Feasibility and acceptability of a whole-school social-marketing intervention to prevent unintended teenage pregnancies and promote sexual health: evidence for progression from a pilot to a phase III randomised trial in English secondary schools
Authors
Ponsford, RuthBragg, Sara
Meiksin, Rebecca
Tilouche, Nerissa
Van Dyck, Laura
Sturgess, Joanna
Allen, Elizabeth
Elbourne, Diana
Hadley, Alison
Lohan, Maria
Mercer, Catherine H.
Melendez-Torres, G. J.
Morris, Steve
Young, Hannah M.L.
Campbell, Rona
Bonell, Chris
Affiliation
London School of Hygiene and Tropical MedicineUniversity College London
University of Bedfordshire
Queens University Belfast
University of Exeter
Cardiff University
University of Bristol
Issue Date
2022-03-04
Metadata
Show full item recordAbstract
Reducing unintended teenage pregnancy and promoting adolescent sexual health remains a priority in England. Both whole-school and social-marketing interventions are promising approaches to addressing these aims. However, such interventions have not been rigorously trialled in the UK and it is unclear if they are appropriate for delivery in English secondary schools. We developed and pilot trialled Positive Choices, a new whole-school social marketing intervention to address unintended teenage pregnancy and promote sexual health. Our aim was to assess the feasibility and acceptability of the intervention and trial methods in English secondary schools against pre-defined progression criteria (relating to randomisation, survey follow-up, intervention fidelity and acceptability and linkage to birth/abortion records) prior to carrying out a phase III trial of effectiveness and cost-effectiveness.Pilot RCT with integral process evaluation involving four intervention and two control schools in south-east England. The intervention comprised a student needs survey; a student/staff-led school health promotion council; a classroom curriculum for year-9 students (aged 13-14); whole-school student-led social-marketing activities; parent information; and a review of local and school-based sexual health services. Baseline surveys were conducted with year 8 (aged 12-13) in June 2018. Follow-up surveys were completed 12 months later. Process evaluation data included audio recording of staff training, surveys of trained staff, staff log books and researcher observations of intervention activities. Survey data from female students were linked to records of births and abortions to assess the feasibility of these constituting a phase III primary outcome. All six schools were successfully randomised and retained in the trial. Response rates to the survey were above 80% in both arms at both baseline and follow-up. With the exception of the parent materials, the fidelity target for implementation of essential elements in three out of four schools was achieved. Student surveys indicated 80% acceptability among those who reported awareness of the programme and interviews with staff suggested strong acceptability. Linkage to birth/abortion records was feasible although none occurred among participants. The criteria for progression to a phase III trial were met. Our data suggest that a whole-school social-marketing approach may be appropriate for topics that are clearly prioritised by schools. A phase III trial of this intervention is now warranted to establish effectiveness and cost-effectiveness. Births and terminations are not an appropriate primary outcome measure for such a trial. ISRCTN65324176.Citation
Ponsford R, Bragg S, Meiksin R, Tilouche N, Van Dyck L, Sturgess J, Allen E, Elbourne D, Hadley A, Lohan M, Mercer CH, Melendez Torres GJ, Morris S, Young H, Campbell R, Bonell C (2022) 'Feasibility and acceptability of a whole-school social-marketing intervention to prevent unintended teenage pregnancies and promote sexual health: evidence for progression from a pilot to a phase III randomised trial in English secondary schools', Pilot and Feasibility Studies, 8 (1)Publisher
BMCJournal
Pilot and Feasibility StudiesPubMed ID
35246272Additional Links
https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-022-00971-yType
ArticleLanguage
enISSN
2055-5784ae974a485f413a2113503eed53cd6c53
10.1186/s40814-022-00971-y
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