Study protocol for the optimisation, feasibility testing and pilot cluster randomised trial of Positive Choices: A school-based social marketing intervention to promote sexual health, prevent unintended teenage pregnancies and address health inequalities in England

Ruth Ponsford, Elizabeth Allen, Rona Campbell, Diane Elbourne, Alison Hadley, Maria Lohan, GJ Melendez-Torres, Catherine Mercer, Steve Morris, Honor Young

Research output: Contribution to journalArticle

3 Citations (Scopus)
216 Downloads (Pure)

Abstract

Abstract

Background
Since the introduction of the Teenage Pregnancy Strategy (TPS), England’s under-18 conception rate has fallen by 55%, but a continued focus on prevention is needed to maintain and accelerate progress. The teenage birth rate remains higher in the UK than comparable Western European countries. Previous trials indicate that school based social marketing interventions are a promising approach to addressing teenage pregnancy and improving sexual health. Such interventions are yet to be trialled in the UK. This study aims to optimise and establish the feasibility and acceptability of one such intervention: Positive Choices.

Methods
Design: Optimisation, feasibility testing and pilot cluster randomised trial

Interventions: The Positive Choices intervention consists of: a student needs survey; a student/staff led School Health Promotion Council (SHPC); a classroom curriculum for year nine students covering social and emotional skills and sex education; student led social marketing activities; parent information; and a review of school sexual health services.

Systematic optimisation of Positive Choices will be carried out with the National Children’s Bureau Sex Education Forum (NCB SEF), one state secondary school in England and other youth and policy stakeholders.

Feasibility testing will involve the same state secondary school and will assess progression criteria to advance to the pilot cluster RCT.
Pilot cluster RCT will involve six different state secondary schools (four intervention and two control) and will assess the feasibility and utility of progressing to a full effectiveness trial.

The following outcome measures will be trialled as part of the pilot:

•self-reported pregnancy and unintended pregnancy (initiation of pregnancy for boys) and sexually transmitted infections,
•age of sexual debut; number of sexual partners; use of contraception at first and last sex; non-volitional sex;
•educational attainment

The feasibility of linking administrative data on births and termination to self-report survey data to measure our primary outcome (unintended teenage pregnancy) will also be tested.

Discussion
This will be the first UK based pilot trial of a school-wide social marketing intervention to reduce unintended teenage pregnancy and improve sexual health. If this study indicates feasibility and acceptability of the optimised Positive Choices intervention in English secondary schools, plans will be initiated for a phase III trial and economic evaluation of the intervention.

Trial Registration
ISRCTN registry (ISCTN 12524938. Registered 03/07/2017)
Keywords: teenage pregnancy; sexual health; SRE; RSE; school intervention; adolescent; cluster-randomised trial.
Original languageEnglish
Pages (from-to)1-15
JournalPilot and Feasibility Studies
Volume4
DOIs
Publication statusPublished - 23 May 2018

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