HIS-UK feasibility study
A study to adapt, specify, and assess the feasibility of an intervention to increase condom use amongst young men
Role: Co-investigator (research lead: Prof Cindy Graham, Kinsey Institute, USA)
Funder: Medical Research Council (MRC), Public Health Intervention Development (PHIND) scheme
Dates: February 2015 to August 2016
Background
The Department of Health has identified the need to reduce rates of HIV, sexually transmitted infections (STIs), and unintended pregnancies as priorities for improving sexual health. Although male condoms can be highly protective against pregnancy and the transmission of most STIs, there is evidence that they are often not used consistently or correctly. The Kinsey Institute® developed an intervention targeting condom skills, enjoyment, and self-efficacy (Homework Intervention Strategy (KIHIS)), and reported early evidence of efficacy in two US studies. This study aimed to adapt this intervention for a UK population (HIS-UK), to manualise its content, and to assess feasibility of delivery and evaluation in preparation for a main trial.
What did we do?
We conducted a systematic review to identify existing interventions addressing condom fit and feel issues, and interviewed 15 young men (16-25 years) reporting low/no condom use during recent sexual intercourse. This was used to identify determinants of non-use (with a focus on fit, feel and pleasure) and candidate Behaviour Change Techniques (BCTs) that could be used to address these in the adpated intervention. Workshops with health care professionals and young people were conducted to explore current condom promotion strategies, agree content and delivery of HIS-UK, and to discuss the evaluation approach. Feasibility was then assessed by inviting young men (a minumum of 50, reporting low/no condom use during recent sexual intercourse) to participate in a pre-post evaluation in which measures of condom use and targeted determinants were taken (with aim to have a minimum of 20 participants completing all measures). Process evaluation interviews with participants and health promotion professionals (HPPs) were also conducted post trial.
What did we find?
Five studies met the inclusion criteria in our systematic review. Whilst most were small-scale pilot studies, they showed promise in increasing condom use. One unique BCT 'credible source' was identified from these studies and incorporated into HIS-UK . Interviews identified no additional BCTs but were informative in terms of BCT delivery. In the feasibility study, 57 young men completed the baseline survey, 33 of whom went on to receive the intervention. Of these, 21 completed both follow-up surveys (thus achieving the target sample size of =>20). Fifteen participants and five HPPs took part in process evalaution interviews and indicated strong acceptability of the intervention.
Next steps
The favourable results led to a successful application being made to the NIHR to conduct a full trial of HIS-UK. See details of HIS-UK RCT for more details.
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