BRINGING SEXUAL HEALTH RESEARCH INTO THE COMMUNITY

Evaluation of Home-based Intervention Strategy (HIS-UK) is a Wessex-led and NIHR-funded multi-site condom education study. The team at Dorset HealthCare has been driving recruitment to the study through outreach visits to Weymouth College, Bournemouth University and Bovington Army Camp alongside in-clinic recruitment. We caught up with them to hear about their experience of research in sexual health.

EVALUATION OF THE HIS-UK STUDY

INTERVIEWEES:

KASIA MALCZUK, Research Practitioner and Study Coordinator, Dorset HealthCare University Foundation Trust (DHC)

JULIE HYDE, Research Nurse & Study Coordinator, DHC

IAN LEADBITTER, Research Nurse, DHC

KASIA: HIS-UK is an education and training programme about condom use. The aim is to help young people find condoms more enjoyable and pleasurable to use, in turn helping to reduce the risk of Sexually Transmitted Infections (STIs).

We want young people to move away from thinking ‘condoms aren’t for me’ if ones they've tried previously don't fit or aren’t comfortable, and to explore all the options available. The hope is that it will reduce STIs and the risks, we want to know if this approach works.

The study has three arms. In the control arm, participants receive the standard condom education you currently get at sexual health clinics and free condoms, which are usually 10 of the same type.

Then there is the pro HIS-UK training, which is delivered by a member of the research team, where we talk participants through all the different condoms, sizes and materials. We educate on how to put them on, take them off, how to use lubricants and why to use them – focussing on the safety as well as the pleasure aspect. Participants receive a kit full of different types of condoms to try out.

Then there is e-HIS which is the same education programme but online. We want to see how those three groups compare and which has better outcomes.

Will the online delivery be sufficient, or will we need the face-to-face approach? The study team will also need to analyse the cost effectiveness of these approaches.

The Recruitment Challenge

KASIA: It seemed like a good opportunity to further integrate our research team with the Sexual Health team, so that we could work together and build a stronger partnership. The Sexual Health team was actively involved in research at both University Hospitals Dorset and Dorset County Hospital (where they were based before) and we were keen to continue this when the service moved over to us at Dorset HealthCare. However, we did find screening and introducing the study to eligible patients a big challenge.

IAN: We worked closely with clinicians to identify eligible patients, maintaining confidentiality and sensitivity, to ensure that those we do approach are happy for the research team to speak with them about opportunity to get involved in the study.

KASIA: Twice a week, we screened the patient list with a member of clinic staff to identify patients who might be eligible. We would then come into the clinic when the potentially eligible patients had their appointment and be available to speak to them if they were interested in taking part. The change in provision with sexual health clinics during COVID-19 was probably our biggest challenge because there used to be more face-to-face opportunities. The pandemic resulted in more phone appointments and a lot of the asymptomatic STI screening was diverted online, where people would carry out their tests at home. This decreased the pool of eligible people we could speak to. This resulted in reduction of potential participants to the study, so we decided to take recruitment out of the clinical setting.

A New Approach

KASIA: We took the recruitment out of the clinical context, into universities and freshers’ fairs, and quickly found that the environments were much more open and fun. People were keen to talk and curious to find out more.

IAN: The participants were approaching us on their own terms outside of the clinical area. It made a big difference to this type of research.

KASIA: I’m new to the NHS and research and this was the first study I’ve overseen. I wonder if that was a benefit because when you don’t know how things typically work, you think of what else could work. It wasn’t working in clinic, due to COVID-19, so we asked what else we could do. We were open to changing the recruitment process.

We’re targeting 16–25-year-olds so naturally that’s people at universities, colleges etc. So I emailed Bournemouth University and that began to change how we recruited to the study.

JULIE: We also started working with the Sexual Health Targeted Outreach team who were happy for us to accompany them to a variety of events including the Weymouth College Equality and Diversity Fair. They helped us network and introduced us to other services who we would have not otherwise been aware of. The Outreach Team's experience of working across different sectors with young people completely changed the success we had in our recruitment.

KASIA: We then went on to visit Bournemouth University, Bovington Army Barracks and Hamworthy Marine Barracks.

JULIE: With a mixture of networking, making contacts with external services and following up these leads, resulted in finding new opportunities to outreach.

IAN: This approach was new for me as I came from an acute clinical background. I really enjoyed the experience of going out and talking to people in the community. It was much nicer taking it to them, rather than people coming to our hospital clinic and not expecting to see us or be involved.

KASIA: Going outside of the clinics and having exciting display boards with freebies such as sweets and condoms to demonstrate the study – it opened the channels of communication. Talking to young people in an environment that's familiar to them removed barriers and we found that people were up for a chat. It was nice to be able to be so open with them. We gave out posters, leaflets and business cards with QR codes. The study is also regularly advertised on Twitter and in our internal comms and newsletters. We had a target of 25 people to recruit and we are currently on 57, so we’ve managed to more than double this. It was good to build relationships within our Trust but also outside the NHS. That’s something we hope to keep growing so that we can do more studies of this nature and make research accessible, inclusive and available to everyone, including those who may find it more difficult to engage with research opportunities.

The study, which is running at sites across Wessex, is sponsored by the University of Southampton and funded by the NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC).

The study closed to recruitment at the end of February 2023, with results expected in by December 2023.