Respect Yourself evaluation

Role: Co-investigator (research lead: Prof Katherine Brown, Universty of Hertfordshire)

Funder: West Midlands (South) Health Innovation and Education Cluster (HIEC)

Dates: 2013-2013

Background

In 2012, a website aiming to improve sexual health service access among 13–19-year olds was launched in Warwickshire, UK (see project: 'Respect Yourself intervention development' for further information on the intervention and its development).

What did we do?

This real-world evaluation employed a pre-post design, comparing outcome data collected before and after launch of the Respect Yourself website. Gender was included as a between-subjects variable. The primary outcome variable was self-reported sexual health service access. Additional secondary measures included beliefs about services and service access targeted by the intervention (as identified during development), and objective service access data provided by local sexual health services. Measures of intervention engagement (e.g. mode, frequency, pages visited) were also collected via the post-delivery survey. Participants were drawn from five schools in Warwickshire. Baseline (pre-delivery) surveys were completed in July 2012 and participants were encouraged to access the intervention over the summer break. At the start of the autumn term participants were reminded to access the website and then the post-delivery survey was completed 2-3 weeks later. We were able to successfully match baseline and post-delivery surveys for 148 participants aged 13-18 years (total at baseline = 287; total at post-delivery = 227).

What did we find?

Analysis suggested that the intervention had had a significant positive effect on psychological barriers to and antecedents of service access among females (e.g. following the intervention, females experienced enhanced beliefs about services being accessible to anyone of any age and they felt more confident that they could access a sexual health service when they needed to). Males, who reported greater confidence in service access compared with females, significantly increased service access by the time of follow-up (i.e. at point completed post-delivery survey; no signficant increase in access observed for females). Available objective service access data (comparing data pre- and post-launch of Respect Yourself) showed that there had been a statistically significant increase in the number of visits to two of five sexual health settings in Warwickshire by 13-19 year olds. Fewer than 45% of matched participants reported having visited two or more of the main intervention pages (embedded within the wider website) suggesting that intervention engagement had been ‘light-touch’ for many. Whilst promising, caution should be taken in interpreting these findings because a number of factors could have influenced service access, and it is not possible to demonstrate that any increases were due purely to the launch of the Respect Yourself website. The pilot nature of the data and other methodological weaknesses must also be considered.

Impact

Although the Respect Yourself website was set up for use within the West Midlands, evidence indicated significant international reach. In the 9 months after its launch in July 2012, it was visited 164,463 times (data from Google analytics), with visitors from over 20 countries worldwide. The significance of the resource was demonstrated by good repeat use of the site, with 30% of unique users having visited the site previously. One year after its launch the resource was still attracting more than 6000 visitors per month (data from Google analytics August 2013). In 2014 and 2015, licenses to replicate the Respect Yourself website were purchased from the group by Gloucestershire County Council and Doncaster City Council respectively, and new sister versions of the website and content were produced for each of these local authorities. This project was featured in a REF 2014 impact case study which was singled out has having 'elements of outstanding impact'. Unfortunately, in 2019 Respect Yourself was removed due to local objection about content on the wider website (outside of that developed by the research team).

Publications

Brown, K.E., Newby, K., Caley, M., Danahay, A. & Kehal, I. (2016). Pilot evaluation of a web-based intervention targeting sexual health service access. Health Education Research, 31(2):273-82, doi: 10.1093/her/cyw003.

Related projects

See project: 'Respect Yourself intervention development' for details on the intervention and its development.