Feasibility study of peer-led and school-based social network Intervention (STASH) to promote adolescent sexual health

Kirstin R. Mitchell, Carrie Purcell, Sharon A. Simpson, Chiara Broccatelli, Julia V. Bailey, Sarah J.E. Barry, Lawrie Elliott, Ross Forsyth, Rachael Hunter, Mark McCann, Lisa McDaid, Kirsty Wetherall, Laurence Moore

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Abstract

Background: 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. Methods: 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. Results: The PS role was acceptable; on average across schools >50% 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. Conclusion: The weight of evidence supports continuation to full-scale evaluation. Trial registration: Current controlled trials ISRCTN97369178

Original languageEnglish
Article number125
JournalPilot and Feasibility Studies
Volume7
Issue number1
Early online date14 Jun 2021
DOIs
Publication statusE-pub ahead of print - 14 Jun 2021

Keywords

  • Acceptability
  • Adolescents
  • Diffusion of innovation
  • Feasibility trial
  • Non-randomised
  • Peer education
  • Peer support
  • Process evaluation
  • Programme theory
  • School
  • Sex education
  • Sexual health
  • Social media
  • Social network intervention
  • Young people

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