham Hart Melissa Palmer Paula Baraitser |
| author_sort | Caroline Free |
| collection | DOAJ |
| description | Background: Younger people bear the heaviest burden of sexually transmitted infections (STIs). Partner notification, condom use and STI testing can reduce infection but many young people lack the knowledge, skills and confidence needed to carry out these behaviours. Text messages can provide effective behavioural support. The acceptability and feasibility of a randomised controlled trial of safer sex support delivered by text message are not known. Objectives: To assess the acceptability and feasibility of a randomised controlled trial of a safer sex intervention delivered by text message for young people aged 16–24 years. Design: (1) Intervention development; (2) follow-up procedure development; (3) a pilot, parallel-arm randomised controlled trial with allocation via remote automated randomisation (ratio of 1 : 1) (participants were unmasked, whereas researchers analysing samples and data were masked); and (4) qualitative interviews. Setting: Participants were recruited from sexual health services in the UK. Participants: Young people aged 16–24 years diagnosed with chlamydia or reporting unprotected sex with more than one partner in the last year. Interventions: A theory- and evidence-based safer sex intervention designed, with young people’s input, to reduce the incidence of STIs by increasing the correct treatment of STIs, partner notification, condom use and STI testing before unprotected sex with a new partner. The intervention was delivered via automated mobile phone messaging over 12 months. The comparator was a monthly text message checking contact details. Main outcome measures: (1) Development of the intervention based on theory, evidence and expert and user views; (2) follow-up procedures; (3) pilot trial primary outcomes: full recruitment within 3 months and follow-up rate for the proposed primary outcomes for the main trial; and (4) participants’ views and experiences regarding the acceptability of the intervention. Results: In total, 200 participants were randomised in the pilot trial, of whom 99 were allocated to the intervention and 101 were allocated to the control. We fully recruited early and achieved an 81% follow-up rate for our proposed primary outcome of the cumulative incidence of chlamydia at 12 months. There was no differential follow-up between groups. In total, 97% of messages sent were successfully delivered to participants’ mobile phones. Recipients reported that the tone, language, content and frequency of messages were appropriate. Messages reportedly increased knowledge of and confidence in how to use condoms and negotiate condom use and reduced stigma about STIs, enabling participants to tell a partner about a STI. Conclusions: Our research shows that the intervention is acceptable and feasible to deliver. Our pilot trial demonstrated that a main trial is feasible. It remains unclear which behaviour change techniques and elements of the intervention or follow-up procedures are associated with effectiveness. A further limitation is that in the trial one person entering data and the participants were unmasked. A randomised controlled trial to establish the effects of the intervention on STIs at 12 months is needed. Trial registration: Current Controlled Trials ISRCTN02304709. 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. 20, No. 57. See the NIHR Journals Library website for further project information. |
| first_indexed | 2024-12-11T05:31:32Z |
| format | Article |
| id | doaj.art-a92e5dfbe0934385949042f574ce87d1 |
| institution | Directory Open Access Journal |
| issn | 1366-5278 2046-4924 |
| language | English |
| last_indexed | 2024-12-11T05:31:32Z |
| publishDate | 2016-07-01 |
| publisher | NIHR Journals Library |
| record_format | Article |
| series | Health Technology Assessment |
| spelling | doaj.art-a92e5dfbe0934385949042f574ce87d12022-12-22T01:19:24ZengNIHR Journals LibraryHealth Technology Assessment1366-52782046-49242016-07-01205710.3310/hta2057010/93/04Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trialCaroline Free0Ona McCarthy1Rebecca S French2Kaye Wellings3Susan Michie4Ian Roberts5Karen Devries6Sujit Rathod7Julia Bailey8Jonathan Syred9Phil Edwards10Graham Hart11Melissa Palmer12Paula Baraitser13Clinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKClinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKDepartment of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UKDepartment of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UKFaculty of Population Sciences, University College London, London, UKClinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKDepartment of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UKClinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKFaculty of Population Sciences, University College London, London, UKSexual Health Research Group, King’s College London, London, UKClinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKFaculty of Population Sciences, University College London, London, UKClinical Trials Unit, Department for Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UKSexual Health Research Group, King’s College London, London, UKBackground: Younger people bear the heaviest burden of sexually transmitted infections (STIs). Partner notification, condom use and STI testing can reduce infection but many young people lack the knowledge, skills and confidence needed to carry out these behaviours. Text messages can provide effective behavioural support. The acceptability and feasibility of a randomised controlled trial of safer sex support delivered by text message are not known. Objectives: To assess the acceptability and feasibility of a randomised controlled trial of a safer sex intervention delivered by text message for young people aged 16–24 years. Design: (1) Intervention development; (2) follow-up procedure development; (3) a pilot, parallel-arm randomised controlled trial with allocation via remote automated randomisation (ratio of 1 : 1) (participants were unmasked, whereas researchers analysing samples and data were masked); and (4) qualitative interviews. Setting: Participants were recruited from sexual health services in the UK. Participants: Young people aged 16–24 years diagnosed with chlamydia or reporting unprotected sex with more than one partner in the last year. Interventions: A theory- and evidence-based safer sex intervention designed, with young people’s input, to reduce the incidence of STIs by increasing the correct treatment of STIs, partner notification, condom use and STI testing before unprotected sex with a new partner. The intervention was delivered via automated mobile phone messaging over 12 months. The comparator was a monthly text message checking contact details. Main outcome measures: (1) Development of the intervention based on theory, evidence and expert and user views; (2) follow-up procedures; (3) pilot trial primary outcomes: full recruitment within 3 months and follow-up rate for the proposed primary outcomes for the main trial; and (4) participants’ views and experiences regarding the acceptability of the intervention. Results: In total, 200 participants were randomised in the pilot trial, of whom 99 were allocated to the intervention and 101 were allocated to the control. We fully recruited early and achieved an 81% follow-up rate for our proposed primary outcome of the cumulative incidence of chlamydia at 12 months. There was no differential follow-up between groups. In total, 97% of messages sent were successfully delivered to participants’ mobile phones. Recipients reported that the tone, language, content and frequency of messages were appropriate. Messages reportedly increased knowledge of and confidence in how to use condoms and negotiate condom use and reduced stigma about STIs, enabling participants to tell a partner about a STI. Conclusions: Our research shows that the intervention is acceptable and feasible to deliver. Our pilot trial demonstrated that a main trial is feasible. It remains unclear which behaviour change techniques and elements of the intervention or follow-up procedures are associated with effectiveness. A further limitation is that in the trial one person entering data and the participants were unmasked. A randomised controlled trial to establish the effects of the intervention on STIs at 12 months is needed. Trial registration: Current Controlled Trials ISRCTN02304709. 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. 20, No. 57. See the NIHR Journals Library website for further project information.https://doi.org/10.3310/hta20570sexual healthbehaviour changeintervention designrandomised controlled trialsafer sexyoung peoplepartner notificationcondom usesexually transmitted infections |
| spellingShingle | Caroline Free Ona McCarthy Rebecca S French Kaye Wellings Susan Michie Ian Roberts Karen Devries Sujit Rathod Julia Bailey Jonathan Syred Phil Edwards Graham Hart Melissa Palmer Paula Baraitser Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial Health Technology Assessment sexual health behaviour change intervention design randomised controlled trial safer sex young people partner notification condom use sexually transmitted infections |
| title | Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial |
| title_full | Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial |
| title_fullStr | Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial |
| title_full_unstemmed | Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial |
| title_short | Can text messages increase safer sex behaviours in young people? Intervention development and pilot randomised controlled trial |
| title_sort | can text messages increase safer sex behaviours in young people intervention development and pilot randomised controlled trial |
| topic | sexual health behaviour change intervention design randomised controlled trial safer sex young people partner notification condom use sexually transmitted infections |
| url | https://doi.org/10.3310/hta20570 |
| work_keys_str_mv | AT carolinefree cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT onamccarthy cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT rebeccasfrench cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT kayewellings cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT susanmichie cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT ianroberts cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT karendevries cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT sujitrathod cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT juliabailey cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT jonathansyred cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT philedwards cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT grahamhart cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT melissapalmer cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial AT paulabaraitser cantextmessagesincreasesafersexbehavioursinyoungpeopleinterventiondevelopmentandpilotrandomisedcontrolledtrial |