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      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

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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.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-023-15541-x.

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          Most cited references41

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          Using the framework method for the analysis of qualitative data in multi-disciplinary health research

          Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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            A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance

            The UK Medical Research Council’s widely used guidance for developing and evaluating complex interventions has been replaced by a new framework, commissioned jointly by the Medical Research Council and the National Institute for Health Research, which takes account of recent developments in theory and methods and the need to maximise the efficiency, use, and impact of research.
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              The "What" and "Why" of Goal Pursuits: Human Needs and the Self-Determination of Behavior

              Psychological Inquiry, 11(4), 227-268
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                Author and article information

                Contributors
                carrie.purcell@open.ac.uk
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                11 April 2023
                11 April 2023
                2023
                : 23
                : 675
                Affiliations
                [1 ]GRID grid.10837.3d, ISNI 0000 0000 9606 9301, Open University, ; 10 Drumsheugh Gardens, Edinburgh, EH3 7QJ UK
                [2 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, School of Health and Wellbeing, , University of Glasgow, ; Glasgow, UK
                [3 ]GRID grid.1003.2, ISNI 0000 0000 9320 7537, Institute for Social Science Research, The University of Queensland, ; Long Pocket Precinct, 80 Meiers Rd, Indooroopilly, Brisbane, QLD 4068 Australia
                [4 ]GRID grid.8756.c, ISNI 0000 0001 2193 314X, MRC/CSO Social and Public Health Sciences Unit, , University of Glasgow, ; Clarice Pears Building, Byres Road, Glasgow, G12 8TA Scotland
                [5 ]GRID grid.5214.2, ISNI 0000 0001 0669 8188, School of Health and Life Sciences, Department of Nursing and Community Health, , Glasgow Caledonian University, ; Room 420 George Moore Building, Cowcaddens Road, Glasgow, G4 OBA UK
                [6 ]GRID grid.426108.9, ISNI 0000 0004 0417 012X, University College London E-Health Unit, Royal Free Hospital, ; Upper Third Floor, Rowland Hill Street, London, NW3 2PF UK
                Author information
                http://orcid.org/0000-0002-2651-9201
                Article
                15541
                10.1186/s12889-023-15541-x
                10088210
                37041542
                6dd79263-1cc7-4195-8a40-f4d105f79f5e
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 28 February 2022
                : 23 March 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000272, National Institute for Health Research;
                Award ID: 14/182/14
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000265, Medical Research Council;
                Award ID: MC_UU_00022/1
                Award ID: MC_UU_00022/3
                Award ID: MC_PC_13027
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100000589, Chief Scientist Office;
                Award ID: SPHSU16
                Award ID: SPHSU18
                Funded by: FundRef http://dx.doi.org/10.13039/100012095, Scottish Government;
                Funded by: FundRef http://dx.doi.org/10.13039/100010898, Edinburgh and Lothians Health Foundation;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2023

                Public health
                intervention development,sexual health,young people,co-development,6squid,school-based,social networks,social media,peer-led

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