Social Network Research contribution to evaluating process in a feasibility study of a peer-led and school-based sexual health intervention

AbstractThere is growing interest in social network-based programmes to improve health, but rigorous methods using Social Network research to evaluate the process of these interventions is less well developed. Using data from the “STis And Sexual Health” (STASH) feasibility trial of a school-based, peer-led intervention on sexual health prevention, we illustrate how network data analysis results can address key components of process evaluations for complex interventions—implementation, mechanisms of impacts, and context. STASH trained students as Peer Supporters (PS) to diffuse sexual health messages though face-to-face interactions and online Facebook (FB) groups. We applied a Multilevel Exponential Random Graph modelling approach to analyse the interdependence between offline friendship relationships and online FB ties and how these different relationships align. Our results suggest that the creation of online FB communities mirrored offline adolescent groups, demonstrating fidelity of intervention delivery. Data on informal friendship networks related to student’s individual characteristics (i.e., demographics, sexual health knowledge and adherence to norms, which were included for STASH), contributed to an understanding of the social relational ‘building’ mechanisms that sustain tie-formation. This knowledge could assist the selection of opinion leaders, improving identification of influential peers situated in optimal network positions. This work provides a novel contribution to understanding how to integrate network research with the process evaluation of a network intervention.

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Peer-to-peer sharing of sexual health social media messages in a school-based intervention: Opportunities and Challenges Identified in the STASH Feasibility Trial (Preprint)

10.2196/preprints.20898 ◽

2020 ◽

Author(s):

Maija-Kaisa Hirvonen ◽

Carrie Purcell ◽

Lawrie Elliott ◽

Julia V Bailey ◽

Sharon Anne Simpson ◽

...

Keyword(s):

Social Media ◽

Sexual Health ◽

Descriptive Analysis ◽

Peer To Peer ◽

Health Messages ◽

Feasibility Trial ◽

Friendship Networks ◽

Post Intervention ◽

School Based Intervention ◽

School Based

BACKGROUND There is strong interest in the use of social media to spread positive sexual health messages through young people’s social networks. However, research suggests this potential may be limited by a reluctance to be visibly associated with sexual health content online, and by lack of trust in the veracity of peer sources. OBJECTIVE To investigate opportunities and challenges of using social media to facilitate peer-to-peer sharing of sexual health messages within the context of a secondary school-based and peer-led sexual health intervention (STASH; Sexually Transmitted infections And Sexual Health). METHODS Following training, and as part of their role, student-nominated peer supporters (aged 14-16) invited school friends to trainer-monitored, private Facebook groups. Peer supporters posted curated educational sex and relationships content within these groups. Data come from a feasibility study of the STASH intervention in 6 UK schools. To understand student experiences of the social media component we used data from: 11 semi-structured paired and group interviews with peer supporters and their friends (collectively, ‘students’; n=42; aged 14-16); a web-based post-intervention questionnaire to peer supporters (n=88); and baseline and follow-up questionnaires to students in the intervention year group (n=680 and 603 respectively). We carried out thematic analysis of qualitative data and descriptive analysis of quantitative data. RESULTS Message-sharing by peer supporters was hindered by variable engagement with Facebook. The trainer-monitored and private Facebook groups were acceptable to student members (peer supporters and their friends), and reassuring to peer supporters, but led to engagement that ran parallel to – rather than embedded in –their routine social media use. The offline context of a school-based intervention helped legitimate and augment the Facebook posts; but even where friends were receptive to STASH messages, they did not necessarily engage visibly. Preferences for content design varied, but humor, color and text brevity were important. Preferences for online versus offline message-sharing varied. CONCLUSIONS Invitation-only social media groups formed around peer supporters’ existing friendship networks hold potential for diffusing messages in peer-based sexual health interventions. Ideally, interactive opportunities should not be limited to single social media platforms and should run alongside offline conversations. There are tensions between offering young people autonomy to engage flexibly and authentically, and the need for adult-oversight of activities for information accuracy and safeguarding. CLINICALTRIAL Isrctn97369178

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Association between sexually transmissible infection testing, numbers of partners and talking to partners and friends about sexual health: survey of young adults

Sexual Health ◽

10.1071/sh16076 ◽

2017 ◽

Vol 14 (4) ◽

pp. 378 ◽

Cited By ~ 5

Author(s):

Natalie A. Hendry ◽

Graham Brown ◽

Gary W. Dowsett ◽

Marina Carman

Keyword(s):

At Risk ◽

Young Adults ◽

Sexual Health ◽

Health Knowledge ◽

Sexual Partners ◽

Group Method ◽

Friendship Networks ◽

Sti Testing ◽

Sexually Transmissible Infection ◽

Transmissible Infection

Background Young adults, aged 18–30 years, comprise the largest proportion of sexually transmissible infection (STI) notifications in Australia compared with other age groups. Understanding the influence of partner and friendship networks on their STI testing practices may enhance health promotion efforts to increase testing for this group. Method: Participants aged 21–30 years, living in Australia for ≥3 years, were recruited within nightlife precincts in Melbourne, Australia. They completed a survey on demographic items, sexual health attitudes, sexual health knowledge and STI testing experiences and perceptions. Responses to items related to talking to partners and friends about STI testing were allocated partner and friend communication scores. Analyses included χ2 tests of independence and independent sample t-tests. Results: Overall, 36.5% (61/167) of participants had tested for STIs in the previous 12 months. Of those who had tested for STIs, most had significantly higher numbers of sexual partners in the same period (P < 0.05), and were significantly more likely to have felt at risk of STI acquisition (P < 0.05). Significantly greater mean partner and friend communication scores were associated with higher numbers of sexual partners, feeling at risk of STIs, and testing for STIs in the previous 12 months (all P < 0.05). There were no significant differences when participants were stratified by gender or age. Conclusion: Talking to partners and friends about STI testing is associated with testing rates for young adults. Feeling at risk and increased numbers of sexual partners may be associated with the promotion of STI testing among friends and partners.

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Effect of an iPad-Based Intervention to Improve Sexual Health Knowledge and Intentions for Contraceptive Use Among Adolescent Females at School-Based Health Centers

Clinical Pediatrics ◽

10.1177/0009922816681135 ◽

2017 ◽

Vol 56 (13) ◽

pp. 1227-1234 ◽

Cited By ~ 10

Author(s):

Veronika V. Mesheriakova ◽

Kathleen P. Tebb

Keyword(s):

Sexual Health ◽

Health Knowledge ◽

Unplanned Pregnancy ◽

Health Centers ◽

Average Score ◽

Sexually Active ◽

School Based ◽

Effective Contraception ◽

School Based Health Centers ◽

Sexual Health Knowledge

Objectives: The use of effective contraception can decrease the incidence of unplanned pregnancy among adolescents. This study aims to examine the effectiveness of an iPad-based application (app) on improving adolescent girls’ sexual health knowledge and on its ability to influence their intentions to use effective contraception. Study Design: This was a prospective study of girls aged 12 to 18 years recruited from 3 school-based health centers in California. Results: A total of 120 racially/ethnically diverse participants used the iPad app; 54% were sexually active, with only 26% using effective contraception at baseline. The average score on baseline sexual health knowledge assessment was 58%. After using the app, 68% of the sexually active participants reported intention to use effective contraception in the future, and sexual health knowledge improved significantly to 79% ( P < .001). Conclusions: This iPad-based app is a promising intervention to educate adolescents about sexual health and support them in selecting an effective contraception method.

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Peer-to-peer sharing of sexual health social media messages in a school-based intervention: Opportunities and Challenges Identified in the STASH Feasibility Trial (Preprint)

Journal of Medical Internet Research ◽

10.2196/20898 ◽

2020 ◽

Author(s):

Maija-Kaisa Hirvonen ◽

Carrie Purcell ◽

Lawrie Elliott ◽

Julia V Bailey ◽

Sharon Anne Simpson ◽

...

Keyword(s):

Social Media ◽

Sexual Health ◽

Peer To Peer ◽

Feasibility Trial ◽

School Based Intervention ◽

Media Messages ◽

School Based ◽

Health Social Media

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Associations within school-based same-sex friendship networks of children’s physical activity and sedentary behaviours: a cross-sectional social network analysis

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-018-0653-9 ◽

2018 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Ruth E. Salway ◽

Simon J. Sebire ◽

Emma Solomon-Moore ◽

Janice L. Thompson ◽

Russell Jago

Keyword(s):

Physical Activity ◽

Social Network ◽

Social Network Analysis ◽

Network Analysis ◽

Friendship Networks ◽

Same Sex ◽

Cross Sectional ◽

Sedentary Behaviours ◽

School Based ◽

Children’S Physical Activity

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Comprehensive sexuality education in Hong Kong: study protocol for process and outcome evaluation

BMC Public Health ◽

10.1186/s12889-021-10253-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ellie Bostwick Andres ◽

Edmond Pui Hang Choi ◽

Alice Wai Chi Fung ◽

Kevin Wing Chung Lau ◽

Neda Hei Tung Ng ◽

...

Keyword(s):

Hong Kong ◽

Sexual Health ◽

Education Program ◽

Sexuality Education ◽

Health Knowledge ◽

Comprehensive School ◽

Comprehensive Sexuality Education ◽

School Based ◽

Sexual Health Knowledge ◽

Education In Hong Kong

Abstract Background Hong Kong lacks comprehensive school-based sexuality education. Recent public health concerns have brought the inadequacies of sex education in Hong Kong to the forefront. The aim of the proposed study is to develop and evaluate the effectiveness of a comprehensive school-based sexuality education program in Hong Kong. Methods The proposed study is a prospective longitudinal study implemented in six secondary schools in Hong Kong over two academic years. The study adopts an ecological approach providing informational workshops for students, teachers and school management, social workers and guidance counsellors and parents. Study outcomes will be evaluated through pre- and post-tests. Results Key outcomes of interest among students include sexual health knowledge, awareness of values motivating healthy sexual decisions, understanding and efficacy of sexual communication and intention to use contraception. Among school employees and parents key outcomes include self-efficacy to engage in sexual health discussions with students/children, sexual health knowledge and awareness of Hong Kong community sexual health resources. Conclusions The proposed study will result in the development of a tested school-based culturally relevant comprehensive sexual health education program. Ultimately, this program aims to not only empower adolescents and their trusted adults in building a supportive environment for sexual health promotion but also construct a learning network to generate longitudinal evidence for the effectiveness of comprehensive sexuality education in improving sexual health outcomes. The program has the potential for expansion through widespread adoption in Hong Kong schools to benefit more adolescents and reduce the medical and societal burdens related to crisis pregnancy, sexually transmitted infections and sexual abuse.

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