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An interactive digital behaviour change intervention (Wrapped) to decrease incidence of sexually transmitted infections (STIs) amongst users of STI self-sampling websites: A randomised controlled feasibility trial.

What is the problem?

Last year in England, 210,000 15-24-year olds were diagnosed with a Sexually Transmitted Infection (STI), half of all total diagnoses. If individuals experience symptoms, they can be unpleasant and painful. Often though, STIs have no symptoms and individuals unknowingly pass them on to others. Without treatment, STIs can have serious consequences such as infertility which negatively impact on quality of life. The cost to the National Health Service (NHS) of treating STIs is estimated to be £620 million per year. Each individual case of STI is preventable. The only way for sexually active people to avoid STIs is to use a condom, but young people report inconsistent use. It is important that we look for ways to reach young people at risk of future STIs and identify what will help them to increase their condom use. One way of reaching large numbers of young people at risk of STIs, that has been almost entirely overlooked, is through STI self-sampling websites. Through these sites, young people can request a free self-sampling kit that is received and returned via post. Demand for this service is rising rapidly. Users include groups known to be most at risk of future STIs, such as those from poorer backgrounds.

What have we done so far?

Together with young people and health professionals, we have developed a website called ‘Wrapped’. It aims to reduce future STI diagnoses amongst users of STI self-sampling websites through increasing their condom use. After placing an order for a self-sampling kit, users are immediately directed to Wrapped. Here they are asked to identify their main barriers to condom use before being allocated up to six different components. Components include a condom sample pack, access to a free monthly condom ordering service, a free condom carrier, a condom demonstration video, videos of young people giving tips on communicating about condoms, and videos of real couples discussing and using condoms.

What are we going to do?

What we want to know is whether Wrapped works. To find this out, we need to run a type of experiment called a Randomised Controlled Trial (RCT). RCTs are time consuming and expensive, often involving thousands of participants. In line with good practice, to prepare for this we are going to run a feasibility study. The primary aim is to identify whether we can recruit and retain the numbers of participants required for an RCT.

How are we going to do it?

Throughout this study we will work with users of a chlamydia self-sampling website (our Patient and Public Involvement (PPI) group). Initially, we will work with this group to develop materials and procedures that we think will work well to attract people to an RCT and keep them engaged throughout. The materials and procedures we select will be based on evidence of what has worked in the past but also on feedback from other young people sought via focus groups. We will then test these out by running a mini version of a full RCT. Throughout, we will carefully monitor engagement and interview participants, including those who drop-out, to see what we can learn about what it is like to be a participant in our study. Working again with our PPI group, we will use this evidence to adapt our materials and procedures so that we are ready to carry out a full RCT.

Project Start Date: May 2020

Project End Date: August 2022

Contact us

We’d love to hear any questions or comments you might have about the study: wrapped@herts.ac.uk


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Disclaimer: This output is the result of independent research funded by the National Institute for Health Research (NIHR Public Health Research, NIHR128148 - An interactive digital behaviour change intervention (Wrapped) to decrease incidence of sexually transmitted infections (STIs) amongst users of STI self-sampling websites: A randomised controlled feasibility trial). The views expressed are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.

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