Development of a digital intervention to increase condom use amongst those selftesting for chlamydia

卫生部已将降低性传播感染(STI)比率作为优先事项。这在年轻人中尤其如此，因为与其他年龄段相比，这个年龄段受影响的人数更多。性传播感染可能会给个人带来严重的健康后果，国民健康保险制度的治疗费用很高。对于性行为活跃的人来说，避免性传播感染的最好方法是使用避孕套，但年轻人报告说使用不一致。为了降低一种特别普遍的性传播感染--衣原体感染的发病率，15-24岁的年轻人能够从一些临床和社区服务中获得免费检测。作为这一倡议的一部分，这一群体的自我测试可以通过一些互联网提供商在线获得。在输入一些基本的个人信息后，这项服务的用户会在邮寄中收到一个没有标记的小盒子，里面装着一个检测试剂盒。在采集尿液(男性和女性)或阴道拭子(仅限女性)样本并将其放入盒子中退回后，结果为阴性的用户将在2-5天内收到一条有关此问题的短信或电子邮件。那些结果呈阳性的人会收到一封电子邮件或短信，要求他们联系当地的衣原体筛查协调员，后者与他们讨论结果并安排治疗。每年平均有13万名年轻人通过这一途径接受检测。这些接受测试的人未来感染性传播疾病的风险很高，包括其他服务机构发现很难参与的群体，如年轻男性和贫困背景的人。这些网站通常很少或根本没有为用户提供关于保护自己免受未来性传播感染的建议。此外，来自一家互联网测试提供商(freetest.me)的信息表明，大约40%的测试人员以前使用过这项服务。这表明，测试的经历本身并不会导致行为的改变。这项研究将开发一种数字干预措施，在互联网测试网站的用户中增加避孕套的使用，以防止未来的性传播感染。它将在发送样品和接收检测结果之间向用户展示。这被认为是一个潜在的重要的“可教的时刻”，因为用户能够接受关于改变他们性行为的信息。它将是简短的，并高度量身定做的个人用户。在干预开始时，用户将被要求从一系列选项中指出他们不使用避孕套的主要原因是什么。然后，他们将收到一些相关的干预“大块”。例如，如果他们报告说购买避孕套令人尴尬，他们可能会与一个计划联系起来，该计划在收到短信请求时就会邮寄避孕套包装。我们将发展对年轻人的干预。在几个阶段中，我们将确定目标群体使用避孕套的主要障碍，并制定内容来解决每个障碍。在最终确定之前，我们将在年轻人中测试我们的干预措施，以确保它简单、易于使用和吸引人。如有需要，我们会作出相应的更改。在这项研究结束时，我们将申请进一步的资金，以测试干预是否有效。

The Department of Health has made reducing the rates of Sexually Transmitted Infections (STIs) a priority. This is particularly so amongst young people, as larger numbers are affected in this age group compared to others. STIs can lead to serious health consequences for individuals, and the cost to the NHS of treatment is high. The best way for sexually active people to avoid STIs is to use a condom but young people report inconsistent use. In an effort to reduce the rate of one particularly widespread STI called chlamydia, young people aged 15-24 years old are able to access free testing from a number of clinical and community services. As part of this initiative, self-testing for this group is available online via a number of internet providers. After inputting some basic personal information, users of this service receive a small unmarked box in the post containing a testing kit. After taking a sample - urine (males and females) or vaginal swab (females only) - and returning this in the box, users with a negative result receive a text or email message to this effect within 2-5 days. Those with a positive result receive an email or text asking them to contact their local chlamydia screening coordinator who discusses the result with them and arranges treatment. On average 130,000 young people are tested via this route every year. Those tested are at high risk of future STIs and include groups which other services have found difficult to engage, such as young men and those from deprived backgrounds. These websites typically provide little or no advice to users about protecting themselves against future STIs. Furthermore, information from one of the internet testing providers (freetest.me) indicates that approximately 40% of those testing have used the service before. This suggests that the experience of testing in itself does not lead to a change in behaviour. This study will develop a digital intervention to increase condom use amongst users of internet testing websites in order to prevent future STIs. It will be shown to users in between sending off their sample and receiving their test results. This has been identified as a potentially important 'teachable moment' when users are receptive to information about changing their sexual behaviour. It will be brief and highly tailored to the individual user. At the start of the intervention users will be asked to indicate from a list of options, what their main reasons for not using condoms are. They will then receive a number of relevant 'chunks' of the intervention. If for example they report that purchasing condoms is embarrassing, they could be linked up to a scheme which posts out packs of condoms upon receipt of a text request. We will be developing the intervention with young people. Over a number of stages, we will identify the main barriers to condom use for our target group and develop content to address each of these. We will test our intervention with young people before we finalise it to make sure that it is simple, easy to use and engaging. Changes will be made accordingly if necessary. At the end of this study we will apply for further funding to test whether the intervention works.